Spinal + Other disease affecting Jts

Question 1

Degen Disk Disease (DDD)

peaks at ____

Epidem

Clinical Manifes + Complication

Most common cause of ____

Tx

Answer 1

Lumbar DDD early onsit, 5% adult peak 40-50

Genetics most impt 50-70%

Age+weight 2ndry

Sciatica: Men 1.5-3x

Dehydr nucelus pulp, fibrous stress tears annulus = disk collapse

Stenosis (narrow), spondylolisthesis (vert. shift fwd)

–

LB(P) + radiculopathy (symp re: nerve pinch in VC)

Disk fail is irreversible. Bed rest NOT standard care, surgery (diskectomy), replacmt, fusion

Question 2

Rheumatoid arthritis (RA)

Affects:

Onset peaks @ ___, ____prevalent

_____ women and _____ incr. risk by ____

Etiology

Prog.

Answer 2

Affect CVP, GI , Eye, osteo

Nulliparus, not taking contraceptive - 4x
—
T-lymph into synov fluid
—
Irreversible, QOL mgmt - mobility, stiffness, edema, destruction. Jt defrm-sublux, Ulnar dev., asymp subcut nodul in organ

Question 3

RA Diagx

RA clinical manifestations

Answer 3

80% +ve for RF (rheumatoid factor)

Pannus

Systemic Disease, insidious - general (P), weakness - wrist, knee, fingers

Question 4

Juvenile Idiopathic Arthritis (JIA)

3 type

Prog

Answer 4

Arthritis starting <16y

Girls (1-5yrs) more:
      Oligoarthritis or pauciarticular 
(50% all JIA) Mild.
\:  knees, elbows, wrist, ankle)  
       Polyarticular (40% of all JIA), 5+ joints. More severe.

Equal sex: (Still’s disease) Systemic-onset. Severe.

Mortality 3-5x, No cure, immuno-modulatory, preserve ROM, dec. (P)

Question 5

Ankylosing spondylitis

Epid, onset at _____y

Clinical Manifest

Prog

Answer 5

Marie-Strumpell: Inflammatory of axial sk w/ asym involv (hip, knee, shoulder)

Higher in Caucasian, onset at 15-30y, rarely 40

Men 2-3x, 90% faulty gene = 2% dev

• Insidious onset, (low back, buttock, hip pain for >3mths)
• (P) not below knee, loss of Lumbar lord, incr. thor Kyp.

Fusion IV Disk space (bamboo x-ray)

Mgmt (maintain mobil, red. inflam, prev frax)

Question 6

Sjorgen Syndrome

Epid ___ most comn ____

Clinical Manifest

Mgmt

Answer 6

Autimmune arthrits-re: affects - Moisture-producing gland Mouth + eyes. Lung, kidney, Liver

2nd most cmn autoimmue rheumatic, high malignancy risk

Dry throat (detnal decay), esophag, gastr,

Moisturize dryness/eye infec

Question 7

Psoriatic Arthritis

Etiology

Clinical Man

Answer 7

Affects 20% of severe psoriatic pt

Genetic, 80-90% dev if 1st degree relative with disorder

Distal IP finger jt (Claw), no cure usually mild

Question 8

Lyme Disease

Bacterial disseminates ___ and survives for ___

Clinical Manifest early dissem

Diagnosis + Tx

Answer 8

Chronic arthritis from untx Lyme in NA most cmn, most cmn vector-borne infectius disease in US

Usually unilat

blood stream/lymph, years

–
Fatigue, chills, skin erythema, fever

Bloodtest Spriochete antibodies (late stages of infect - 32 days), Antibiotic Tx.

No natural immu from B. Brugdorferi

Question 9

Gout ____ disorder marked by ____ + ____ in___

3 group

Incidence/Epid

Clinical Manifestations

Answer 9

Metabolic disorder by elevated Uric acid in jts, soft tissue and kidney

Primary hyperuricemia (inherit)- Middle age, peak 50, symptomatic post 10-20 yr of hyperuricem, women post-meno

2ndry (Rduced kidneyf - leukemia, psoriasis, chemo) block xcrtion of urin acid)
idiopathic

Acute monoarticular inflam arthritis, @ night of 1st MTP jt

Question 10

Gout Clinical manifest mechanism

Answer 10

Tophus (deposit of uric crystals, leukocytes splat = inflam)and bone abnormalities

Question 11

Pseudogout

Epid

Answer 11

Calc crystal deposit not urate, knee of older women

Question 12

Reactive Arthritis

Presentation, prog

Answer 12

Post-artic. infect remote from primary

> 1 jt affect, usually not SI, good prog

Question 13

Reiter’s Syndrome

Symptoms

Tx

Answer 13

cmn reactive arthritides, follows Ven. Disease (Clamydia), or enteric infec (shigella, salmonella

Triad: Urethritis, conjunctivitis, arthritis

Antibiotic Tx may not help, resolves in 3-12mth, may recur.