Spondilita anchilozanta Flashcards

1
Q

Clasificare in functie de manif clinica predominanta

A

afectare AXIALA

artic sacroiliace + coloana vertebrala

afectare PERIFERICA

artrita

entezita

dactilita

*posibile suprapuneri

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2
Q

Test Schober

A

⇑ <5cm → rigiditate spinala

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3
Q

Manifestari extraspinale

Inflamatia jonctiunii costocondrale

A

dureri toracice anterioare

⇓ masurabila expansiune torace

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4
Q

Afectare articulara periferica

A

ASIMETRICA

afecteaza cateva articulatii, predominant MARI

afectare sold → deformari fixe in flexie

deteriorare postura

adolescenti → mono-artrita a mb inferioare → mai tarziu evolueaza catre SA

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5
Q

Uveita anterioara acuta

inflam tractului uveal - iris, corp ciliar si coroida

A

30% pacienti cu AxSpA

ocazional manifestarea de prezentare

urgenta medicala: durere oculara severa, fotofobie, vedere incetosata

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6
Q

Leziuni cutanate in artritele reactive identice histologic cu

A

psoriazis pustular

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7
Q

Distrofie unghiala in

A

psoriazis

artritele reactive

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8
Q

Aortita in

A

SA

artrite reactive

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9
Q

Afectare cardiovasculara

A

Insuficienta aortica → 1% pac cu SA constituita

Anomalii de conducere cardiaca → 5%

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10
Q

Afectare respiratorie RAR

A

rigiditate perete toracic + boala pulmonara interstitiala

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11
Q

Insuficienta renala

A

10-35% pac cu SA

utilizare cronica AINS

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12
Q

Osteoporoza axiala

A

25%

10% + fractura vertebrala

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13
Q

BASDAI

A

scor 1-10 → eval clinica generala activitate boala

oboseala

durere spinala

artralgie

tumefactie articulara

sensibilitate localizata

inflamatie tendoane / enteze

durata + severitatea redorii matinale

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14
Q

Testare HLA-B27

A

NU e diagnostic

poate consolida / confirma dg suspectate

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15
Q

Radiografii

marginile corticale mediale + laterale ale AMBELOR articulatii sacroiliace

A

isi pierd conturul din cauza eroziunilor → sclerotice

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16
Q

Aspect radiologic

coloana vertebrala

A

estompare a marginilor vertebrale superioare / inferioare la jonctiunea toraco-lombara

cauzate de entezita insertiei ligamentelor intervertebrale

afect intreaga coloana vertebrala, ducand la

formare sindesmofite

anchiloza osoasa

rigidizare permanenta

calcificare ligg. intervertebrale

fuziune apofize spinale

formare sindesmofite

→ COLOANA DE BAMBUS

17
Q

IRM cu gadoliniu

A

demonstreaza

sacroilita inainte de a fi vizualizabila pe Rx

entezita persistenta

18
Q

Cheia pentru gestionarea eficienta a SA

A

diagnostic precoce

19
Q

Exercitii preventive MATINALE

A

inainte de formarea sindesmofitelor

+ AINS regulat

20
Q

Esecul de a controla durerea si de a incuraja exercitiile regulate ale coloanei vertebrale si toracice duce la

A

cifoza dorsala ireversibila

atrofiere muschi paraspinali

+ rigidizare coloana vertebrala cervicala

→ vedere frontala afectata

21
Q

inflamatie activa

durere si redoare matinala prea severe pentru a permite exercitii fizice eficiente

A

AINS cu actiune lunga / elib lenta SEARA

supozitor cu AINS

22
Q

Sulfasalazina

A

artrita periferica

NU afectare spinala

23
Q

AINS au esuat

A

blocanti TNF alfa

Adalimumab

Etanercept

Golimumab

Certolizumab

Infliximab

artic spinale + periferice

recadere la intreruperea terapiei

24
Q

Alte bDMARD

A

blocant IL-17 = SECUKINUMAB