Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Spondyloarthropathy > Flashcards

Spondyloarthropathy Flashcards

1
Q

what is spondyloarthropathy

A

family of inflammatory arthritides characterised by involvement of both the spine and joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what gene predisposes patients to all spondyloarthropathies

A

HLA B27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is HLA B27 assocaited with

A

ankylosing spondylitis, reactive arthritis, crohns disease, uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the four subgroups of spondyloarthritic diseases

A

ankylosing spondylitis
psoriatic arthritis
reactive arthritis
enteropathic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe mechanical back pain

A

worsened by activity, worst at end of the day, better with rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe inflammatory back pain

A

worse with rest, better with activity, significant early morning stiffness (>30 minutes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is enthesis

A

site of insertion of a tendon, ligament or articular capsule into bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is enthesopathy

A

alteration to enthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is enthesitis

A

inflammation at enthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the common rheumatoid features of the spondyloarthopathies

A

sacroiliac and spinal involvement, enthesitis, inflammatory arthritis, dactylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is dactylitis

A

inflammation of the entire digit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the inflammatory arthritis like in the spondyloarthropathies

A

oligoarticular (just a few joints)
asymmetric
predominantly lower limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the shared extra articular features of the Spondyloarthropathies

A

occular inflammation (anterior uveitis, conjunctivitis)

mucocutaneous lesions (involvement of oral mucosa and genitals)

rare aortic incompetence or heart block

no rheumatoid nodules

inflammatory bowel disease symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is ankylosing spondylitis

A

chronic systemic inflammatory disorder that primary affects the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the hallmark and other common features of Ankylosing Spondylitis

A

hallmark- sacroiliac joint involvement (sacroiliitis)

peripheral arthritis uncommon

enthesopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

who gets Ankylosing Spondylitis

A

more common in men, late adolescence or early adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the main symptoms and signs of Ankylosing Spondylitis

A 
inflammatory back pain 
arthritis 
enthesitis 
anterior uveitis 
psoriasis 
crohns/ colitis 
good response to NSAIDs
family history 
HLA-B27
elevated CRP
cardiovascular, neurological and pulmonary involvement 
amyloidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is seen on imagine in Ankylosing Spondylitis

A

sacrolitis

active (acute) -inflammation on MRI, bone marrow oedema, enthesitis

x-rays (late disease)- sacroiliac sclerosis, vertebral fusion, erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why is Ankylosing Spondylitis called the ‘A’ disease (7)

A 
Axial arthritis 
Anterior uveitis
Aortic regurgitation 
Apical fibrosis
Amyloidosis/ IgA nephropathy
Achilles tendinitis
plAntar fasciitis
20
Q

why can movement of spin become limited in Ankylosing Spondylitis

A

inflammation causes syndesmophytes (fusion of vertebrae)

21
Q

what posture is seen in Ankylosing Spondylitis

A

question mark spin; hip flexes, straightening if lumbar spine, thoracic kyphosis

22
Q

how do you diagnosis Ankylosing Spondylitis

A 
history 
exam;
-tragus/occiput to wall 
-chest expansion (reduced)
-modified schober test

bloods

  • inflammatory markers (ESR, CRP, PV) raised
  • HLA- B27

x-rays

  • sacroilitis
  • syndesmophytes
  • bamboo spine
23
Q

what is the occiput to wall test

A

when shoulder, bum and feet touching wall try to touch head to hall- people with Ankylosing Spondylitis cant

24
Q

what is the schober test

A

Distance between ASIS and 10cm above when standing, normal will increase by at least 5cm when bent over,
Ankylosing Spondylitis will be less

25
Q

what happens to bone density in late Ankylosing Spondylitis

A

reduced

26
Q

what does bamboo spine mean

A

in Ankylosing Spondylitis x ray in late disease will show shiny corners of vertebrae which suggests fusion

27
Q

what is the treatment for Ankylosing Spondylitis

A

physiotherapy and occupational therapy

NSAID
DMARD (for peripheral joint involvement, doesnt work on spine)
Anti TNF in severe

28
Q

what is psoriatic arthritis

A

inflammatory arthritis associated with psoriasis (10-15% have no psoriasis)

29
Q

is rheumatoid associated with psoriatic arthritis

A

psoriatic arthritis has no rheumatoid nodules and is rheumatoid factor negative

30
Q

what are the clinical features of psoriatic arthritis

A 
inflammatory arthritis 
sacroiliitis
nail involvement (pitting, hyperkeratosis, onycholysis)
dactylitis 
enthesitis 
extra articular features (eye disease)
31
Q

what are the five clinical subgroups of psoriatic arthritis

A
  1. confined to distal interphalangeal joints (DIP) on hands/feet
  2. symmetric polyarthritis (similar to RA)
  3. spondylitis (spine involvement) with/without peripheral joint involvement
  4. asymmetric oligoarthritis with dactylitis
  5. arthritis mutilans (fast progression)
32
Q

how do you diagnose psoriatic arthritis

A

bloods
-raised inflammatory markers
negative RF

x-rays

  • marginal erosions and whiskering
  • pencil in cup deformity
  • osteolysis
  • enthesitis
33
Q

what is the medical treatment for psoriatic arthritis

A 
NSAIDs
corticosteroids/joint injections 
DMARDs
anti TNF
secukinumab (anti-IL17)
34
Q

what is the non medical treatment for psoriatic arthritis

A

physiotherapy
occupational therapy
orthotics
chiropodist

35
Q

what is reactive arthritis

A

infection induced systemic illness characterised primarily by an inflammatory synovitis from which viable microorganisms cannot be cultured

36
Q

when do you get symptoms in reactive arthritis

A

1-4 weeks after infection

37
Q

what are the most common infections causing reactive arthritis

A

urogenital (chlamydia), enterogenic (salmonella, shigella, yersinia)

38
Q

who gets reactive arthritis (what gene)

A

young adults (20-40)
equal sex distribution
HLA-B27 positive

39
Q

what is reiters syndrome

A 
a form of reactive arthritis 
triad of;
-urethritis 
-conjunctivitis/ uveitis/iritis 
-arthritis
40
Q

what are the general features of reactive arthritis

A

general symptoms (fever, fatigue, malaise)
asymmetrical monoarthritis or oligoarthritis
enthesitis
mucocutaneous lesions
occular lesions (conjunctivitis, iritis)
visceral manifestations (mild renal disease, carditis)

41
Q

how do you diagnose reactive arthritis

A

bloods:

  • inflammatory parameters (ESR, CRP, PV)
  • FBC, U&ES
  • HLA B27 (rarely necessary)

cultures (blood, urine, stool)

joint fluid (to rule out infections or crystal arthropathy)

xray of affected joints
ophthalmology opinion

42
Q

what is the treatment for reactive arthritis

A

90% resolve within 6 months

NSAIDs
corticosteroids
antibiotics (for underlying infection)
DMARDs (in chronic)

physiotherapy
occupational therapy

43
Q

what is enteropathic arthiritis

A

inflammatory arthritis associated with inflammatory bowel disease

44
Q

how do patients with enteropathic arthiritis present

A

arthritis in several joints especially the knees, ankles, elbows, wrists, spine, hips or shoulders

worsening symptoms during flare ups of inflammatory bowel disease

GI-loose watery stool with mucous and blood, apthous ulcers

weight loss, low grade fever, eye involvement, skin involvement, enthesitis

45
Q

what investigations into enteropathic arthiritis can you do

A

upper and lower GI endoscopy

joint aspirate

raised inflammatory markers

X-ray/MRI showing sacroilitis

USS showing synovitis/ tenosynovitis

46
Q

what is the treatment for enteropathic arthiritis

A

treat IBD

not NSAIDs as may exacerbate IBD

analgesia (e.g. paracetamol, cocodamol)

steroids

DMARDS

Anti tnf

physiotherapy, occupational therapy,orthotics

47
Q

what is the treatment for ankylosing spondylitis

A

NSAIDs, physion, exercise

if this doesn’t work anti TNF or anti IL 17

MSK (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions