Brainscape's Knowledge GenomeTM

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


See full index

MSK > Swollen Hand Joint > Flashcards

Swollen Hand Joint Flashcards

1
Q

What are the 4 sub categories of arthritis?

A
  1. Inflammatory
  2. Non-inflammatory
  3. Septic
  4. Crystal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 types of crystal arthritis?

A

Gout

Pseudogout

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

What is septic arthritis?

A

Acute onset monoarthritis or oligoarthritis
Infection of a joint/few joints
Underlying RF - diabetes and immunosuppresion
Systemic features common

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

What is osteoarthritis (OA) AKA non-inflammatory arthritis?

A

Wear and tear of joints
Insidious onset
<30mins morning stiffness, worsened with activity

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

What does “boggy” swelling indicate?

A

It feels similar to like when you squash a grape

Suggestive of synovitis which occurs in inflammatory arthritis

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

Which joints does RA typically affect?

A

Symmetrical distribution
Wrists
MCP
PIP

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

Describe a swan neck deformity

A

Hyperextension of the PIP and flexion of the DIP

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

Define the Boutonniere deformity

A

Flexion of the PIP and hyperextension of the DIP

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

What is guttering?

A

Muscle wasting seen over the dorsum of the hand

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

What percentage of patients with RA will have a negative rheumatoid factor?

A

20%

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

What is Rheumatoid Arthritis (RA)?

A

An autoimmune condition that causes chronic inflammation of the synovial lining of the joints, tendon sheaths and bursa

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

How would you describe the distribution of RA?

A

Symmetrical

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

Who is more likely to get RA?

A

Women

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

How do we monitor disease activity in RA?

A

Using the Disease Activity Score (DAS 28)

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

What information is needed to calculate someones DAS score?

A
  1. Number of swollen joints
  2. Number of tender joints
  3. ESR or CRP
  4. Patient VAS score
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the typical joints affects in patients with RA?

A

Small joints in the hands (wrist, MCP and PIP) and feet (ankle)

17
Q

What are the systemic features of inflammatory conditions?

A
  • Fatigue
  • Weight Loss
  • Flu like illness
  • Muscles aches and weakness
18
Q

Which joints are almost NEVER affected by RA?

A

The distal interphalangeal joints (DIP)

19
Q

What is a potential spinal cord emergency in someone with RA?

A

Atlantoaxial subluxation - synovitis at the axial atlanto joint in the cervical spine

20
Q

What are the extra-articular manifestations of RA?

A
  1. Pulmonary fibrosis (Caplan’s syndrome)
  2. Bronchiolitis obliterans
  3. Felty’s syndrome (RA, neutropenia and splenomegaly)
  4. Sjogren’s syndrome (secondary) Sicca Syndrome
  5. Anaemia of chronic disease
  6. Cardiovascular disease
  7. Episcleritis and scleritis
  8. Rheumatoid nodules
  9. Lymphadenopathy
  10. Carpel tunnel syndrome
  11. Amyloidosis
21
Q

What investigations would you organise for someone who is clinically presenting like RA?

A
  1. Check rheumatoid factor
  2. RF -ve? Check anti-CCP
  3. Inflammatory markers (CRP/ESR)
  4. X-Ray hands and feet
22
Q

What is the name of the diagnostic criteria used for RA?

A

American College of Rheumatology (ACR)

23
Q

What are the ACR diagnostic criteria points?

A
  1. Joints that are involved
  2. Serology (RF and anti-CCP)
  3. Inflammatory markers
  4. Duration of symptoms (more or less than 6 weeks)
24
Q

What factors give a worse prognosis for a patient diagnosed with RA?

A
  1. Younger onset
  2. Male sex
  3. More joints and organs affected
  4. Presence of RF and anti-CCP
  5. Erosions seen on X-Ray
25
Q

What are the NICE guidelines for DMARDs (describe each of the lines of therapy)?

A

FIRST LINE: mono-therapy with methotrexate, leflunomide or sulfasalazine
SECOND LINE: 2 of the mono-therapies used in conjunction with one another
THIRD LINE: methotrexate + biological therapy (usually TNF inhibitor)
FOURTH LINE: methotrexate plus rituximab

26
Q

What are the DMARDs of pregnancy?

A

Sulfasalazine and hydroxychloroquine

27
Q

What are the most common biological therapies?

A

TNF inhibitors - adalimumab, infliximab and etanercept

Anti-CD20 - rituximab

28
Q

What are the main side effects of the following medication; methotrexate?

A

Bone marrow suppression
Leukopenia
HIGHLY teratogenic

29
Q

What are the main side effects of the following medication; leflunomide?

A

Hypertension

Peripheral neuropathy

30
Q

What are the main side effects of the following medication; sulfasalazine?

A

Male infertility

31
Q

What are the main side effects of the following medication; hydroxychloroquine?

A

Nightmares

Reduced visual acuity

32
Q

What are the main side effects of the following medication; Anti-TNF medications?

A

Reactivation of Hep B or TB

33
Q

What are the main side effects of the following medication; rituximab?

A

Night sweats

Thrombocytopenia

MSK (10 decks)

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