Wk 7-12 LO Consolidation

Question 1

What is onycholysis? In what condition is it commonly seen?

Answer 1

• Removal of the nail from the nail bed (onycho = nail, lysis = cut away)
• Commonly seen in psoriatic arthritis

Question 2

What signs of psoriatic arthritis may be seen in the hands/feet?

Answer 2

• Pitting of the nails (small spots)
• Onycholysis
• Dactylitis
• Enthesitis

Question 3

X ray changes in psoriatic arthritis

Answer 3

(DOPPA)
- Dactylitis
- Osteolysis
- Pencil-in-cup appearance
- Periostitis
- Ankylosing (fusing of bones)

Question 4

What are DMARDS? Give an example of one. What conditions can they be used to treat?

Answer 4

• Disease Modifying Anti-Rheumatic Drugs
• One example is methotrexate
• They can be used to treat RA and seronegative arthritides (Ank Spond, Psoriatic Arthritis, Reactive Arthitis)

Question 5

Outline the types of drugs used for rheumatoid arthritis and seronegative arthritides. How do each of these work, and what do they do?

Answer 5

• NSAIDS (inhibit COX-1/COX-2 pathways, reducing inflammation)
• DMARDS (e.g. methotrexate; immunosuppressant)
• Corticosteroids (reduce inflammation by altering dna transcription at the cellular level)
• Biologic agents (obtained directly from biologic sources)

Question 6

Describe distribution of pain in the hands in RA, OA, and psoriatic arthritis

Answer 6

RA: MCP and PIP, carpus

OA: PIP, DIP

Psoriatic: PIP, DIP

Question 7

Marginal erosions of the MCP and PIP found on x ray. Most likely type of arthritis?

Answer 7

Rheumatoid.

Question 8

What is the difference between OA and erosive OA, mechanistically?

Answer 8

Erosive OA has an inflammatory component

Question 9

Are bone erosions seen in gout vs CPPD?

Answer 9

• No erosions seen in CPPD
• Erosions seen in gout