Seronegative Spondylo's - Background + AS Flashcards

1
Q

name the big 4 on the spectrum

All tend to affect the ? and ?large joints, with more limited joint involvement than ??.
Joint ? and ? are more common than in RA.

A

AS
Ps A
Reactive A
IBD related arthropathy

spine
proximal
RA
ankylosis
enthesitis
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2
Q

? (? finger) is also seen commonly in these conditions,
o Particularly common in ? arthritis.
The cause and pathogenesis of the diseases are largely unknown, although
they all have a common aetiological factor of ? presence.
o Often a ? of other spondyloarthritidies.
They are all ? negative (‘seronegative’), and generally anti-? negative

A
dactylitis
sausage
psor
HLA B27
FH
RF
CCP
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3
Q

AS

Presents usually as ? inflammation of the ? joints in young adults (around 18-?), with a ? preponderance of 3:1.

Other joints involved may be ?/? joints asymmetrically, or more rarely other ? joints.
? joints can also be affected, giving ? chest pain.

A
episodic
sacroiliac
30
male
hip/shoulder
peripheral
costochondral
anterior
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4
Q

AS

Presentation
o Episodes of pain and ? in the lower back/?, worse in
the ?, relieved by ?.
o Remain otherwise ? between episodes.
o The pain in the buttocks may ? between sides.
o It may cause disruption from ? in the second half of the ?.

A
stiffness
buttocks
morning
exercise
aSx
alternate
sleep
night
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5
Q

AS

On examination;

o LOOK: ‘? ? posture’ due to retention of the ? ? during spinal flexion (early sign), ?muscle wasting (later sign).
o FEEL: pain on ? over the ??Js.
o MOVE: limited ? and forward ? of the ? spine.

A
q mark
lumbar lordosis
paraspinal
pressure
SIJs
lateral
forward
lumbar
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6
Q

AS

o Special tests: ? test;
• A line is drawn along the ?, ?cm above and ?cm below
the level of L? (or L? AT the level of the iliac crest).
• The distance between the two lines should ? by more than ?cm when the patient bends ?.

A
shobers
midline
10
5
5
4
increase
5
forward
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7
Q
Extra-articular manifestations;
o ? ?: 20%.
o Pulmonary (?) fibrosis
.o ?? node ?.
o ? (inflammation of the ? root, leading to fibrosis and aortic ?)
o ?osis.
A
ant uveitis
apical
av node block
aortitis
aortic
regurgitation
amyloidosis
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8
Q

AS

Investigations;
o ?: normal in 50% of patients with aggressive disease.
o Pelvis XR: bilateral ?(indistinct, ? joint line eventually leading to total ?).
o Spinal XR: vertebral bodies become ?, and ossification of the ? ? and interspinous ? can give a classical ‘? spine’ in severe disease.
–> • ?= ossified ligament.
–> • This ossification of the ligaments is what leads to the ? and ? spine.

A
esr
sacroiliitis
narrow
fusion
squared
annulosus fibrosus
ligaments
bamboo
syndesmophytes
inflexible
rigid
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9
Q

AS

Management;
o Full dose ? for 6 ?.
o If there is no improvement on two different ? (as shown by a high ? score), then ? are started, e.g. ?.
• ? is not used in AS.

A
nsaids
weeks
nsaids
DAS
biologics
etanercept
infliximab
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