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Y2 MSK > Artheropathies > Flashcards

Artheropathies Flashcards

(104 cards)

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1
Q

what is the difference between arthropathy, arthralgia and arthritis

A

arthropathy joint disease
arthralgia joint pain
arthritis joint inflam

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2
Q

name 5 seronegative arthropathies

A 
OA
ank spon
psoriatic arthritis
reactive arthritis
IBD arthritis
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3
Q

where are Heberden and Bouchards nodes in osteoarthritis

A

Heberden DIP

Bouchard PIP

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4
Q

bony swellings are seen in osteoarthritis. true or false

A

true

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5
Q

osteoarthritis pain is relieved by rest. true or false

A

true

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6
Q

what is seen in the knee that is linked to osteoarthritis

A

baker’s cyst

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7
Q

what is the first line investigation for osteoarthritis

A

x-ray

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8
Q

what is seen on x-ray is osteoarthritis

A

L loss of joint space
O osteophytes
S subchondral sclerosis
S subchondral cysts

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9
Q

what drug can be given for osteoarthritis pain relief

A

TOP/PO NSAID, capsaicin

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10
Q

what drug can be given during osteoarthritis flare ups

A

intraarticular CCS

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11
Q

what surgeries can be offered for OA

A

arthroplasty, arthrodesis, osteotomy

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12
Q

what is arthroplasty

A

joint replacement

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13
Q

what is arthrodesis

A

surgical induction of ossification of a joint

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14
Q

what is osteotomy

A

removing 1 or both sides of a joint surface

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15
Q

what age can qualify for a total hip replacement

A

older than 65

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16
Q

what are some indications for total hip replacement

A

pain whilst taking analgesia, pain in the night, impaired activities of daily living

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17
Q

what are some side effects of NSAIDs

A

peptic ulcers, renal disease, CVD, asthma, exacerbation, dyspepsia

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18
Q

what gender is RA more common in

A

women

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19
Q

what lifestyle factors affects rheumatoid arthritis

A

smoking

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20
Q

what genetic type predisposes rheumatoid arthritis

A

HLA-DR4

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21
Q

what is seen on x-ray in rheumatoid arthritis

A

soft tissue swelling, juxta-articular osteopaenia, subluxation, loss of joint space

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22
Q

which joints in the hand / feet are commonly affected by rheumatoid arthritis

A

MCP, MTP, PIP

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23
Q

describe how a joint affected by rheumatoid arthritis would appear on examination

A

swollen, warm, tender

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24
Q

what type hypersensitivity is rheumatoid arthritis

A

iv

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25
what clue in the history helps differentiate rheumatoid and osteoarthritis
rheumatoid arthritis morning stiffness for longer than 30 minutes
26
name some extra-articular presentations of rheumatoid arthritis
rheumatoid nodule, pulmonary nodule, eye disease
27
what blood tests would you order for rheumatoid arthritis
FBC, CRP, PV, CCP, ACPA, RF
28
which autoantibody is most specific for rheumatoid arthritis
anti-CCP
29
which autoantibodies are less specific for rheumatoid arthritis
rheumatoid factor, ACPA
30
what is seen on mri in rheumatoid arthritis
bone marrow oedema
31
what is seen on ultrasound in rheumatoid arthritis
synovitis
32
what score is used to measure rheumatoid arthritis disease activity
DAS28
33
what DAS28 score indicates remission
<2.6
34
what DAS28 score qualifies treating with a biologic
>5.1
35
what is the standard combination of medications for rheumatoid arthritis patients
NSAID + PO/IM CCS + DMARD
36
what is the 1st line DMARD for rheumatoid arthritis
methotrexate
37
what are the important side effects of methotrexate
pneumonitis, teratogen, hepatotoxic, mouth ulcer
38
what DMARD can be tried instead of methotrexate for rheumatoid arthritis if the patient has side efffects
leflunomide
39
which DMARDs for rheumatoid arthritis are suitable in pregnancy
1st sulfazalazine | 2nd azathioprine
40
what drug can be given as an adjuvant to DMARDs in rheumatoid arthritis
hydroxychloroquine
41
how quickly should DMARDs be started for rheumatoid arthritis
within 3 months
42
which biologic would be used first for rheumatoid arthritis
IM infliximab
43
what is the mechanism of infliximab
anti-TNF
44
which biologic would be used 2nd for rheumatoid arthritis
rituximab
45
what is the mechanism of rituximab
CD20 B cells
46
what are some important side effects of biologics
reactivate latent TB, teratogen, > melanoma risk
47
what deformities caused by rheumatoid arthritis can be seen on the hands?
Boutonniere, swan neck, Z shape thumb
48
what is a spondyloarthropathy
arthritis affecting spine and sacroiliac joints
49
give 4 examples of spondyloarthropathies
ank spon, psoriatic arthritis, reactive arthritis, enteropathic arthritis
50
what is enthesitis
inflam at insertion of tendon to bone
51
give 2 examples of enthesitis
plantar fasciitis, achilles tenditinitis
52
what gender and age are risk factors for ank spon
men in late teens / early adult
53
what genetic type is a risk factor for ank spon
HLA-B27
54
ank spon mainly affects small joints. true or false
false, affects large joints
55
what are the extra-articular presentations of ankylosing spondylitis
anterior uveitis, photophobia, pulmonary fibrosis
56
what blood tests would be done for ankylosing sponylitis
CRP, PV, ESR (all raised)
57
what imaging is done for ank spon
MRI, XR
58
what is seen on MRI in ank spon
sacroilitis, bone marrow oedema
59
what is seen on XR in ank spon
Romanus lesions, enthesitis, syndesmophyte, bamboo spine
60
what are the first line medications for ank spon
pain relief + biologic
61
what biologics are given for ank spon
anti-TNF | anti-IL17
62
what drugs are given for ank spon if it affects a peripheral joint
methotrexate, sulfasalazine
63
psoriatic arthritis is always symmetric. true or false
false. can be asymmetric
64
what areas of the body are affected by psoraitic arthritis
just spine or just DIP or same pattern as RA
65
what is seen on the hand in psoriatic arthritis
nail changes, sausage finger (dactylitis)
66
what is seen on xr in psoriatic arthritis
pencil in cup, erosions, whiskering enthesopathy
67
management options for psoriatic arthritis
steroids, methotrexate, sulfasalazine, biologics
68
what is the other name for reactive arthritis
reiter's syndrome
69
what predisposes reactive arthritis
UTI or gastroenteritis 1-4wk before
70
genetic predisposition to reiter's syndrome
HLA-B27
71
what are the 3 components that must be present for a diagnosis of reiter's syndrome
urethritis uveitis/conjunctivitis arthritis
72
what joints are affected by reactive arthritis
asymmetric lower limb
73
investigations for reiter's syndrome
ESR, CRP, PV, FBC, XR, blood/urine/stool culture
74
management of reactive arthritis
should resolve 6mth. NSAID + CCS
75
management of reactive arthritis present for >6mth
DMARD
76
what condition is associated with enteropathic arthritis
IBD
77
what parts of the body are affected by enteropathic arthritis
asymmetric large joints
78
what is seen on ultrasound in enteropathic arthritis
synovitis
79
management of enteropathic arthritis
treat IBD, DMARD if resistant
80
what gender is a risk factor for gout
men
81
what aspect of diet is a risk factor for gout
alcohol, purines (red meat, shellfish, red wine, chickpeas etc.)
82
is gout hypertrophic or erosive
erosive
83
what are purines converted to in the body
uric acid
84
what is deposited at joints in gout
monosodium
85
what medications are risk factors for gout
diuretic, cyclosporine
86
what joint is most commonly affected by gout
1st MTP
87
what sign is seen in chronic gout
tophi
88
what is the gold standard test for diagnosing gout and what does it show
joint aspirate for polarised light microscopy showing needle shaped crystals and negative birefringence
89
what is seen on XR in an acute gout attack
nothing
90
what is seen on XR in recurrent gout
erosions, osteophytes, destructive arthritis
91
management of gout during an acute attack
naproxen or colchicine
92
side effect of colchicine
diarrhoea
93
when is gout prophylaxis indicated
>2 attacks, XR changes, renal stones, tophi
94
prophylactic management of gout
allopurinol
95
mechanism of allopurinol
xanthine oxidase inhibitor
96
side effect of allopurinol
skin rash
97
alternative to allopurinol if side effect (skin rash)
febuxostat
98
age thats a risk factor for pseudogout
70-80 years
99
joints affected by pseudogout
knee, wrist, ankle
100
what is seen on xr in pseudgout
chondrocalcification
101
what is seen on microscopy of joint aspirate in pseudogout
rhomboid chape calcium pyrophosphate crystals, weakly positive birefringence
102
management options for pseudogout
NSAID, colchicine, CCS
103
how do you monitor a DMARD
LFT, FBC 6 monthly
104
name 5 DMARDs
methotrexate, leflunomide, sulfazalazine, azathioprine, hydroxychloroquine

Y2 MSK (20 decks)

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