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24 Cards in this Set
- Front
- Back
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where is ankylosing spondylitis most common?
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in the spines of men
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where must you look to find psoriatic arthitis?
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on the scalp and behind the ears
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what are the 3 different types of spondyloarthropathies?
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ankylosing spondylitis,
psoriatic arthitis, reactive arthritis, |
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what gene is considered a susceptibility for spondyloarthropathies? which type of spondyloarthropathies has the highest correlation
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HLA-B 27
highest- ankylosing spondylitis with >90% association |
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what are the nonvertebral symptoms associated with spondyloarthropathies?
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asymmetric peripheral arthritis
arthritis of Toe and IP joints sausage digits achilles tenosynovitis plantar fasciitis costochondritis iritis mucocutaneous lesions |
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22 yo male pt comes into your office complaining of low back pain that just doesn't go away. He said that he wakes up stiff and flexed and as the day progresses he feels better. You do a schober's test on them and find that their lumbar spine is not becoming kyphotic. Dx. which joint must be involved for your diagnosis to be right?
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ankylosing spondoylitis
the SI joint must be involved. |
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who is more likely to get ankylosing spondylitis?
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men ages 15-40
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what are the laboratory findings for ankylosing spondylitis?
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ESR- increased in 85%
RF- negative Mild anemia HLA- B27 |
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what is a MAJOR concern with undiagnosed anklylosing spondylitis?
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uveitis
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what is the main tx for ankylosing spondylitis? what are the other txs?
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PT and OT- to maintain posture
tx: exercise stop smoking NSAIDs sulfalsalazine and MTX anti-TNF agents |
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what correlates with arthitis better than extensive skin lesions in psoriatic arthritis?
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nail pitting or onycholysis
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pt presents with inflammatroy arthritis in the DIPs, no rheumatoid nodules, sausage digist and onycholysis. dx
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psoriatic arthritis
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what is the most classic case of psoriatic arthritis?
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DIP arthritis w/ nail change
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what is the most common case of psoriatic arthritis?
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asymmetrical oligoarthritis + psoriasis
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how do you manage psoriatic arthritis?
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methotrexate, leflunomide, anti-TNF agents ---- 1st choice
then: topicals, PUVA, NSAIDs, sulfasalazine, and surgery |
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in 80% of pts with psoriatic arthritis, does the psoriasis preceed the arthritis or does it follow the arthritis?
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preceed
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what is reactive arthritis?
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seronegative asymmetrical arthritis following
- urethritis or cervicitis or infectious diarrhea |
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joint pain, RF negative, recent salmonella infection... what should fly to the top of your DDX?
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reative arthritis
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what veneral bacterial infection can cause reactive arthritis?
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chlamydia trichomatis
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Reactive arthritis is often associated with?
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enthesopathy
inflammatory eye disease balanitis, oral ulcer or keratodermia sacroiliitis |
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how do you manage reactive arthritis syndrome?
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antibiotics, NSAIDS, ophthalmic rxns, steroids, remittive agents, cytotoxic drugs and biologic agents.
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why would antibiotics work in the management of reactive arthritis syndrome even if there was NOT an infection?
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it inhhibits metalloproteinase affects which causes an antiinflammatory affect.
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what percentage of reactive arthritis pts are HLA B-27 +?
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50-80%
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what are the four most common features of reactive arthritis?
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oligoarthritis, conjunctivitis, urethritis, and mouth ulcers
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