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Arthritis Flashcards

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1
Q

What is the cause of OA?

A

This is a contain where there is loss of cartilage and synovium in synovial joints, with associated joint space narrowing, there is all decreased collagen synthesis

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2
Q

What is OA the most common cause of?

A

Hip Pain!

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3
Q

What is the M:F prevalence of OA?

A

1:3

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4
Q

What is nodal osteoarthritis?

A

This is OA in the DIP and the PIP joints and is seen unilaterally in the hands of post menopausal women

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5
Q

What are the risk factors for OA?

A 
Previous joint trauma
Obesity 
Hypermobility 
FH 
Occupation
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6
Q

What are the symptoms of OA?

A 
Joint pain
Smooth bony swellings
Stiffness
Loss of range of movement 
Loss of function
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7
Q

What are the signs of OA?

A 
Limited ROM
Bone swelling 
Joint effusion 
Muscle wasting 
Smooth bony out-pouches
Heberdens nodes(DIP)
Bouchards nodes (PIP)
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8
Q

What are the investigations for OA?

A

Full history and hand/ joint examination
X-ray
MRI
Arthroscopy -early fissuring and surface erosion

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9
Q

What is the management of OA?

A

Treat symptomatically
NSAID’s
Hyaluronic acid derivatives
Heat packs and v occasionally surgery to replace joints etc

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10
Q

What are the 3 HALLMARK symptoms of OA?

A

Joint stiffness in the morning that lasts for longer than 3o minutes
Joint pain
Activity exacerbates the pain

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11
Q

Give 3 DD’s of OA

A

Gout
Malignancy
Other arthritis forms
Septic arthritis

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12
Q

What is Rheumatoid Arthritis?

A

This is a chronic systemic autoimmune condition causing symmetrical arthritis in the small joints of the hands and feet

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13
Q

What is the epidemiology if RA?

A

3% of the population
M:F =1:2
Women before menopause have the greater risk

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14
Q

What 2 genes can be afftemed in RA? How do these teens affect the prognosis?

A

HLA-DR4
HLA-DR1
These both carry a worse prognosis

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15
Q

What re the risk factors for RA?

A

Infection
Trauma
Smoking

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16
Q

What are the key symptoms of RA?

A

Morning stiffness lasting longer than an hour
Affects more than 3 joints in the hands and feet
Symetrical pattern
Nodules present

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17
Q

Whta it THE diagnostic test for RA?

A

Anti CCP = Anti-cyclic citrullinated protein antibody

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18
Q

What are some other necessary investigations in RA? Why is RF also raised in another condition?

A

Rhematoid factor - non-specific also increase in Sjoren’s syndrome
X-ray
FBC =anaemia and increased rheumatoid factor
Joint aspiration

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19
Q

What is the 1st line management of RA?

A

NSAID’s

Disease Modifying Anti Rhematic Drugs (DMARD) eg METHOTREXATE and Sulfazaline

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20
Q

What other managements can we use

A

Biologics eg Rituximab
Cortocosteroids
Phsioptherapy etc

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21
Q

What re some of the features in the hand suggestive of RA?

A

Swollen, arm joints
Muscle wasting
Limited ROM
Disturbed sleep

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22
Q

What are some of the systemic sings on RA?

Study These Flashcards
A 
Lymphadenopathy
Splenomegaly 
Anaemia 
Vasculitis 
Diffuse fibrosis and effusion of the lungs
Scleritis/cataracts/glaucoma
23
Q

What is your DD of RA?

24
Q

What is the other name of Seronegative arthritis?

Study These Flashcards
A

Spondyloarthritis

25
What is seronegative arthritis?
This is an inflammatory joint disease afftecing the spine and the sacroiliac joints
26
What is the HALLMARK of the investigation is seronegative? Hint: Clue is literally in the name
Negative RF
27
What gene is SNA associated with?
HLA-B27
28
What is the main type of SNA?
Ankylosing Spondylitis
29
When do men tend to present with AS?
Around age 16
30
What is the pathogenesis of AS?
There is inflammation at the enthuses ie where the ligament joints to the vertebra This heals and causes new bine formation This eventually leads to the fusion of the vertebra This causes the fixed spinal deformity = kyphosis
31
What are the clinical features of AS?
``` Spine and lower back pain Present in the later teenage years Their e more stiff in the morning Woken during the night Relieved by exercise ```
32
What are the systemic features of AS?
Peripheral OA Uveitis Aortic incompetence Nail dystrophy
33
What examination test do you want to do?
Schrober's test
34
What investigations are you going to do? | What is the grading scale of the imaging?
X-ray/ MRI 0-4 depending on the severity Bloods show raised ESR and CRP
35
What are the management options?
Spinal exercises NSAID's Anti-TNF DMARDS Surgical for fusion of joints
36
Is AS familial?
Yes
37
What percentage of those with Psoriasis have psoriatic arthritis?
10%
38
What are the associations with PA?
Smoking, RA | HLA-B27
39
What are the clinical features of PA?
Plaques on the skin | Arthritis and pain in the weight bearing joints
40
What are the investigations?
Clinical diagnosis
41
What is the management of PA?
Same as RA -DMARDs
42
What is reactive arthritis, what is it also known?
Reiter's syndrome
43
What are the associations of reactive A?
``` STI's Acute diarrhoea GI infection Salmonella Shigella Campylobacter ```
44
What are the 3 'E" symptoms of reactive arthritis?
Cant See - conjunctivitis Cant Pee - urethritis Cant bend at the knee - arthritis affects the knee and ankle
45
What are the investigations of reactive arthritis?
Blood culture Stool sample STI screen raised EsR and CRP
46
What are the managements of reactive arthritis?
Rx the original infection and then reassure the arthritis should have cleared in 4 months if it has not then consider DMARD's
47
What is JIA?
Systemic inflammatory disorder that affects children under the age of 16
48
What is a very common presentation of JIA?
A child who has a new limp or is refusing to walk
49
What are the 3 subtypes of JIA?
Pauciarticular Polyarticular Systemic onset
50
What are the 3 types of pauarticular?
``` 1 = most common and more common in girls, 4 or less joints are affected, positive ANA 2 = more boys , affecting lower limbs older than 8 3 = more girls, any age, asymmetrical UL and LL, FH psoriasis ```
51
What are the features of polyarticular?
5 or more joints and tend to affect more girls, they also have systemic disease Can be RF +/-
52
What are the features of systemic onset? What is it otherwise known as?
They have other features such as rash, lymphadenopathy | Hepatosplenomegaly, PE, fevers
53
What are the managements of JIA?
NSAIDs DMARDs Biologics

MSK Revision (14 decks)

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