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PY365 Autoimmune Cluster > Rheumatic disease 2 > Flashcards

Rheumatic disease 2 Flashcards

1
Q

what does SpA stand for

A

spondyloarthropathies

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2
Q

what does SpA consist of

A

consists of a group of related disorders
- example of articular inflammatory disease

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3
Q

when does SpA occur and describe its prevalence

A

occurs more age at diagnosis in 3rd decade and peak commonly among young men
- mean incidence between 25-34 years
- prevalence is about 1%
- 4:1 male to female ratio

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4
Q

what are the causes of SpA

A
  1. cause is unclear but there is strong evidence that the initial event involved interaction between genetic and environmental factors, particularly bacterial infections
  2. Reiters syndrome may follow a wide range of GI infections
    - bowel inflammation has been implicated in pathogenesis of endemic Reiters syndrome, psoriatic arthritis and ankylosing spondylitis
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5
Q

give examples of the groups of disorders within SpA

A
  1. Reiters syndrome
  2. ankylosing spondylitis
  3. crohns disease
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6
Q

what are the characteristics of SpA

A
  1. the SpA share certain common features, including:
    -the absence of serum rheumatoid factor
    - an oligoarthritis commonly involving large joints in the lower extremities
    - frequent involvement of the axial skeleton
    - familial clustering
    - linkage to HLA-B27
  2. These disorders are characterised by inflammation at sites of attachment of ligament, tendon, fascia, or joint capsule to bone
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7
Q

what is sacroilitis

A
  • type of SpA
  • inflammation of the sacroiliac joint
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8
Q

what might an x ray show for sacroilitis

A

x ray may show inflamed and narrowed SI joint that are white due to bony sclerosis around joints

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9
Q

what is ankylosing spondylitis

A
  1. chronic SpA disease that primarily affects the spine and may lead to stiffness of the back
  2. the joints and ligaments that normally permit the back to move become inflamed
    - the joints and bones may grow and fuse together
  3. inflammation and stiffness usually starts where the lower spine is joined to the pelvis or hip
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10
Q

how is ankylosing spondylitis diagnosed

A
  1. medical history including symptoms
  2. x rays
  3. blood tests for HLA-B27 gene
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11
Q

outline the treatment of ankylosing spondylitis

A
  1. with early diagnosis and treatment, pain and stiffness can be controlled and may reduce fusing
    - in women, AS is usually mild and hard to diagnose
  2. exercise
  3. medications: NSAIDS, sulfasalazine
  4. posture management
  5. self help aids
  6. surgery
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12
Q

what is Reiters syndrome

A
  • arthritis that produces pain, swelling, redness and heat in the joints
  • can affect the spine and commonly involves the joints of the spine and sacroiliac joints
  • can also affect arms and legs
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13
Q

what are the main characteristic features of Reiters syndrome

A
  • inflammation of the joints
  • urinary tract
  • eyes
  • ulceration of skin and mouth
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14
Q

what are the symptoms of Reiters syndrome

A
  • fever
  • weight loss
  • skin rash
  • inflammation
  • sores and pain
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15
Q

describe the onset of Reiters syndrome

A
  1. often begins following inflammation of the intestine or urinary tract
  2. many patients have periodic attacks which last from 3-6 months
  3. some have repeated attacks, which are usually followed by symptom free periods
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16
Q

how is Reiters syndrome diagnosed

A
  1. physical exam
  2. skin lesions
  3. test for HLA-B27 gene
17
Q

outline the treatment of Reiters syndrome

A

for different parts of the body, different treatments are used
1. medications- NSAIDS, antibiotics, topical skin medications
2. eye drops
3. joint protection

18
Q

what does psoriatic arthritis cause

A

causes pain and swelling in some joints and scaly skin patches on some areas of the body

19
Q

what are the symptoms of psoriatic arthritis

A
  • swelling in joints outside of spine and nail lesions
  • silver or grey scaly spots on the scalp, elbows, knees or lower end of spine
  • pitting of fingernails/toenails
  • pain and swelling in 1 or more joints
  • swelling of fingers/toes that gives them a ‘sausage’ appearance
20
Q

how is psoriatic arthritis diagnosed

A
  1. x rays
  2. blood tests
  3. joint fluid tests
21
Q

outline the treatment of psoriatic arthritis

A
  1. skin care
  2. light treatment- UVB or PUVA
  3. corrective cosmetics
  4. medications- glucocorticoids, NSAIDS, DMARDS
  5. exercise
  6. rest
  7. heat and cold
  8. splints
  9. surgery
22
Q

what is inflammatory bowel disease

A
  1. consists of 2 diseases that cause inflammation of the bowel and can cause arthritis or inflammation in joints
    - crohns disease involves inflammation of the colon or small intestine
    - ulcerative colitis is characterised by ulcers and inflammation of the lining of the colon
23
Q

what does the amount of bowel disease usually influence

A

influences the severity of arthritis symptoms

24
Q

what other areas of the body affected by inflammatory bowel disease are affected

A

ankles, knees, bowel, liver, digestive tract, skin, eyes, spine and hips

25
Q

outline the treatment of IBD

A
  1. diet
  2. exercise
  3. medication- corticosteroids, immunosuppressants, NSAIDs, sulfasalazine
  4. surgery
26
Q

describe the functional presentation and disability of the SpAs

A
  1. when the axial skeleton is involved, the initial symptom is morning stiffness and lower back pain
  2. as the disease worsens, there is progressive diminution of motion of the spine
  3. eventually, the sacroiliac joints, lumbar, thoracic and cervical spine become fused
  4. at this stage, the spine is no longer painful but the patient has lost all ability to flex or rotate the spine and generally develops a hunched over posture with fused flexion of the cervical spine and flexion contracture of the hips to compensate for the loss of the lordosis curvature in the lumbar spine
27
Q

which body structure is predominantly affected by ankylosing spondylitis? what symptoms are most common and what causes these problems

A
  1. axial spine and connective tissue surrounding it
  2. pain and stiffness in lower back and spine caused by inflammation of the connective tissue

PY365 Autoimmune Cluster (19 decks)

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