Quiz 3- Reactive arthritis:

Question 1

Key Points:
•Arises following a what?
•Highly associated with?
•It is considered a?
•75% of patients are \_\_?\_\_ positive.
•Arthropathy generally continues despite clearance of?
•Usually self-limiting within ? months.

Answer 1

• Arises following an infection elsewhere in the body (not in the joints).
• Highly associated with GU and GI infections.
• It is considered a spondyloarthritis.
• 75% of patients are HLA-B27 positive.
• Arthropathy generally continues despite clearance of the infection with antimicrobials.
• Usually self-limiting within 6 months.

Question 2

Epidemiology/Etiology:
•Arthritis that develops soon after a?
•Infections usually stem from the?

Answer 2

• Arthritis that develops soon after an infection elsewhere in the body
• Infections usually stem from the GU tract or the GI tract.

Question 3

Clinical Features:
•Acute asymmetric
•Common joints affected:
•Generally preceded by ??? infection by 1-6 weeks
•Urethritis from ??? may be asymptomatic.
•Significant swelling usually in the ??? extremities;
•Extraarticular involvement:

Answer 3

• Acute asymmetric oligoarthritis lasting 1-4 weeks
• Common joints affected: knee, ankle, heel
• Generally preceded by a GI or GU infection by 1-6 weeks
• Urethritis from Chlamydia may be asymptomatic.
• Significant swelling usually in the lower extremities;
• Extraarticular involvement: Conjunctivitis, pelvic pain, urethritis, oral ulcers, fever, malaise, headache.

Question 4

RA Diagnostic Criteria:

Answer 4

• There is no established diagnostic criteria for reactive arthritis
• Diagnosis is based on history and physical exam

Question 5

RA Lab Testing: 6

Answer 5

• Stool culture or urine/genital swab
• Test for concomitant infections
• ESR/CRP
• HLA-B27
• Joint Aspiration
• Elevated leukocyte

Question 6

Conventional Medications: 2

•Acute reactive arthritis

Answer 6

• NSAIDs – usually for 2 weeks in duration; pain treatment ONLY
• Glucocorticoids – oral or injected for severe inflammation

Question 7

Conventional Medications: 3

•Chronic reactive arthritis

Answer 7

• Sulfasalazine – 500mg qd; can increase weekly – most effective
  
  • Methotrexate – for those who do not respond to SSZ
  • TNF inhibitor

Question 8

RA Nutritional Supplementation: 6

Answer 8

• Selenium
• Zinc
• Proteolytic/pancreatic enzymes
• Glucosamine sulfate
• Curcumin
• Vitamin D:

Question 9

RA Botanical Medicine: 4

Answer 9

• Uncaria tomentosa – Cat’s claw
• Harpagophytum procumbens – devil’s claw
• Boswellia serrata
• Topical capsicum

Question 10

Dysbiosis: 5

Answer 10

All patients with a spondyloarthropathy should be assessed for dysbiosis
Reactive arthritis has also been linked to IBD and GI inflammation.

• Berberine:
• Oregano Oil:
• Probiotics:
• L-Glutamine:
• DGL: