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PHTH 565 - Rheumatology > Ankylosing Spondylitis > Flashcards

Ankylosing Spondylitis Flashcards

(66 cards)

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1
Q

2 areas of inflammation of the spine?

A
  1. sacroiliitis

2. spondylitis

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2
Q

_________ affects peripheral joints of the body, legs > arms and is typically on one side of the body

A

synovitis

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3
Q

_______ = inflammation where ligaments, tendons and joint capsule attach to bone

A

enthesopathy

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4
Q

Does blood work of spondyloarthritis usually show RF?

A

NO

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5
Q

Tendency for spondyloarthritis to run in families (T/F).

A

TRUE

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6
Q

_______ = sausage like fingers and toes due to swelling, seen in psoriasis

A

dactylitis

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7
Q

________ = in psoriasis, especially in heels and back

A

enthesitis

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8
Q

Psoriatic arthritis = affects __-__% of those with ideas

A

15-30

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9
Q

Male and female prevalence in psoriasis? Age of onset?

A

male = female; 30-50, can begin in childhood

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10
Q

5 subgroups of psoriatic arthritis ?

A
  1. DIP arthritis
  2. olygoarthritis less than or equal to 2-4 joints (asymmetric)
  3. symmetrical polyarthritis
  4. arthritis mutilans
  5. SI joins and spine (psoriatic spondylitis)
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11
Q

Can psoriatic arthritis have conjunctivitis / iritis in the eye?

A

Yes

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12
Q

Spondylitis and iritis = more common in people who are _____ +

A

HLA-B27

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13
Q

Enteropathic spondylitis = ______ arthropathy

A

intestinal

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14
Q

Enteropathic spondylitis may affect the ____ and ___ joints, also joints in the legs and arms

A

spine; SI

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15
Q

Reactive arthritis = generally (asymmetrical/symmetrical)

A

asymmetrical

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16
Q

Reactive arthritis usually occurs in the _____ limbs.

A

lower

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17
Q

Reactive arthritis = triggered by infection in the _____ or ________ tract

A

bowel; genitourinary

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18
Q

AS = stiffness / fusing of the spine by ______

A

inflammation

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19
Q

AS = essentially a disease of ______ _______

A

young adults

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20
Q

Average age of AS?

A

26

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21
Q

Contracture of which joints are common in AS?

A

hip and knee

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22
Q

Gender ratio of AS?

A

1:1

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23
Q

Cause of AS?

A

unclear

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24
Q

AS associated with genetic marker ____-____

A

HLA-B27

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25
___ - ___ % of people with AS are HLA B27+
90-95
26
MSK involvement of AS?
1. sacroiliitis 2. enthesitis 3. synovitis
27
4 other systems + organs involved in AS?
1. eyes 2. bowel 3. lungs 4. heart
28
_______ = hallmark sign of AS
sacroiliitis
29
Sacroiliitis is more common (bilaterally/unilaterally)
uni
30
______ leads to bony erosion, bony overgrowth (syndesmophytes), possible bony fusion and rigidity
enthesitis
31
Enthesitis in AS = inflammation starts in __ joints, progresses in ascending fashion affecting all levels of spine
SI
32
Common sites for enthesitis can include both ____ and ______ regions
spine; periph
33
Dx of enthesitis time?
up to 5-6 years
34
Early stage enthesitis ?
bony loss --> osteopenia
35
Later stage enthesitis ?
OP --> risk of # | fusion/rigidity --> risk of #
36
______ usually affects peripheral joints, including the shoulder, hips and knees
synovitis
37
In synovitis, involvement of joints may precede, accompany or follow ______ involvement
spinal
38
In synovitis, peripheral joint involvement occurs in __% of cases
30
39
AS pt's will have (increased/decreased) lung capacity
decreased
40
Definite AS = if _______ criterion is associated with at least 1 _____ criterion
radiologic; clinical
41
Radiologic criterion for AS?
sacroilitis grade >/= 2 bilaterally or grade 3-4 unilaterally
42
Iritis and uveitis = ___ % in AS cases
30
43
Increase in CV risk __-__ fold in AS
2-3
44
Pain in spondyloarthritis = worse after ___, intermittent or persistent
rest
45
Sources of pain in spondyloarthritis include what 4 things?
1. enthesitis 2. sacroiliitis 3. synovitis 4. muscle spasm
46
Stiffness in spondyloarthritis?
am stiffness in spine
47
Stiff in spondyloarthritis after periods of _______, relieved with ______
inactivity; movement
48
ROM in spine in pt's with spondyloarthritis decreases in which directions?
All
49
Decreased strength in spondyloarthritis due to what 3 things?
1. disuse 2. joint effusion 3. pain
50
____ posture in spondyloarthritis
flexion
51
Changes in what 2 joints limits lateral costal breathing in spondyloarthritis?
1. cosotchondral | 2. costovertebral
52
5 new criteria for inflammatory back pain (> 3 months)?
1. improvement with exercise 2. pain at night 3. insidious onset 4. age of onset < 40 years 5. no improvement with rest
53
8 standardized measures in arthritis assessment?
1. tragus to wall 2. lateral flexion 3. trunk flexion 4. extension 5. rotation 6. breathing 7. neck side flexion 8. neck rotation
54
5 common enthesitis sites for PsA?
1. achilles 2. patella 3. plantar fascia 4. anseranus bursa 5. greater trochanter of femur
55
4 ways to manage spondyloarthritis ?
1. medication 2. physical interventions 3. lifestyle / self-management 4. sx
56
DMARDS (are/are not) effective in axial disease
are NOT
57
_________ are responsive to all domains
biologics
58
6 key recommendations for PT in pt's with AS?
1. PT should start ASAP once dx 2. PT Ax should be detailed and use outcome measures, rx should be based on clinical status 3. PT should occur regardless of disease status 4. lifelong regular exercise is mainstay of rx 5. flexibility, stretching, breathing ex's, pool ex's, land ex's and recreational activities recommended 6. PT modalities should be used as adjunctive therapies based on use in MSK disorders
59
4 ways to control inflammation?
1. activity / rest 2. ice 3. compression 4. exercise
60
3 ways to increase mobility / decrease stiffness?
1. exercise 2. pool 3. manual therapy
61
3 R's in sx management of spondyloarthritis?
1. realign 2. rest 3. replace
62
Realign in sx mangement?
osteotomy
63
Rest in sx mangement?
arthrodesis
64
Replace in sx mangement?
arthroplasty
65
9 clinical features in AS?
1. pain 2. stiffness 3. decreased ROM 4. decreased strength 5. deformity/instability 6. altered posture/muscle imbalances 7. altered breathing mechanics 8. fatigue 9. deconditioning
66
3 clinical criteria for AS ?
1. LBP w/ stiffness for more than 3 months that improves with exercise but is not relieved by erst 2. limitation of motion of the L spine in both the sagittal and frontal planes 3. limitation of chest expansion relative to normal values correlated for age and sex

PHTH 565 - Rheumatology (8 decks)

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