Brainscape's Knowledge GenomeTM

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


See full index

YR3S2- PM4 > wk 6- arthritis, connective tissue disease > Flashcards

wk 6- arthritis, connective tissue disease Flashcards

1
Q

diagnosing criteria for juvenile rhematoid arthritis

A

criteria of 4 things:

  1. Chronic synovial inflammation of unknown origin
  2. Onset in children less than 16 years of age
  3. Objective evidence of arthritis in one or more joints for 6 consecutive weeks
  4. Exclusion of other diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 types of JRA

A
  1. Pauciarticular or monarticular JRA (~40%)
  2. Polyarticular JRA(~20%)
  3. Systemic JRA (Still’s disease) (~20%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

pauciarticular/ monoarticular JRA

A
  • 4 or fewer joint affected Asymmetrical or symmetrical
  • Early or late onset discrete joints affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

polyarticular JRA

A
  • 5 or more joint involved, typically small joints of hands and feet
  • Seronegative (early onset) or seropositive (late onset)

mean onset is around 10 years
more common in girls

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

SYSTEMIC jra

A
  • Often symmetrical onset usually <5 yrs onset with fever & precipitated by
    infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is there a specific test for JRA, What diagnostic tests could you use in this condition that arent specific

A

No
rheumatoid factor and antinuclear antigen are screening tests but they can be raised in healthy children with infection or other pathology

Full blood count - anaemia, elevated WBC and platelet count (inflammation)
elevated ESR and CRP

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

what diagnositic test is useful for enthesitis arhritis

A

human leukocyte antigen (HLA B27)

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

Does JRA show up on x ray imaging

A

arthritis shows up late in disease on x ray

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

what imaging is gold standard for JRA

A

MRI
early cartilage and soft tissue changes and synovitis

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

typical foot malformations with JRA

A
  1. pes valgoplanus
  2. pes cavus
  3. pseudocavus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what health profession helps with JRA

A

peads rehmatologist

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

TREATMENT for JRA

A

symptom relief, maintaining function

  1. Aspirin/NSAIDs
  2. intravenous and intra articular corticosteroids
  3. methotrexate
  4. biologic if MTX doesnt work
    and
  5. physical therapy for muscle strength and joint ROM
    6.hydrotherapy under paeds physiotherapy - water tempt for inflammatory relief and exercise medium
  6. surgery in chronic cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

prognosis of JRA

A

up to 60% of cases resolve prior to adulthood

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

role of podiatrist for treatment of JRA

A

-manage ROM
-prevent joint alignment issues
-footwear advice/modification
-padding/strapping
-orthoses

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

what impression do you take of accomodative othroses’

A

Foam impression box (SWB/WB/as it lies)- no STJ neurtral

capturing in a compensated foot

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

what impression do you take of functional orthoses

A

suspension cast- holding foot in position that will influence the outcome of orthosis

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

what joints is septic arthritis common in

A

large joints (hip, knee, elbow, shoulder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

clinical features of septic arthritis in infant

A

fever, irritable, sepsis abnormal posture, joint pain, psudeoparalysis

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

clinical features of septic arthritis in child

A

fever, severe pain, muscle spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how can septic arthritis happen

A

haemostasis spread- bacteria carried by bloodstream from infectious area and introduced into joint

contigunous spread- infection overlaying the joint (osteomyleitis or soft tissue infection)

direct implantation- injected into joint or penetrating through trauma

21
Q

what investigations could you use to diagnose septic arthritis

A
  1. CRP/ESR elevated levels
  2. radiography/US for effusion levels
  3. joint aspiration

WBC is unreliable

22
Q

septic arthritis treatment

A

hospital visit
-empirical IV antibiotics
-drainage/ clean out of joint
-immobilisation post drainage
-culture for infection
-directed IV antibiotics
-oral antibiotics for 3 weeks

23
Q

what is the most common cause of limp with hip pain in kids under 10

A

transient synovitis of hip (inflammatory arthirtis of hip)

24
Q

clinical features of transient synovitis of hip

A

pain in hip, anteromedial thigh and knee,
reduced range of motion,
limp,
unilateral pain,
psuedo paralysis (kids dont want to move joint)
more common in boys under 10

25
Q

difference in ROM, fever, ESR and synovial fluid in transient synovitis and sepctic arthritis

A

TS:
ROM- guarded hip rotation
fever- low grade
ESR- <15
synovial fluid- clear

septic:
ROM- pronounced, spasm, guarding, fixed position
Fever- high
ESR->20
synovial fluid- WBC/bacteria

26
Q

connective tissue do what, made up of what

A

hold structures of body together, elastin/collagen

collagen found in- tnedons, ligaments, skin, cartilage, bone and blood
elastin- ligaments and skin

27
Q

until what age are kids expected to be hypermobile (general hypermobility)

A

3 females,
4 males

28
Q

beighton score for hypermobility

A

5/9

29
Q

what is hypermobility spectrum disorder

A

hypermobility that becomes chronically painful and assciated with impaired function (strains, sublax, dislocations)

30
Q

clinical features of hypermobility spectrum disorder

A

joint/muscle pain
fatigue
rolling ankles common

31
Q

what is ehlers danlos syndrome

A

group of genetic connective tissue disorders

can be autosomal dominant or recessive inherited

it is decrease in tensile strength and integrity of skin, joints andother connective tissues

32
Q

most common type of Ehlers danlos syndrome

A

hypermobile type 5- only subtype with an unknown genetic basis/protein pathway

33
Q

clinical features of classic/classic like EDS (type 1/2)

A

skin hypersensitivity
wide, atrophic scars
spheroid formation
joint hypermobility
delay in milestones
hernias due to organ shift

-skin/joints affected

34
Q

clinical features of vascular EDS (type 4)

A

most severe form
mortality reduced to 50years
acrogeria
thin, pale, transluscent skin
fragile blood vessels/ruptures
high risk during vagina delivery
extensive bruising
facial features charaacteristic

35
Q

clinical fetures of hypermobile EDS

A

type 5, most common
skin hyperextensibility
dislocations, sublaxations, hyperextension, pes planus
muscle atrophy/weakness
brusing
smooth skin
early onset osteopenia/OA

36
Q

tests for EDS

A

skin elasticity
thumb to wrist
bruising
pectus exavatum - h-EDS

37
Q

types of EDS

A
  1. hypermobile EDS (type 5)
  2. classic EDS (type 1
  3. classic like EDS (type 2)
  4. vasuclar EDS (type 4)
38
Q

management of EDS

A

activity moderation
sport technique
footwear mods/devices for stability and offloading
strapping/padding

39
Q

marfans syndrome gene and what does it cause

A

autosomal dominant

highest cause of morbitity/mortality from aneurysmal dilation, aortic regurgitation and dissection

40
Q

clinical features of marfans

A

-excess linear growth of long bones (long thumb for example, wrapping hand around wrist)
-hypermobility
-pectus defomrity
-scoliosis/kyphosis
-facial features (sunken eyes, head width/length ratio, under developed cheekbones)
-ocular abnormalities- colour of eyes
-skin straie
-henrias

41
Q

osteogenesis imperfecta clinical features

A

brittle bone disease

-fragile bones/osteopenia
-regular factures
-small stature
-blue sclerae
-hearing loss
-brittle teeth
-muscle weakness
-hypermobility

42
Q

what is epidermis bullosa

A

group of rare genetic diseases of skin causing easy bruising/wounds

elastin/collagen deficiences

43
Q

marfans testing

A

thumb sign, pertrudes past ulnar border
wrist wrap with thumb and 5th finger
ectopia lentis

44
Q

brighton criteria what do you need

A

dignoses hypermobility specturm disorders

need one of the following:
-2 major criterias
-1 major and 2 minor
-4 minor
-2 minor (first degree relative)

45
Q

brighton crtieria

A

major:
-beightons 5/9 or more
-arthralgia 5 or more joints for 3 months or more

minor:
-beightons 1, 2, 3
-back pain or arthralgia longer than 3 months
-sublaxation
-soft tissue rheumatism
-abnormal skin (striae, atrophic healing, excessive extensibility)
-ocular signs
-marfanoid appearance
-exclusion if known marfans or EDS

46
Q

beightons score used to measure

A

generalised hypermobility

47
Q

LLAS used for

A

hypermobility of lower limb

48
Q

pGALS used for

A

detecting abnormal joints

49
Q

PGALS indicated in

A

-unwell child with fever
-limping child
-delayed/regression milestones
-clumsy child

YR3S2- PM4 (12 decks)

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