R/O - Arthropathies and septic arthritis Flashcards
what is the triad for gonococcal arthritis?
- tenosynovitis
- vesiculopustular skin lesions
- polyarthralgia
is gonococcal monoarthritis purulent or non-purulent?
purulent
what is the treatment for gram positive cocci septic arthritis?
vancomycin
what is the treatment for gram negative bacilli septic arthritis?
3rd gen ceph
what medications can induce gouty monoarthritis?
- ASA (low dose)
- hydrochlorothiazide
what is the diagnosis for gout?
- synovial fluid analysis
- intracellular monosodium urate
- crystals are NEGATIVELY birifringent
- WBC 10k - 100k
parallel and yellow - gout (negative)
what does plain radiography show in gout?
- subcortical bone cysts
- bone erosions with overhanging edges
what is the primary pathophysiology mechanism of gout?
impaired excretion
what is the goal uric acid level for prevention of recurrent gout?
6 mg / dL (solubility level)
where is febuxostat cleared?
liver
what drugs are used for prophylaxis during initiation of antihyperuricemic therapy?
- colchicine
- NSAIDs
acute attacks of calcium pyrophosphate crystal deposition disease (CPPD) occur in _____ (men / women), and osteoarthritis with chondrocalcinosis occurs in _________ (men / women)
- men
- women
what are the clinical manifestations of CPPD?
- spine involvement
- crowded dens syndrome: recurrent fever, elevated CRP and ESR, neck and shoulder girdle pain and stiffness
how is CPPD diagnosed?
- synovial fluid
- positively birifringent CPP crystals
- WBC 15k - 30k
- rhomboid crystals
- pale blue when aligned with axis of compensator
CPPD
what is the treatment of acute pseudogout?
- oligoarticular: steroids
- polyarticular: NSAIDs, colchicine, oral steroids, ACTH
definition: spondyloarthropathies
inflammation of axial joints, asymmetrical oligoarthritis, dactylitis, and enthesitis
spondyloarthropathies are often associated with manifestations in what other parts of the body?
- eye and bowel inflammation
- preceding infection
- positive familiy history
- HLA B27
dactylitis - sausage finger is seen in what condition?
spondyloarthropathies
what are the clinical manifestations of spondyloarthropathies?
- skeletal: low back pain (inflammatory), peripheral arthritis, enthesopathy, dactylitis
- non-skeletal: conjunctivitis, anterior uveitis, inflammatory bowel disease, psoriasis
what is the lab eval for spondyloarthropathies?
- HLA B27
- ESR
- CRP
what do radiographs show for spondyloarthropathies?
- SI joints
- hands
- feet
what are the pharm treatments for spondyloarthropathies?
- NSAIDs
- analgesics
- DMARDs
- biologics
