Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DEN303 - IHD > Rheumatological disorders > Flashcards

Rheumatological disorders Flashcards

1
Q

Types of rheumatic disease

A

Non-inflammatory

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of rheumatic disease
Non-inflammatory

Inflammatory

A

Osteoarthritis

Rheumatoid arthritis
Systemic Lupus
Vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rheumatoid arthritis

What is it - what kind of disease

Who does it affect?

What does it involve

A

Disease of synovial joints
Affects 1%
Autoimmune, systemic inflammatory illness
Symmetrical joint inflammation and deformity - sub luxation of the bone
Extra-Articular features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rheumatoid arthritis symptoms

Inflammatory

Relieving factors

A 
Pain
Early morning stiffness 
Stiffness after rest 
Ease with use/exercise 
Swelling Flu like symptoms 
Anti-inflammatory drugs e.g NSAIDs may be helpful, heat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inflammation signs

Can lead to

A

Calor, Rubor, Tumor, Dolor

Progressive joint deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side effects of rheumatology drugs

Infection

Bone Marrow toxicity =

Hepatotoxic = signs

Gastric upset signs =

Skin rashes

A

All increase risk
Reactivation of TB

Low WBC, low platelets, pancytopenia

Abnormal liver tests

Nausea, diarrhoea, flatulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Methotrexate

Don’t co prescribe with…

Lung issues

Contraindicated in

A

DMARD
1x weekly dose 15-25mg

Never co prescribe with trimethoprim –> severe bone marrow suppress =om

Lung complications
Pneumonia and fibrosis

Renal excretion

Nausea and mouth ulcers

Pre-conception period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Biological drugs

A 
Stop 2 weeks pro
Greater infection risk 
Reactivation of TB/Hep B and C 
Contraindicated if patient develops cancers
May exacerbate MS if TNF given
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rheumatoid neck

A

Erosive change at C1 C2 and lower levels
Subluxation at the atlanto-axial level

Erosion causes changes at pannus articulating point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Steps for rheumatoid neck

A

Ask about pain
When positioning check no new pain arises
Pre- inctubation - flexion and extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Caries/gingivitis in RA

A

Poor hand/neck/shoulder fx can impair dental hygiene
Immunsuppresive may compound this
Many have osteoporosis

Gingivitis MAY be a trigger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Juvenile idiopathic arthritis

A 
Occurring before age of 16 
Many different patterns 
Jaw underdevelopment
- micrognathia, malocclusion 
- pain

TMJ inflammation which as leads to altered mandiublar growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spondyloarthropathy

A

Ankylosing spondylitis

Psoriatic arthritis
Enteropathic arthritis

Reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ankylosing spondylitis

A

Inflammatory spinal pain
Gradual calcification of vertebrae –> limited movement
Rigid fused neck or atlanto-axial subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Common feature of spondyloarthropathy

A

Enthesistis - inflammation of junction between tendon and ligament e.g swelling around achilles

Dactylitis - SAUSAGE finger/toe

Skin psoriasis

Inflammatory eye disease - red painful photophobic eye –> IRITIS/uveitis

Inflammatory bowel disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Large joint oligoarthritis

A

Swelling of knee

17
Q

Psoriasatic arthritis

A 
Psoriasis of nail bed 
Inflammation of fingers 
Distal arthritis 
Nail pitting
Dactylitis
18
Q

Osteoarthritis

x ray findings

A

Degenerative process, exaggerated repair response
Pain, stiffness, deformity, reduced joint movement and instability
Increases with age
Occupation/hobbies increase risk
Footballers, hands and wrists

Loss of joint space
Osteophytes
Sub-chondral sclerosis

19
Q

Commonest indication for joint replacement surgery

A

Banding of legs

20
Q

Gout

What is it

Why

Treatment

A

Sudden, painful, red, swollen

Urate crystals which precipitate out into the joints from bloodstream
Intense neutrophil led inflammatory response

High serum rate

  • genetics
  • renal impairment
  • diuretics
  • dehydration
  • intercurrent illness
  • high alcohol, fructose, red meat, shellfish
  • part of a metabolic syndrome

NSAIDS
COLCHICINE
STEROIDS

Rate lowering drugs e.g allopurinol and febuxostat

21
Q

Severe chronic gout

A

Chronic polyarticular tophaceous gout

22
Q

Connective tissue disease

A

Rare auto immune systemic diseases
Certain common features

Life threatening due to organ involvement

Auto-antibodies

23
Q

Examples of connective tissue disease

A

Systemic lupus erythematosus
Scleroderma
Primary Sjogrens
Polymyositis/dermatomyositis

24
Q

Common features of connective tissue disease

A

Raynaud’s syndrome –> vasoconstriction of fingers and toes in response to cold (white for constriction, blue for cyanosis then red for hyperaemia)
Mouth ulcers
Cardiorespiratory disease

25
Q

SLE

A

Lupus

Malar rash
Photosensitivity
Non-erosive arthritis

26
Q

Scleroderma / systemic sclerosis

A

Skin thickening and tightening
Severe Raynauds –> digital ulcers, frank tissue necrosis, digital gangrene
Can be limited to hands, feet and face –> LIMITED SYSTEMIC SCLEROSIS
Widespread - DIFFUSE systemic sclerosis
Oral tethering and telangiectasia
Tethered digital skin

27
Q

Sjogren’s syndrome

What is it

Which glands does it affect and names of conditions

Mechanism

Signs of affected glands

A

Auto-immune inflammatory disorder

Lacrimal, salivary, nasal, laryngeal, tracheal and vaginal
Xerostomia and keratoconjunctivitis sicca

Marked lymphocytic infiltration destroying gland architecture and fx

Swollen, inflamed, tender and later atrophic
Glossitis

28
Q

Polymyositis and dermatomyositis

A

Associated with muscle inflammation
Weakness of arms and thighs
painless wasting
Both associated with lung fibrosis

  1. muscle involvement ONLY
  2. inflammation of muscles AND skin - photosensitivity - strong association with internal malignancy
29
Q

Treatment for connective tissue diseases

A

NSAIDs steroids

DMARDS

Cytotoxic drugs

Biological drugs

30
Q

Sjogrens’ phases

Associated with

A

Primary - if occurs on its own

  • dry eyes and mouth
  • high immunoglobulins
  • fatigue and joint pain
  • rare but serious complications - vasculitis, renal involvement, neurological involvement, lymphoma

Secondary - if occurs in association with other rheumatoid diseases

Histology - intense lymphocytic infiltration –> disruption of normal gland

Atrophy of tongue and parotid gland, bilateral parotid enlargement

Lymphoma and rheumatoid arthritis

Bilateral parotid enlargement, inflammatory arthritis, neuropathy, neuralgia

31
Q

Xerostomia

Occurs due to..

Causes

Signs and symptoms

A

Marked reduction in saliva production

Difficulty chewing or swallowing, articulation, increased caries risk

Sore tongue, oral mucosa

32
Q

Keratoconjunctivitis sicca

A 
Common symptom complex
Dry red itchy sore photophobic eyes
Decreased tear secretion --> conjunctival ulcers 
Painful to blink 
Eyes feel gritty
33
Q

Further investigations of Sjogren’s

A

Sialometry - rate of saliva production
Sialography - anatomy of gland
Scintigraphy
Labial gland biopsy

34
Q

Treatment of Sjogren’s

A 
Control disease
Symptomatic control 
Stimulation of residual salivary gland 
Attention to dental hygiene 
Avoid smoking and drugs e.g antidepressants
35
Q

Behcet’s disease

Symptoms

Treatment

When else can ulcers be found

A

Oral and genital apthous ulcers

Skin lesions
Thrombophlebitis

Good OH 
Review physical trauma 
Topical barriers
Topical steroids 
Oral colchicine
Oral steroids 
Disease modifying drugs

Inflammation of mucous membranes as part of systemic illness

36
Q

Mouth ulcer tx

A

Topical steroids

Mouthwashes

37
Q

Reiter’s syndrome

Due to

A

Associated with reactive arthritis post GUI or GI infection
Rash of hands and feet
Ulceration of the tongue and palate

Infection (gut or STI)

38
Q

Candidiasis

Tx

A 
Common in rheumatology patients 
Immunosuppressed
Sore red mouth 
Reduce steroids 
Nystatin 
Flucanazole 
Mouthwashes

DEN303 - IHD (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions