PSORIATRIC ARTHRITIS (TB)

Question 1

What type of disease is psoriatic arthritis (PsA)?

Answer 1

Inflammatory musculoskeletal disease

Question 2

What are the key immune features of PsA?

Answer 2

Autoimmune and autoinflammatory features

Question 3

Is arthritis with psoriasis typically seropositive or seronegative?

Answer 3

Seronegative

Question 4

Which joints are primarily affected in PsA?

Answer 4

Distal interphalangeal (DIP) joints

Question 5

How does joint involvement in PsA differ from rheumatoid arthritis (RA)?

Answer 5

PsA affects distal joints , RA affects proximal joints

Question 6

What genetic factor is associated with PsA?

Answer 6

HLA-Cw*0602 gene

Question 7

How does synovial inflammation in PsA compare to RA?

Answer 7

Less hyperplasia and cellularity in PsA; more cells in RA

Question 8

What percentage of patients with psoriasis develop PsA?

Answer 8

30%

Question 9

Does psoriasis usually precede or follow joint disease in PsA?

Answer 9

Psoriasis precedes joint disease in 60–70% of cases

Question 10

What percentage of PsA cases present with arthritis before psoriasis?

Answer 10

15–20%

Question 11

At what age does PsA typically begin?

Answer 11

Fourth or fifth decade

Question 12

What is the gender distribution of PsA?

Answer 12

Equal in men and women

Question 13

What are the five patterns of PsA?

Answer 13

DIP arthritis , asymmetric oligoarthritis, symmetric polyarthritis, axial involvement, arthritis mutilans

Question 14

What additional sixth pattern is sometimes described in PsA?

Answer 14

Oligoarthritis , polyarthritis, and axial arthritis

Question 15

What nail changes are associated with PsA?

Answer 15

Pitting , horizontal ridging, onycholysis, yellowish discoloration, dystrophic hyperkeratosis

Question 16

What severe form of psoriasis is associated with severe arthritis?

Answer 16

Pustular psoriasis

Question 17

What are the hallmark features of PsA?

Answer 17

Dactylitis (sausage-like digits) and enthesitis

Question 18

What is dactylitis?

Answer 18

Inflammation of an entire digit; seen in >30% of PsA cases

Question 19

What is the Koebner phenomenon in psoriasis?

Answer 19

Psoriatic lesions arise at sites of skin trauma

Question 20

What is the frequency of DIP joint arthropathy in PsA?

Answer 20

5%

Question 21

Which form of PsA affects 30% of patients?

Answer 21

Asymmetric oligoarthritis

Question 22

What percentage of PsA cases involve symmetric polyarthritis?

Answer 22

40%

Question 23

What percentage of PsA cases have axial arthropathy only?

Answer 23

5%

Question 24

What is “telescoping” in PsA?

Answer 24

Shortening of digits coexisting with ankylosis

Question 25

What percentage of PsA patients have eye involvement?

Answer 25

7–33%

Question 26

How does uveitis in PsA compare to ankylosing spondylitis?

Answer 26

More likely to be bilateral , chronic, and/or posterior

Question 27

What heart valve is affected in PsA?

Answer 27

Aortic valve (aortic insufficiency)

Question 28

Why does PsA cause aortic insufficiency?

Answer 28

Thoracic aorta involvement leads to dilation and outward movement of the valve

Question 29

How does PsA-related valve disease differ from RA?

Answer 29

PsA affects the aortic valve , RA affects the mitral valve

Question 30

How does PsA present in HIV-positive patients?

Answer 30

Severe arthropathy with rare axial involvement

Question 31

What is the CASPAR criteria for PsA classification?

Answer 31

Current psoriasis (2 points) , other features (1 point each), total ≥3 points

Question 32

Which test is most commonly elevated in PsA?

Answer 32

ESR and CRP due to inflammation

Question 33

Are RF and ANA positive in PsA?

Answer 33

Low titers in some cases; 10% have anti-CCP antibodies

Question 34

What metabolic abnormality can be seen in severe psoriasis?

Answer 34

Increased uric acid levels

Question 35

Which HLA marker is associated with PsA?

Answer 35

HLA-B27

Question 36

What is the prevalence of HLA-B27 in PsA?

Answer 36

50-70% in axial disease; ≤20% in peripheral joint involvement

Question 37

What is the classic radiologic finding in PsA?

Answer 37

“Pencil-in-cup” deformity in DIP joints

Question 38

What is “whiskering” on radiographs of PsA?

Answer 38

Marginal erosions with adjacent bony proliferation

Question 39

What other radiologic findings are seen in PsA?

Answer 39

Small-joint ankylosis , osteolysis, telescoping of digits

Question 40

What is a common finding at enthesitis sites in PsA?

Answer 40

Periostitis and proliferative new bone formation

Question 41

What type of sacroiliitis is seen in PsA?

Answer 41

Asymmetric sacroiliitis

Question 42

What are "comma-shaped" syndesmophytes?

Answer 42

Nonmarginal l, bulky syndesmophytes seen in PsA

Question 43

What is the first-line treatment for PsA?

Answer 43

Anti-TNF-α agents

Question 44

Which immunosuppressants are used for PsA?

Answer 44

Methotrexate and sulfasalazine

Question 45

Why are methotrexate and sulfasalazine used in PsA?

Answer 45

Help with psoriasis but do not stop joint damage progression

Question 46

What are alternative biologic treatments for PsA?

Answer 46

Anti-IL-17A monoclonal antibodies

Question 47

What oral medication is used for PsA treatment?

Answer 47

Phosphodiesterase-4 inhibitor , JAK inhibitor

Question 48

What treatments are used for severe psoriasis with PsA?

Answer 48

Cyclosporine , retinoic acid derivatives, PUVA therapy

Question 49

What medication is used for both psoriasis and PsA?

Answer 49

Pyrimidine synthetase inhibitor (leflunomide)

Question 50

What is the treatment for PsA in HIV-positive patients?

Answer 50

Immunosuppressive therapy