Spondylarthropathies, polyarthritis rheumatica, fibromyalgia Flashcards

1
Q

What antibodies are associated with spondyloarthropathies?

A

HLA B27 antibodies

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2
Q

Inflammation of sites where tendons and ligaments attach to bone

A

enthesitis

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3
Q

Chronic inflammatory disease of the joints of the axial skeleton. Changes seen in sacroiliac joints and hips

A

ankylosing spondylitis

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4
Q

Extra-articular manifestations of ankylosing spondylitis

A

anterior uveitis, aortic valvular disease, restricted chest expansion

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5
Q

How long must a patient have low back pain to be classified as ankylosing spondylitis?

A

3 months

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6
Q

Describe the stiffness/back pain associated with ankylosing spondylitis?

A

awakend by pain during 2nd half of night, morning stiffness, and pain that improves with excercise

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7
Q

Characteristic radiographic finding for ankylosing spondylitis

A

“bamboo spine”

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8
Q

What should always be ordered for any patient suspected of having ankylosing spondylitis?

A

AP view of the pelvis

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9
Q

Acute inflammatory arthritis occurring 1-3 weeks after infectious event

A

reactive arthritis

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10
Q

Triad of reactive arthritis

A

arthritis, urethritis, conjunctivitis

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11
Q

Most common cause of reactive arthritis

A

post-veneral onset (Reiter’s)

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12
Q

Chronic inflammatory arthropathy in setting of psoriasis

A

psoriatic arthritis

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13
Q

Nail changes often noted in psoriatic arthritis

A

pitting, dystrophy, onyholysis

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14
Q

Characteristic inflammatory changes associated with psoriatic arthritis

A

Arthritis in DIPs, sausage digits, and no rheumatoid nodules

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15
Q

Effective for inflammatory back pain, spinal stiffness, peripheral arthritis, enthesopathy. Doesn’t inhibit disease progression

A

NSAIDs

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16
Q

Considered when antiinflammatory therapy is insufficient to control symptoms. Progression of inflammatory axial disease noted. Active persistent polyarthritis or uncontrolled extra-articular disease

17
Q

What needs to be supplemented for when a patient is prescribed methotrexate?

18
Q

Characterized by aching & stiffness in the shoulder and pelvic girdles and the neck. Usually responds to low doses of steroids

A

polymyalgia rheumatica

19
Q

Age that polymyalgia rheumatica occurs

20
Q

Describe pain pattern associated with polymyalgia rheumatica

A

aching, morning stiffness that lasts 30 minutes. Is bilateral and worse w/movement

21
Q

Exam findings of polymyalgia rheumatica that can differentiate it from other arthritides

A

little evidence of proximal joint swelling or tenderness

22
Q

Treatment for polymyalgia rheumatica

A

Corticosteroids are drugs of choice (10-20mg/day) for 1-2 yrs.

23
Q

How soon does polymyalgia rheumatica resolve after intitiation of treatment?

A

Complete or nearly complete resolution of sx is seen in a few days. absence of improvement should cause one to question diagnosis

24
Q

Chronic vasculitis of medium and large vessels. Symptoms are due to end-organ ischemia. More common at age > 50

A

Giant cell arteritis

25
Most frequent symptom of giant cell arteritis
headache
26
Complications of giant cell arteritis
blindness, aortic aneurysms, stroke
27
Should be performed in all patients with suspected giant cell arteritis (GCA)
temporal artery biopsy
28
Initial treatment for GCA
high dose 40-60mg prednisone. IV pulse methylpresnisolone 1000mg x 3days if vision loss present
29
A clinical syndrome characterized by widespread muscular pain (usually chronic), fatigue and muscle tenderness
Fibromyalgia Syndrome (FMS)
30
What is thought to be the underlying pathology of fibromyalgia (FMS)?
abnormal sensory processing in CNS that causes them to be extremely sensitive to pain
31
Associated symptoms include: poor sleep*, HA, IBS, cognitive/memory problems, and paresthesias in fingers/toes
fibromyalgia (FMS)
32
important in transmission and amplification of pain signals to and from brain
substance P
33
Patients with what other rheumatologic disorders are more likely to develop FMS?
Rheumatoid arthritis and SLE (Lupus)
34
How many positive tender points are generally needed to make the diagnosis of FMS?
11 of 18
35
T/F fibromyalgia co-aggregates with somatoform disorder in families
false, it co-aggregates with major mood disorders in families
36
What are the levels of inflammatory markers (ESR, CPR) in FMS?
normal
37
What is the first-line approach for patients with moderate to severe pain due to FMS?
Trial with low-dose TCAs, SSRI, SNRI, or antiseizure medication