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CD 3305 > Rheum #3 > Flashcards

Rheum #3 Flashcards

1
Q

What are the 4 seronegative arthropathies

A

AS
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis

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2
Q

4 commonalities in seronegative rheumatic diseasd

A

1) negative RF test and ANA
2) predilection for spin
3) SI joint involvement
4) Association with HLA-B27

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3
Q

common S&S for ankylosing spondylitis

A

chronic inflammation, often associated with enthesitis

often young males (3:1 ratio for men under 40)

and 90-90% have HLA-B27

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4
Q

Rule of 2s for Ankylosing Spondylitis

A

0.2% of gen pop
2% of HLA-B27 positive individuals
20% of HLA-B27 positive indiivduals with affected family member

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5
Q

Ankylosing Spondylitis clinical presentation

A

mid and lower back stiffness, with morning stiffness lasting longer than 1 hour

night pain that is worse in the second half of the night.

Increasesd occiput to walld istance (because increased thoracic kyphosis and increased cervical flexion?)`

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6
Q

What ortho test for …AS?

A

FABER test for SI joint pain (commonly seen in AS patients I suppose?)

Modified Schober test (less than 5cm increase can be indicative of AS)

increased occiput to wall distance (>5cm)

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7
Q

Peripheral S&S for AS

A

asymmetrical large joint arthritis, and enthesitis.

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8
Q

extra-articular manigestations for AS

A

Opthalmic : acute anterior uveitis

Gastro: IBD (Ulcerative colitis)

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9
Q

Investigations for AS (special tests)

A

x-ray for SI (bony fusion(late) and symmetric sacroilitis)
x-ray for Bamboo spine
MRI (gold standard)
HLA-B27

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10
Q

big general 5 of psoriatic arthritis ***

A

asymmetric Olgioarthritis (<5 small and/or large joints)

  • arhtritis of DIp w/ nail changes
  • symmetric polyarthritis (like RA)
  • Sarcoilitis
  • Arthritis Mutilans (destructive and deforming small joint polyarthritis)
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11
Q

msk signs and symptoms of psoriatic arthritis (3)

A

morning stiffness >30 min
dactylitis (painful digits)
enthesopathy

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12
Q

Psoriatic Arthritis dermatology

A
  • well-demarcated ertyhematous plaques with silvery scale
  • nail involvement: pitting, transverse or longitudinal ridging, discoloration, subungual hyperketarosis, onycholysis, oil drops
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13
Q

Opthalmic cue in psoriatic arthritis

A

conjunctivity and iritis (anterior uveitis)

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14
Q

Classic imaging sign on psoriatic arthritis

A

pencil in a cup deformity of fingers

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15
Q

CASPAR classification of psoriatic arthritis (5, how many do u need to be pos)

A

evidence of psoriasis (current, past, family)

  • psoriatic nail dystrophy
  • negative Rheum Factor
  • Dactylitis
  • Radiological Evidence

patient must have at least 3

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16
Q

Psoriatic arthritis treatmetns (4)

A

treat skin lesions
NSAIDS initially
DMARDS
Anti TNF

16
Q

Psoriatic arthritis treatmetns

A

treat skin lesions
NSAIDS initially
DMARDS
Anti TNF

17
Q

Reactive arthritis/reiter’s syndrome def

A

seronegative, peripheral arthritis >1 month duration, after certain GI or GU tract infection

18
Q

epidemiology of reactive arhtirits (what is it associated w + gender)

A

hla-b27 patients, more men than women

19
Q

Etiology of Reactive Arthritis

A

GI: shigella, salmonella, campylobacter, yersinia, C. Diff

GU: Chlamydia! (16-44% of cases)

20
Q

MSK S&S of reactive arthritis

A

ØAsymmetric peripheral arthritis
ØSpondylitis/sacroiliitis
ØEnthesitis (Achilles tendinitis, plantar fasciitis)
ØDactylitis

21
Q

Opthalmic S&S of reactive arthritis

A

iritis (anterior uveitis) and conjunctivitis

22
Q

Derm signs and symptoms of reactive arthritis (2)

A

Keratoderma blennorrhagicum (hyperkeratotic skin lesions on palms and soles)

Balanitis Circinata (small, shallow, painless ulcers of glans penis)

23
Q

classic triad of reactive arthritis

A

arthritis
conunctivitis/uveitis
urethritis/cervicitis

24
Q

Treatment for Reactive Arthritis (3)

A

NSAIDs + treat underyling cause
Sulfasalazine
Steroid Injections

25
Q

Enteropathic Arthritis Definition

A

MSK manifestations in the setting of either ulcerative colitis or Crohn’s disease (with flares of inflammatory bowel disease) include peripheral arthritis (large joint, asymmetrical), spondylitis, and hypertrophic osteoarthropathy

CD 3305 (15 decks)

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