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Med/Surg III Test 2 > Spondyloarthropathy > Flashcards

Spondyloarthropathy Flashcards

1
Q

Types of spondyloarthropathies

A
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Reactive arthritis
  • Reiter’s syndrome
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2
Q

Common characteristics of spondyloarthropathies

A
  • AsEnIn

- RInHig

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3
Q

I made up AsEnIn to stand for

A
  • Asymmetrical peripheral arthritis
  • Enthesopathy
  • Inflammatory axial spine involvement
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4
Q

I made up RInHig to stand for

A
  • Rheumatoid factor negative
  • Inflammatory eye disease
  • High frequency of HLA B27
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5
Q

What is enthesopathy?

A

inflammation where a ligament or tendon attaches to bone

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6
Q

Arthritis associated with spondyloarthropathies is (asymmetrical, symmetrical)

A

asymmetrical

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7
Q

________ of those with __________________ are HLA-B27+

A

24%; spondyloarthropathies

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8
Q

________ of those with ___________ have AS.

A

1.8%; HLA-B27

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9
Q

AS stands for

A

Ankylosing Spondylitis

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10
Q

24% of those with spondyloarthropathies are

A

HLA-B27+

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11
Q

1.8% of those with HLA-B27 have

A

AS

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12
Q

HLA-B27 Disease Associations - AS

A

> 90%

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13
Q

HLA-B27 Disease Associations - Reiter’s syndrome

A

80%

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14
Q

HLA-B27 Disease Associations - Reactive arthritis

A

85%

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15
Q

HLA-B27 Disease Associations - IBD

A

50%

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16
Q

HLA-B27 Disease Associations - Psoriatic arthritis

A

65%

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17
Q

What disease has >90% association with HLA-B27?

A

AS

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18
Q

What disease has 80% association with HLA-B27?

A

Reiter’s syndrome

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19
Q

What disease has 85% association with HLA-B27?

A

Reactive arthritis

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20
Q

What disease has 50% association with HLA-B27?

A

IBD

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21
Q

What disease has 65% association with HLA-B27?

A

Psoriatic arthritis

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22
Q

IBD stands for

A

Inflammatory Bowel Disease

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23
Q

Ankylosing Spondylitis - general information

A
  • Onset < 40 yo
  • Insidious
  • > 3 months
  • Morning stiffness
  • < with exercise
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24
Q

What does insidious mean?

A

long, slow onset

25
Q

Diagnosis of AS

A
  • LiNoL

- BeRUnBi

26
Q

I made up LiNoL to stand for

A
  • Limited lumbar motion
  • Not relieved by rest (made worse)
  • LBP > 3 months
27
Q

I made up BeRUnBi to stand for

A
  • Better with exercise
  • Reduced chest expansion
  • Unilateral sacroiliitis on x-ray
  • Bilateral sacroiliitis on x-ray
28
Q

Reduced chest expansion in a pt with AS can cause what?

A

difficulty breathing

29
Q

Typically seen in a pt with AS when asked to bend over to touch toes:

A
  • Flat lumbar spine
  • < lordosis
  • Use hips for bending
30
Q

AS non-vertebral symptoms

A
  • CoSAr
  • AsIrI
  • PlAc
31
Q

I made up CoSAr to stand for

A
  • Costochondritis
  • Sausage digits (not as common)
  • Arthritis of toe IP joints
32
Q

I made up AsIrI to stand for

A
  • Asymmetrical peripheral arthritis
  • Iritis
  • IBD
33
Q

I made up PlAc to stand for

A
  • Plantar fasciitis

- Achilles tenosynovitis

34
Q

PT treatment of AS

A
  • Exercise
  • Posture
  • Hot/cold (depending on pt)
35
Q

What type of exercise in particular is good for pts with AS?

A

aerobic and ROM

36
Q

Medications for AS

A
  • Anti-inflammatory
  • Corticosteroids
  • Sulfasalazine
  • DMARDs
  • TNF blockers
37
Q

Side effects of sulfasalazine

A
  • Anorexia
  • Headache
  • Nausea
  • Vomiting
  • Gastric distress
38
Q

Side effects of TNF blockers

A
  • Convulsions
  • Multiple sclerosis
  • Transverse myelitis
  • Paresthesias
  • Infections
  • CHF
39
Q

What medication commonly presents with the side effects of anorexia, headache, nausea, vomiting, and gastric distress?

A

Sulfasalazine

40
Q

What medication commonly presents with the side effects of convulsions, multiple sclerosis, transverse myelitis, paresthesias, infections, and CHF?

A

TNF blockers

41
Q

PT implications of spondyloarthropathies

A
  • New onset of back pain
  • Teach posture
  • During flare ups
42
Q

What are the PT implications of a pt with spondyloarthropathy who develops a new onset of back pain?

A
  • Fever
  • Fatigue
    (think AS)
43
Q

What are the PT implications of a pt with spondyloarthropathy in the middle of a flare up?

A
  • Avoid aggressive stretching
  • Use modalities
  • Use gentle aerobic exercise
44
Q

Reiter’s syndrome aka

A

reactive arthritis

45
Q

reactive arthritis aka

A

Reiter’s syndrome

46
Q

Reiter’s syndrome (reactive arthritis) is a _______________________ arthritis.

A

seronegative; asymmetric

47
Q

What does seronegative mean?

A

no rheumatoid factor

48
Q

Reiter’s syndrome (reactive arthritis) is a seronegative asymmetric arthritis following:

A
  • Urethritis or cervicitis

- Infectious diarrhea

49
Q

What diseases is Reiter’s syndrome (reactive arthritis) associated with?

A
  • Inflammatory eye disease
  • Enthesopathy
  • Sacroiliitis
50
Q

What eye symptom is commonly seen in pts with Reiter’s syndrome (reactive arthritis)?

A

conjunctivitis

51
Q

What is conjunctivitis?

A

inflammation of the outer layer of the eye/inner layer of eyelid; aka pink eye

52
Q

What foot symptom is commonly seen in pts with Reiter’s syndrome (reactive arthritis)?

A

heel tendonitis

53
Q

What low back symptom is commonly seen in pts with Reiter’s syndrome (reactive arthritis)?

A

asymmetrical sacroiliitis

54
Q

Medications for Reiter’s syndrome (reactive arthritis)

A
  • Anti-inflammatory
  • Corticosteroids
  • Antibiotics
  • DMARDs
  • TNF blockers
55
Q

Psoriatic arthritis - prevalence

A
  • 2% of people have psoriasis

- 5-7% of those with psoriasis develop Psoriatic arthritis

56
Q

Psoriatic arthritis - symptoms

A
  • Inflammatory arthritis of DIPs
  • Asymmetrical arthritis
  • Sausage digits (definitely)
  • Nail pitting
  • Enthesopathy
57
Q

What type of arthritis is called “pencil in a cup”?

A

Psoriatic arthritis

58
Q

Psoriatic arthritis - changes in phalangeal joints

A

severe in DIPs, less in PIPs, minimal in MTPs

59
Q

Spondyloarthropathy associations

A
  • Inflammatory bowel disease

- Inflammatory eye disease

Med/Surg III Test 2 (5 decks)

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