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MSK > rheumatology > Flashcards

rheumatology Flashcards

1
Q

what is characteristic of many rheumatological conditions

A

auto antibody production

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2
Q

what does a seropositive condition mean

A

auto antibodies in the serum

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3
Q

what is ann auto antibody

A

it is produced by the immune system and acts against one or more of the individuals proteins

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4
Q

anti CCP associated iwth

A

rheumatoid arthritis

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5
Q

ANA non specific associated with

A

SLE, Sjogrens syndrome, systemic sclerosis, MCTD, antoimmune liver disease

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6
Q

dsDNA antibody associated iwth

A

SLE

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7
Q

anti Sm associated with

A

SLE

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8
Q

Anti-Ro associated iwth

A

SLE, Sjogrens syndrome

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9
Q

Anti-La

A

sjogrens syndrome

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10
Q

anti - centromere antobody

A

systemic sclerosis (limited)

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11
Q

anti-scl-70 antibody

A

systemic sclerosis (diffuse)

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12
Q

ti -RNP antibody

A

SLE, MCTD

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13
Q

ANTI-jO-1 ANTIBODY

A

myositis

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14
Q

anti cardiolipin antibody and lupus anticoagulant

A

anti phospholipid syndrome

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15
Q

ANCA

A

small vessel vasculitis

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16
Q

what is the most common form of arthritis

A

osteoarthrtitis

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17
Q

what is osteoarthtrtits

A

progressive degenerative condition affecting joints due to gradual thinning of cartilage, loss of joint space and formation of bony spurs

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18
Q

what are bony spurs

A

osteophytes

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19
Q

what is pathogenesis of osteoarthrtitis

A

loss of matrix cartiage, release of cytokines including IL-1, TNF, and mixed metalloproteinases as well as prostaglandins by the chondrocytes

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20
Q

signs and symptoms of osteoarthritis

A

gradual onset, mechanical pain, crepitus, stiffness, body swelligs and deformity of the joint, can get effusions and soft tissue swelling which can lead to loss of function and mobility

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21
Q

most effected joint of osteoathritis

A

hands, knees, hip and spine

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22
Q

what are the risk factors for osteoarthritis

A

age, female, genetic, occupation, previous injury, obesity, underlying conditions

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23
Q

what is an example of genetic predisposition to osteoarthritis

A

nodal OA

24
Q

investigations of osteoarthritis

A

bloods, X ray

25
Q

blood findings in osteoarthtritis

A

inflammatory markers are usually normal

26
Q

typical radiological findings in osteoarthtritis

A

joint space narrowing, subchondral sclerosis, bony cysts, osteophytes

27
Q

non pharmalogical managment of OA

A

education, physio, wgt loss, floot wear, aids sich as walking sticks and jar openers

28
Q

pharmalogical management of OA

A

analgesia, NSAIDs, pain modulators, intraarticular steroids

29
Q

surgical intervention of OA

A

arthroscopic washout, loose body, soft tissue trimming, joint replacement

30
Q

what is rheumatoid arthritis

A

aymmetrical inflammation affecting mainly peripheral joints (mostly synovial) which can lead to joint damage and irreversible deformities leading to loss of function and increased morbidity and mortality

31
Q

who is RA most common in

A

women

32
Q

what is the prevelance of RA

A

1% in the uk

33
Q

what is RA mediated by

A

HLA DR4

34
Q

what are the triggers of RA

A

infections, stress, cigerrettes

35
Q

what is early RA

A

less than 2 years of symptoms

36
Q

what is the therapuetic window of opportunity for RA

A

first 3 months

37
Q

extra articular manifestations in RA

A

rheumatoid nodules on extensor surfaces, lung involvement - pleaural effusions, interstitial fibrosis and pulmonary nodules, CVS morbidity and mortality increased, occular

38
Q

diagnosis of RA

A

history and clincial exam, prolonged morning stiffness in small joints, positive compression test, blood testing for anaemia and raised platelets, inflammatory markers raised, auto antibodies RF and ACPA, X ray for periarticular osteopenia and soft tissue swelling, per articular erosions can occur later, US for synovial inflammation and MRI for tendons

39
Q

what score should you use to assess weather the patient is improving or worsening in RA

A

DAS28^2

40
Q

first line treatment for RA

A

methotrexate, analgesia and steoirds for symptosm releif

41
Q

second line for RA

A

biologic therapy - anti TNFAalpha drigs

42
Q

what mist patients have to qualify for biologic therapy

A

a score larger than 5.1

43
Q

complications of RA

A

joint damage and deformaties, atlanto axial sublucation causing cervical cord compression

44
Q

what does spondyloaryhropathy affect

A

spine and joints - sacroiliac

45
Q

what causes spondylarthrtopathy

A

HLA B27 +ve

46
Q

what is enthesitis

A

inflammation at insertation of tendons into bones

47
Q

what is dactylitis

A

sausage digits

48
Q

what is anklyosing spondylitis

A

inflammation of the spine

49
Q

who is AS more common in

A

men

50
Q

clinical features of AS

A

back pain enthestitis, peripheral arthritis

51
Q

extra articular features of AS

A

anterior uveitis, CVS involvement, pulmonary, asymptomatic enteric mucosal inflammation, nuero involvement

52
Q

what does syndesmophytes mean

A

fusion of vertebrae

53
Q

diagnosis of AS

A

examine - occiput to wall test, chest expansion, schober test, bloods, Xrays

54
Q

what % of people have PsA without psoriasis

A

10-15%

55
Q

clinical features of PsA

A

inflammatory arthritis, sacrolitis, nail involvement, dactylitis, enthesitis, extra articular

56
Q

diagnosis of psoriatic arthritis

A

bloods and Xrays

57
Q

treatment of PsA

A

NSAIDs, corticosteroids, DMARDs, antiTNF if severe, secukinumab, physio, OT, orthotics

MSK (19 decks)

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