HLA B27 Disorders

Question 1

HLA-B27 disorders

Answer 1

Ankylosing spondylitis
Reactive arthritis
Reiters syndrome
IBD
Psoriatic arthritis
Whipples dz

Question 2

HLA-B27 is associated with which race?

Answer 2

Scandanavian males

Question 3

Ankylosing Spondylitis (AS)

Answer 3

Chronic inflammatory dz of the joints and skeleton.
Sacroiliac joints and hips
Enethesis inflammation

Question 4

AS S/S

Answer 4

Insidious onset low back pain over 3 months.
Improves with exercise
Morning stiffness for >30 mins
Awakened by pain during 2nd half of night

Question 5

AS imaging

Answer 5

Erosion and sclerosis of SI joints

Bamboo spine

Question 6

AS epidemiology

Answer 6

Male 20-40

Question 7

Reactive arthritis

Answer 7

Post-infection arthritis

Usually GI, GU

Question 8

Reactive Arthritis Triad

Answer 8

Arthritis
Urethritis
Conjunctivitis

Question 9

Reiters Syndrome

Answer 9

Post-venereal reactive arthritis plus other manifestations

Question 10

Psoriatic Arthritis (PsA)

Answer 10

Chronic inflammatory arthropathy in setting of psoriasis.

Question 11

PsA S/S

Answer 11

Inflammatory arthritis in DIP’s
Assymetric arthritis
Sausage digits
Nail pitting

Question 12

Reiters saying

Answer 12

Cant See
Cant Pee
Cant climb a tree
Don’t sleep with me

Question 13

Do you see nodules on the fingers in PsA?

Answer 13

No

Only in rheumatoid

Question 14

PsA radiology

Answer 14

Pencil and cup deformity

Question 15

Tx for all spondyloarthropathies

Answer 15

NSAIDS first
PT
Sulfasalazine, methotrexate

Question 16

Polymyalgia Rheumatica (PMR)

Answer 16

Aching and stiffness in shoulder and pelvic girdles and neck.
Older people
Responds to low dose steroids

Question 17

PMR is associated with?

Answer 17

Giant cell arteritis

Question 18

PMR discomfort

Answer 18

Stiffness in the morning
BIlateral
Worse w/ movement and exercise

Question 19

Most common presenting pain of PMR

Answer 19

Shoulder pain (70-95%)
Hips and neck (50-70%)
Pain usually radiates distally

Question 20

DIfferentiation PMR from RA

Answer 20

RA is small joints in hands and feet and only partially responds to steroids

Question 21

PMR Tx

Answer 21

NSAIDS
Corticosteroids
Resolutions seen in a few days

Question 22

Giant Cell Arteritis (GCA)

Answer 22

Chronic vasculitis of medium and large vessels

Common in older women

Question 23

GCA Patho

Answer 23

Vasculitis of extracranial branches of aorta, spares intracranial.
Transmural inflammation

Question 24

GCA S/S

Answer 24

Headache
Jaw Claudication
Constitutional

Question 25

GCA Tx

Answer 25

Prednisone

ASA

Question 26

Is biposy required for Tx of GCA?

Answer 26

Not if clinical suspicion is high

Question 27

Fibromyalgia Syndrome (FMS)

Answer 27

Widespread muscular pain, fatigue and muscle tenderness.

Question 28

Is FMS inflammatory?

Answer 28

No

Question 29

FMS Patho

Answer 29

Causes by abnormal sensory processing in CNS.

May be extremely sensitive to pain and unpleasant sensations.

Question 30

FMS Systemic sx

Answer 30

Poor sleep
HA
IBS
Memory problems
Paresthesias
RLS
TMJ

Question 31

FMS is most common in?

Answer 31

MIddle aged women

Depression

Question 32

FMS Tx

Answer 32

TCA's
SSRI's
NSAIDS
Stress MGMT
Exercise

Question 33

Differentiating FMS from PMR

Answer 33

Sed Rate

Steroid challenge