• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/65

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

65 Cards in this Set

  • Front
  • Back
list the spondyloarthropathies
ankylosing spondylitis
psoriatic arthritis
reactive arthritis
enteropathic arthritis
undifferentiated spondyloarthropathy
what are the common features of spondyloarthropathies?
spinal and sacroiliac joint inflammation
large joint asymmetrical oligoarthritis
RF negative
enthesopathy
specific extra-articular features
family history of psoriasis, IBD or spondyloarthropathy
increased prevalence of HLA-B27
what is the prevalence of ank spond?
0.1%
which gender is more likely to have ank spond? what is the peak age of onset?
3M:1F
peak age onset: 20-30
what is the major presentation of ank spond?
back pain (75%)
what is the enthesis?
site where ligaments and tendons join bone
where in the joint does inflammation occur in ank spond?
enthesis
which sites are affected in ank spond?
fibrocartilaginous sites: SI joint, pubic symph, fibrocartilaginous entheses, manubriosternal junction, intervert disc, specific areas of some tendons, fibrocartilage also in root and wall of aorta
which cells infiltrate the subchondral bone in ank spond?
CD8+ T cells and macrophages
in ank spond, what occurs following infiltration by immune cells?
destruction of cartilage and subchondral bone->new bone formation->formation of syndesmophytes
what is a syndesmophyte?
bony growth attached to a ligament
where does the pain of ank spond begin?
thoraco-lumbar junction or SI joints
t/f... ank spond is not associated with systemic features like fatigue and weight loss
false
t/f... ank spond is associated with inactivity stiffness and pain
true
when is the inactivity stiffness and pain of ank spond worse?
night or early morning
t/f... the loss of lumbar lordosis occurs late in ank spond
false, this occurs early
restriction of which movement occurs earliest in ank spond?
lateral flexion
what is the most common extraspinal feature of ank spond?
peripheral arthritis (occurs in 50%)
which joints are usually involved in the arthritis of ank spond?
large joints in the lower limbs
what extraspinal feature of ank spond affects the eyes?
acute anterior uveitis/acute iritis
what percentage of those with ank spond have acute anterior uveitis?
25%
which sites are affected by enthesitis in ank spond?
lateral epicondyle
plantar fascia
achilles tendon
what are the rare extraspinal features associated with ank spond?
aortitis
upper lobe pulmonary fibrosis
cauda equina syndrome
how long do radiological changes of ank spond take to develop?
5-6 years
in what situation will ESR and CRP be elevated in ank spond?
when peripheral arthritis present
what percentage of those with ank spond are positive for HLA-B27?
90-95%
what percentage of the caucasian population are positive for HLA-B27?
10%
what is the management of ank spond?
exercise
education
NSAIDs (control pain and stiffness)
DMARDs in severe disease (sulphasalazine, methatrexate, TNF-alpha inhibitors)
what is the mean age of onset of psoriatic arthritis?
45 years
what is the peak age of onset of psoriatic arthritis?
30-55
t/f... more men than women are affected by psoriatic arthritis
false, ratio is 1:1
t/f... more women than men are affected by psoriatic arthritis
false, ratio is 1:1
what percentage of those with psoriatic arthritis have skin manifestations before arthritis?
joints before skin?
simultaneous onset?
75%
10%
15%
what is the prevalence of psoriatic arthritis?
2%
what percentage of those with psoriasis have arthritis?
20%
t/f... presence of arthritis is related to the severity of psoriasis
false
where does psoriasis usually occur?
extensor surfaces
t/f... psoriatic arthritis is associated with nail changes such as pitting and onycholysis
true
what are the five patterns of psoriatic arthritis?
oligoarthritis
DIP joints
polyarthritis
arthritis mutilans
spondylitis
what is the commonest pattern of psoriatic arthritis?
oligoarthritis (70%)
what percentage of those with psoriatic arthritis have the DIP type?
10%
how is the polyarthritis pattern of psoriatic arthritis distinguished from RA?
asymmetry and involvement of DIPs
what percentage of those with psoriatic arthritis suffer from arthritis mutilans?
5%
what occurs in arthritis mutilans?
severe joint destruction and osteolysis
t/f... sacroiliitis and spondylitis can be the only manifestation of psoriatic arthritis
true (occurs in 5%)
what is the management of psoriatic oligoarthritis?
NSAIDs
intra-articular corticosteroids
if loss of joint function, DMARDs
synovectomy
what is the management of psoriatic polyarthritis and arthritis mutilans?
DMARDs (methotrexate, salazapyrin, TNF-alpha inhibitors)
intra-articular corticosteroids
physio and exercise
what is the management of psoriatic spondylitis?
physio and exercise
NSAIDs
what is reactive arthritis?
arthritis that occurs 10-14 days after a genital and enteric infection
what causes reactive arthritis?
persistence of bacterial antigen (lipopolysaccharide) in the joint
which infections are associated with reactive arthritis?
chlamydia
shigella
salmonella
yersinia
campylobacter
C. difficile
what is the peak age of onset of reactive arthritis?
20-40
what is the male to female ratio of reactive arthritis?
1:1
what percentage of those with an enteric or gential infection develop a reactive arthritis?
1-5%
how long after an infection does reactive arthritis occur?
10-14 days
what is the average number of joints affected in reactive arthritis?
3
which joints are most commonly affected in reactive arthritis?
knee
ankle
MTP
wrist
what percentage of those with reactive arthritis have sacroiliitis?
9%
what is the average duration of reactive arthritis?
5 months
what percentage of those with reactive arthritis are asymptomatic at 1 year?
85%
which infections are associated with recurrent reactive arthritis?
chlamydia (50%)
campylobacter (33%)
salmonella/yersinia (15%)
t/f... radiography is a useful investigation for acute reactive arthritis
false, radiography has limited value at acute stage
what is Reiter's syndrome?
more severe form of reactive arthritis consisting of arthritis, conjunctivitis and urethritis
t/f... those with Reiter's syndrome are more likely to develop a chronic arthritis
true
apart from arthritis, conjunctivitis and urethritis, what are the other clinical features of Reiter's syndrome?
skin lesions (keratoderma blenorrhagicum, circinate balanitis)
eye involvement (conjunctivitis and anterior uveitis)
carditis (conduction defects)
nephritis (mild proteinuria, macroscopic haematuria)