Rheumatology Intro and Vasculitis Flashcards
What are the different causes between inflammatory and non-inflammatory joint paun?
I: AI disease (RA, CTD) , crystal arthritis, infection
NI: Degenerative disease(OA), non-degenerative disease (Fibromyalgia)`
What are the 5 cardinal signs of inflammation?
1) Dolor (pain)
2) Rubor (redness)
3) Calor (heat)
4) Tumor (swelling)
5) Loss of function (Functio laesa)
How does inflammatory pain differ from degenerative non-inflammatory?
Inf: Pain eases with use
Deg: Pain increases with use
In which type of pain is swelling most likely to occur?
Inflammatory - Synovial swelling
What are the 2 markers in blood tests that can be detected for inflammation?
1) ESR (erythrocyte sed rate –> How fast falls to bottom)
2) CRP (presence of C reactive proteins0
Why do ESR levels increase in inflammatory joint pain?
Increased fibrinogen causes RBC’s to clump together, so fall faster increasing ESR rate
Why do CRP levels increase in inflammatory joint pain?
Increased levels of IL-6, and liver produces CRP in response to ^ IL-6 causing raised levels
What happens to the levels of ESR and CRP in someone with lupus?
ESR levels increase
CRP is low
Define vasculitis
Inflammation and subsequent necrosis of blood vessel walls with subsequent impaired blood flow
What cells could be present on a histological slide from a patient with vasculitis?
Giant Cells
Neutrophils
Give examples of each of the Chapel Hill classification for vasculitis?
Large Artery P: Giant cell arteritis
Large Artery S: Aortitis in RA
M/S Artery P: Wegener’s granulomatosis (GPA)
M/S Artery S: Vasculitis secondary to AI disease, malignancy, drugs etc.
What does ANCA an acronym for?
Anti-Neutrophil cytoplasmic antibodies (IgG)
What are the symptoms and presentations of giant cell arteritis?
S: Headache, scalp tenderness, jaw claudication, acute blindness and malaise
1) Palpable and tender temporal arteries with a reduced pulsation
2) Optic disc pale and swollen, with sudden monocular visual loss
What is the epidemiology and diagnostic criteria for GCA?
Over 50 years old, 2x common in women, ^ in age,
DC: Over 50, new painful headache, temporal artery tenderness and abnormal artery biopsies
What are the investigations and treatment for GCA?
Inv: Blood tests and Temporal artery biopsy
Treat: Prompt corticosteroids (Prednisolone), Methotrexate and Oporosis prophylaxis
