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Rheum AM > Seronegative spondyloarthritides > Flashcards

Seronegative spondyloarthritides Flashcards

1
Q

What are some types seronegative spondyloarthritides?

A

Axial spondyloarthritis- ankylosing spondylitis is a subtype
Psoriatic arthritis
Enteropathic arthritis
Reiter’s syndrome

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2
Q

What are the common features of seronegative spondyloarthritides?

A 
RF -
Associated w HLA B27
Asymmetric 
Sacroilitis, spondylitis, enthesitis
Ant uveitis
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3
Q

What is axial spondyloarthritis?

A

Umbrella term

Chronic auto-inflammatory diseases affecting mainly the axial skeleton

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4
Q

What is the most known type of axial spondyloarthritis?

A

ankylosing spondylitis

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5
Q

What is the presentation of axial spondyloarthritis?

A

Articular- inflammatory back pain, arthritis, enthesitis

Extra articular- ant uveitis, dactylics

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6
Q

What conditions are associated with axial spondyloarthritis?

A

Psoriasis
IBD
Restrictive lung disease

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7
Q

What are the diagnostic criteria for axial spondyloarthritis?

A

> 3 months back pain with onset <45yo + 1 of

  • sacroilitis on XR and >1 feature
  • HLA B27 plus >2 features
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8
Q

What investigations are done for axial spondyloarthritis?

A

RF, HLA B27
XR
MRI

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9
Q

What is the management of axial spondyloarthritis?

A 
Rhysio
NSAIDs
DMARD= sulfasalazine
Anti TNF= infliximab 
Surgery- joint replacement, spinal surgery
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10
Q

Who is ank spond seen in?

A

Men, late teens to early 20s

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11
Q

What is the presentation of ank spond?

A 
Inflammatory back pain
Enthesitis
Bilateral sacroilitis
Kyphosis
Ant uveitis
Dyspnoea
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12
Q

What are the features of back pain in ank spond?

A 
Insidious onset
Worse i morning
Improves with exercise 
Loss of lumbar lordosis
Can progress to complete fusion i.e. bamboo spine
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13
Q

What causes dyspnoea in ank spond?

A

Costochondral joit involvement limiting chest expansion

Apical pulmonary fibrosis

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14
Q

What is the management of ank spond?

A

Physio and NSAIDs- generally good response

Biologic- Anti TNF- if 2 anti inflammatories have failed

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15
Q

What is psoriatic arthritis?

A

Inflammatory autoimmune arthritis

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16
Q

What is the presentation of psoriatic arthritis

A 
Pain and stiffness- hot red and swollen over affected joints
Enthesitis- esp of achilles
Dactylitis
Psoriatic skin and nail changes 
PMH/FH psoriasis/psoriatic arthritis
17
Q

What joints are commonly affected in psoriatic arthritis?

A

DIP= characteristic
PIP, MCP and wrist
Sacroiliac joints

18
Q

What investigations are done for psoriatic arthritis?

A

Bloods- RF -, HLA B27, CRP and ESR

XR- pencil in cup and plantar spur deformities

19
Q

What is the management of psoriatic arthritis?

A 
Physio 
NSAIDs
Steroids
DMARDs
Biologics 
Surgery
20
Q

What is reactive arthritis?

A

Sterile inflammatory arthritis that develops in response to distant infection

21
Q

What are the common causative organisms associated with reactive arthritis?

A

Chlamydia trachomatis= most common
Salmonella
Shigella
Campylobacter

22
Q

What is the presentation of reactive arthritis?

A

Reiter’s syndrome= arthritis, uveitis, urethritis/cervicitis
Arthritis= often knee or sacroiliac, 1-4 joints involved
Dactylitis
Enthesitis
Skin and mucous membrane involvement- keratoderma blenorrhagica, circulate balanitis

23
Q

What investigations are done for reactive arthritis?

A

CRP and ESR
HLA B27
XR
Aspiration

24
Q

What is the management of acute reactive arthritis?

A

Ongoing infection= antibiotics

NSAIDs

25
Q

What is the management of chronic reactive arthritis?

A

NSAIDs

DMARDs- Sulfasalazine/methotrexate

26
Q

What is enteropathic arthritis associated with?

A 
Common= IBD
Less= infectious enteritis, Whipple's disease, coeliac
27
Q

What is the presentation of enteropathic arthritis?

A

Arthritis- often leg or axial spine, flares with bowel disease flares
Enthesitis

28
Q

What investigations are done for enteropathic arthritis?

A

ESR, CRP
HLA B27
XR

29
Q

What is the management of enteropathic arthritis?

A

NSAIDs
Steroids
Biologic- anti TNF- infliximab
DMARDs- sulfasalazine/methotrexate

Rheum AM (7 decks)

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