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MS1: Seronegative Spondyloarthropaties Flashcards

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1
Q

what are spondyloarthropaties

A

group 2 inflammatory but non infectious - so negative sa RH factor

erosive din sha

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2
Q

what parts of the body do spondyloarthropaties usually affect

A

SI joint

sa IV disc

bony insertions ng mga tendon sa spine

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3
Q

classifications of spondyloarthropaties

A

inflammatory back pain

axial spondyloarthritis

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4
Q

mga disease under axial spondyloarthritis

A

ankylosing spondylitis

reiter’s

psoriatic arthritis

chronic inflammatory disease

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5
Q

general characteristics present in SS

A

negative RH
sacroilitis
axial involvement
peripheral arthrtis
enthesopathy
eye involvement
family clustering
LOM
HLA-B27

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6
Q

common symptoms SS

A

insidous onset of backpain at 30 yo for several months

pain more at rest - relieved by lakad

if may family history

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7
Q

discuss criteria of classification for axial spondyloarthritis

A

sacroilitis plus 2 other features

IBP
arhtritis peripheral
enthesitis
uveitis
dactylitis
psoriasis
crohns or UC
family history
HLA B27
elevated CRP

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8
Q

most common type of SS

A

ankylosing spondylitis

nag ffuse spine

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9
Q

discuss charactericts AS

A

chronic progressive inflammatory - SI pataas

undetermined cause

inflammation of insertion ng ligaments, tendons and capsules

may extraarticular involvement

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10
Q

primary joints affected AS

A

SI - hallmark

spine

large peripheral joints - hips and joints

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11
Q

hallmark joint of AS

A

SI

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12
Q

which popu is AS more common

A

males 35 yo.

genetic sa HLA-B27

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13
Q

classic presentation of AS

A

mid 20s sa male

middle or low back pain localized to pelvis, buttocks and hips

morning stiffness more than an hour - more than 3 mo.

paravertebral muscle spasm, aching stiffness

xray sacroilitis

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14
Q

PE of AS

A

dec mob = reduced lumbar flexion and lordosis

rarely tender and SI

spine becomes fused

+ schober’s test

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15
Q

lab findings of AS

A

+ HLA-B27
- RF and ANA
elevated ESR, serum IGA, bone alkanise phosphatase and CK

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16
Q

radiologic finding of ankylosing spondylitis

A

bamboo spine

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17
Q

complications of AS

A

fracture/SCI common sa cervical

osteoporosis

pseudoarthrosis sa thoracolumbar

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18
Q

discuss reactive arthritis

A

sterile infflamatory arthritis - reactive to infections away from joint

UTI ganun

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19
Q

discuss reiter’s syndrome

A

type of reactive arthritis

may triad - conjunctivitis, urethritis and arthritis

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20
Q

discuss DD of reactive from reiter

A

may triad yung reiter

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21
Q

discuss DD of reactive to septic arthritis

A

pag inaspirate no pus in joint sa reactive

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22
Q

how are reactive and reiters related

A

both positive for HLA-B27

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23
Q

features of reiters

A

triggered by infection - 1-4 wks after onset

fever, malaise, weight loss

assymetric affecting large joints

group 2 - sterile inflammatory

may extraarticular - eyes and mucocutaneous lesion

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24
Q

other name for reiters

A

oculo-urethro-synovial syndrome

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25
hans reiter description of reiter's
urethritis conjunctivitis arthritis following bloody diarrhea
26
what are the mucocutaneous lesion in reiters
oral ulcers keratoderma blennorrhagica circinata balatis nail changes 4th criteria toh
27
common popu of reiters
3rd decade and less in children men
28
discuss post venereal and dysenteric reiters syndrome
venereal - males dysenteric - equal males and females
29
urogenital pathogens of reiters
chlamydia
30
enteric pathogens of reiters
shigella salmonella yersinia campylobacter vibrio
31
common joints affected of reiters
knees and ankles less sa SI weight bearing joints of LE
32
discuss skin lesions reiters
resembles psoriasis keratoderma blennorrhagica - soles, palms circinata balatis - tite onycholysis - nails oral ulcers
33
other extraarticular manifestations in reiters
cardio-pulmo and nerve lesions
34
determine if AS or reiters no urethritis and conjunctivitis
AS
35
determine if AS or reiters urethritis and conjunctivitis is common
reiters
36
determine if AS or reiters SI and spine is involved and symmetric involvement
AS
37
determine if AS or reiters knee and ankle and assyemtric involvement
reiters
38
what is psoriatic arhtritis
chroninc and recuurent tas erosive GROUP 2 - associated w psoriasis combines features of RA and spondyloarthropathies
39
sex predilection of psoriatic
equal sex but women tend to develop symmertric and spinal involvement
40
common age for psoriatic
20-30 yo
41
discuss onset for psoriatic
acute or insidous preceded by skin disease
42
risk factors fro psoriatic
unknown cause but HLA B27 marker is common
43
common joints affected in psoriatic
DIP, spine and SI precedes skin lesion after 1 yr
44
pattern of arthritis in psoriatic
DIP - MCP and MTP later assymetric oligo but symmetric poly axial - ankylosing arthritis mutilans - erosive
45
SSx psoriasis
pain and stiffness in inflamed joint morning stiffness more than 30 mins pain on stressing joint, tenderness and effusion aggravated by prolonged immob and reduced by rest
46
if PSA or AS less SI involvement
PSA
47
if PSA or AS back and neck pain LOM of lumbar and cervical
AS
48
if PSA or AS ankylosing
both
49
if PSA or AS 20-30 yo
PSA
50
if PSA or AS 40 up
AS
51
if PSA or AS SI changes in 10-30%
PSA
52
if PSA or AS agad na grade 4 sacroilitis
AS
53
if PSA or AS skin lesion
PSA
54
dicuss dactylis in PSA
sausage digits - inflammation of tendon sheat in fingers
55
nail lesion in PSAs
pitting ridging crackling onycholysis
56
other manifestations in psoriatic
uveitis conjunctivitis aortic valve insuff
57
skin manifestations psoriatic
auspitz - pinpoint bleeding koebners - new skin lesions on injured skin areas
58
lab findings in psoriatic
+ HL4 - Rh
59
radiologic findings in psoriatic
pencil cup deformity
60
discuss inflammatory bowel disease
chronic inflammatory dieases in GIT
61
causes of inflammatory bowel disease
genetic predispo environment autoimmune
62
2 major types of inflammatory bowel disease
crohns ulcerative colitis
63
discuss occurence of inflammatory bowel disease
15-35 yo UC - women CD - men
64
UC or CD bloddy diaarhea
UC
65
UC or CD tender RLQ mass
CD
66
UC or CD acute flares
Uc
67
UC or CD indolent and chronic
CD
68
UC or CD rectal pain
69
UC or CD uveitis
CD
70
UC or CD erythma nodosum
CD
71
UC or CD aphtous ulcer
CD
72
UC or CD colitic arthirtis
CD
73
UC or CD ankylosing
UC
74
UC or CD cholangitis
UC
75
UC or CD amyloidosis leading to renal failure
CD
76
UC or CD gangrene
UC
77
STD in reiter is commonly seen in
men
78
GI involvment in reiter is commonly seen in
female
79
what does post venereal reiters mean
disease is from sex - STD
80
what does post dysneteric reiters mean
assoc w GI infection

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