PBL 2 Flashcards
(42 cards)
what are some consequences of untreated rheumatoid arthritis?
infection heart disease osteoporosis deformity and loss of mobility rashes, blisters and nodules on skin lung problems kidney disease eye problems loss of muscle tone next to affected joints carpal tunnel syndrome anaemia depression lymphoma dementia
what are examples of normocytic anaemia causes?
haemorrhage haemolytic aplastic renal disease malignancy membrane deficits e.g. spherocytes hemoglobinuria sickle cell deficient enzymes e.g. pyruvate kinase malaria
what are examples of microcytic anaemia causes?
iron deficiency
anaemia of chronic diseases
thalassemia
sideroblastic
what are examples of macrocytic anaemia causes?
folate deficiency vitamin B12 deficiency liver disease alcoholism reticulocytosis drug induced
whats more accurate for diagnosing rheumatoid arthritis, anti-CCP or rheumatoid factor?
anti-CCP s its more sensitive and more specific - RF shows up in other autoimmune conditions
when are anti-CCP levels raised?
rheumatoid arthrtis
lupus
and otger inflammatory arthritis
what are the limitatons of a disability?
- mental health issues
- loss of freedom and independance
- frustration and anger at having to rely on others
- practical problems e.g. transport, choice of activities, accessing buildings
- unemployment
- loss of self-esteem and confidence
- self-limiting behaviours due to fear of falling
what are examples of inflammatory arthritis?
ankylosing spondylitis gout pseudogout lymes disease lupus psoriatic arthritis rheumatoid arthritis
what is a seronegative spondyloarthropathy?
a group of inflammatory rheumatic diseases with common clinical and aetiological features, including axial and peripheral inflammatory arthritis, enthesitis, extra-articular manifestations and a close link to the presence of the human leucocyte antigen (HLA)-B27 epitope
what are examples of seronegative spondyloarthropathies?
ankylosing spondylitis psoriatic arthritis inflammatory bowel disease associated arthritis reactive arthritis undifferentiated SpA.
what is enthesitis?
inflammation of the ‘enthesis,’ which is where a tendon or ligament attaches to bone
what is ankylosing spondylitis?
chronic inflammatory disease of intervertebral and facet joints of the spine which leads to damage of joints
why can ankylosing spondolytisis make the spine immobile?
fibroblasts replace damaged joint tissue with fibrin
osteoblasts are activated and ossify this fibrous tissue making the spine immobile
what gene is most commonly associated with ankylosing spondylitis?
HLA_B27
when does ankylosing spondylitis tend to develop?
in teenagers and young adults
what are symptoms of ankylosing spondylitis?
back pain
pain and swelling in other parts of the body caused by arthritis and enthesitis
fatigue
what would be seen on an x-ray of a spine of someone with ankylosing spondylitis?
a bamboo spine appearance due to ossification of annulus fibrosus
narrowing of joint spaces
what is gout?
a form of inflammatory arthritis that is caused by the deposition of monosodium urate crystals in joints
outline how monosodium urate crystals come about in gout?
at a pH of 7.4, uric acid loses a proton and instead binds a Na+, forming monosodium urate
what are the symptoms of gout?
intense joint pain - often the big toe
lingering discomfort
infammation and redness
limited range of movement
what is the underlying cause of gout?
hyperuricaemia or under excretion of uric acid
outline some ways in which hyperuricaemic states can come about?
increased consumption of purines e.g. seafood, red meat, alcohol (particularly beer)
increased production of purines e.g. high fructose corn syrup beverages
decreased clearance of uric acid e.g. dehydration
chemotherapy
radiation treatment
medicatiosn e.g. low dose aspirin or thiazide diuretics
what is the indication for xanthine oxidase inhibitors?
treatment and prevention of gout
whats are some exampes of xanthine oxidase inhibitors?
oxypurinol
allopurinol
febuxostat
