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Arthritides Flashcards

(48 cards)

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1
Q

What condition is associated with Heberden’s and Bouchard’s nodes?

A

Osteoarthritis

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2
Q

What does osteoarthritis look like on an X ray?

A

Loss of joint space
Osteophytes
Subchondral cysts
Subarticular sclerosis

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3
Q

What are the main medical options for analgesia in osteoarthritis?

A

First line is paracetamol and topical NSAIDs

Then add oral NSAIDs and codeine

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4
Q

Apart from paracetamol, NSAIDs and codeine, what other pharmacological therapies can be used to relieve pain in osteoarthritis?

A

Topical capsaicin

Intra-articular steroid injections

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5
Q

What is hallux rigidus?

A

Osteoarthritis of the first metatarsophalangeal joint

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6
Q

What is the management of hallux rigidus?

A

Shoe modification
Orthotics
Debridement of osteophytes

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7
Q

Where are Heberden’s nodes found?

A

Distal IP joints

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8
Q

Where are Bouchard’s nodes found?

A

Proximal IP joints

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9
Q

What signs suggest joint damage as a result of rheumatoid arthritis?

A 
Ulnar deviation of the wrist and fingers
Swan neck and Bouttoniere deformities
Z deformity of the thumb
Rupture of extensor tendons
Atlanto-axial joint subluxation
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10
Q

Give 3 systemic features of rheumatoid arthritis

A

Weight loss
Fatigue
Fever

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11
Q

Give 3 pulmonary features of rheumatoid arthritis

A

Pleural disease
Fibrosis
Bronchiolitis obliterans

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12
Q

Give 3 cardiac features of rheumatoid arthritis

A

Ischaemic heart disease
Pericarditis
Pericardial effusion

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13
Q

Give 3 ophthalmological features of rheumatoid arthritis

A

Episcleritis
Scleritis
Scleromalacia

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14
Q

In what percentage of rheumatoid arthritis cases is rheumatoid factor positive?

A

70%

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15
Q

Which antibody is highly specific and reasonably sensitive for rheumatoid arthritis?

A

Anti-CCP antibodies

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16
Q

What is the first line management of rheumatoid arthritis?

A

cDMARD monotherapy with glucocorticoid bridging until cDMARD takes effect

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17
Q

Give 3 examples of cDMARDs used to treat rheumatoid arthritis

A

Methotrexate
Leflunomide
Sulfasalazine

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18
Q

What is the goal of drug therapy in rheumatoid arthritis?

A

Remission or low disease activity

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19
Q

What should be done if initial cDMARD dosage is insufficient in the treatment of rheumatoid arthritis?

A

Increase dose

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20
Q

What is the next step in the management of rheumatoid arthritis if maximum dose cDMARD monotherapy is insufficient?

Study These Flashcards
A

Add a second DMARD

21
Q

What is the next step if cDMARD therapy has put rheumatoid arthritis into remission?

Study These Flashcards
A

Step down or stop drugs

22
Q

What is the next step in the management of rheumatoid arthritis if conventional DMARD combination therapy is insufficient?

Study These Flashcards
A

Offer a biological DMARD either alone or with methotrexate

23
Q

Give 3 examples of biological DMARDs used to treat rheumatoid arthritis

Study These Flashcards
A

Infliximab
Adalimumab
Etanercept

24
Q

What is the last resort for treatment of rheumatoid arthritis if all other treatments have failed?

Study These Flashcards
A

Long term glucocorticoid therapy

25
What are risk factors for rheumatoid arthritis?
HLA DR1 and HLA DR4 Smoking Being female
26
Give 4 clinical features shared by the spondyloarthritides?
Axial arthritis Enthesitis Dactylitis Extra-articular manifestations
27
Which bones/joints are affected in ankylosing spondylitis?
Spine and sacroiliac joints
28
Where is the pain in ankylosing spondylitis?
Lower back, radiates from sacroiliac joints to hips/buttocks
29
When is the pain worse in ankylosing spondylitis?
Night
30
Give 3 extra-articular manifestations of ankylosing spondylitis
Enthesitis Costochondritis Iritis
31
What key feature does imaging show in ankylosing spondylitis?
Vertebral syndesmophytes - fusion of vertebral body with the one above
32
What class of biological drugs is used to treat ankylosing spondylitis?
TNF-alpha blockers
33
Give 4 types of spondyloarthritis
Ankylosing spondylitis Enteric arthropathy Psoriatic arthritis Reactive arthritis
34
What can be used to manage resistant cases of enteric arthropathy?
DMARDs
35
Give 2 ways in which psoriatic arthritis can present
Symmetrical polyarthritis | Asymmetrical oligoarthritis
36
What can psoriatic arthritis progress into?
Psoriatic arthritis mutilans
37
Give 5 extra-articular manifestations of psoriatic arthritis
``` Psoriasis Synovitis Nail changes Acneiform rashes Palmo-plantar pustulosis ```
38
What does X ray show in psoriatic arthritis?
Erosive changes | Pencil-in-cup deformity in severe cases
39
Give 3 types of drug used to manage psoriatic arthritis
NSAIDs DMARDs anti-TNF agents
40
How long after infection does reactive arthritis typically occur?
2-4 weeks
41
What HLA allele is associated with psoriatic arthritis?
HLA B27
42
What is the triad in Reiter's syndrome?
Oligoarthritis Urogenital tract infection Uveitis
43
Which organisms are the most common causes of post-enteric reactive arthritis?
Campylobacter Salmonella Shigella
44
Which organisms are the most common causes of post-venereal reactive arthritis?
Chlamydia trachomatis | HIV
45
What is Poncet's disease?
Reactive arthritis associated with tuberculosis
46
What is the immediate management of reactive arthritis?
Splint joints NSAIDs Local steroid injections
47
What drugs can be given if reactive arthritis persists for over 6 months?
Sulfasalazine | Methotrexate
48
What is the management of ankylosing spondylitis?
Exercise TNA-alpha blockers Local steroid injections Surgery

MSK (8 decks)

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