Rheumatic disease 3 Flashcards

1
Q

What is the most common rheumatic disease

A

degenerative articular Rheumatic disease
(osteoarthritis)

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2
Q

what is osteoarthritis characterised by

A

by progressive loss of cartilage and reactive changes at the margins of the joint and in the subchondral bone

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3
Q

describe the prevalence of osteoarthritis

A
  • disease usually begins in >40s
  • prevalence increases with age and disease becomes almost universal in patients aged >65
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4
Q

what does osteoarthritis primarily affect

A

primarily affects weight bearing joints such as knees, hips and lumbrosacral spine

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5
Q

what is the cause of degenerative joint disease

A

cause is unclear
- considered to be a wear and tear arthritis
- frequently associated with obesity
- genetic factors also play role in development (dominant in females)

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6
Q

what is the final outcome of degenerative joint disease

A

full thickness loss of cartilage down to bone
- complete destruction of the joint and surgical intervention is required

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7
Q

describe the effects of degenerative joint disease in early stages

A

in early disease, pain only occurs after joint use and is relieved by rest

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8
Q

describe the effects of degenerative joint disease in later stages

A

as disease progresses, pain occurs with minimal motion or even at rest
- nocturnal pain is commonly associated with severe disease

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9
Q

what are the functional limitations of degenerative joint disease

A
  1. limited use of the involved joint
  2. walking and transfer activities may be impaired
  3. generally, ADLs will not be significantly impaired
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10
Q

outline the treatment and prognosis of DJD

A
  1. medication
  2. early PT/exercises
  3. heat/cold therapy
  4. joint protection
  5. surgery
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11
Q

give an example of a generalised non articular disorder

A

fibromyalgia syndrome

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12
Q

what is fibromyalgia syndrome

A

a chronic musculoskeletal syndrome characterised by diffuse pain in the absence of synovitis or myositis (muscle inflammation)

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13
Q

describe the prevalence of FMS

A
  • 10-12% of general population
  • strong female preponderance
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14
Q

what is the working model of FMS

A
  1. a disorder of pain processing
  2. CNS desensitisation
  3. makes usually non painful stimuli feel painful
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15
Q

what is the presentation of FMS

A
  1. normal physical examination
  2. no significant abnormalities on joint examination
  3. characteristic finding is tenderness upon palpation of discrete anatomical locations (tender points)
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16
Q

what are the associated complaints of FMS

A
  1. diffuse aching/stiffness which is worse in morning
  2. fatigue/exhaustion/sleep disturbance
  3. sensation of swelling of hands and feet
  4. paresthesias
  5. tension headaches/migraines
  6. symptoms of IBS
  7. anxiety/depression
  8. weight gain
17
Q

give examples of local non articular disease

A

typical example is IDDM, but Hashimoto thyroiditis is also good example

18
Q

what is Hashimoto’s thyroiditis characterised by

A

characterised by destruction of thyroid cells by various cell and antibody mediated processes
- presence of typically anti-TPO (anti thyroid peroxidase) and anti-Tg (anti thyroglobulin) antibodies
- but 15% of patients with Hashimoto’s thyroiditis may be antibody negative

19
Q

outline the treatment of hashimotos thyroiditis

A
  1. just like any other hypothyroid state
  2. treatment choice is thyroid hormone replacement
  3. drug of choice is individually tailored and titrated levothyroxine sodium administered orally, usually for life