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xB12W3 > PBL 2 > Flashcards

PBL 2 Flashcards

1
Q

what are some consequences of untreated rheumatoid arthritis?

A 
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
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2
Q

what are examples of normocytic anaemia causes?

A 
haemorrhage
haemolytic
aplastic
renal disease
malignancy
membrane deficits e.g. spherocytes 
hemoglobinuria 
sickle cell
deficient enzymes e.g. pyruvate kinase
malaria
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3
Q

what are examples of microcytic anaemia causes?

A

iron deficiency
anaemia of chronic diseases
thalassemia
sideroblastic

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4
Q

what are examples of macrocytic anaemia causes?

A 
folate deficiency
vitamin B12 deficiency 
liver disease
alcoholism
reticulocytosis
drug induced
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5
Q

whats more accurate for diagnosing rheumatoid arthritis, anti-CCP or rheumatoid factor?

A

anti-CCP s its more sensitive and more specific - RF shows up in other autoimmune conditions

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6
Q

when are anti-CCP levels raised?

A

rheumatoid arthrtis
lupus
and otger inflammatory arthritis

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7
Q

what are the limitatons of a disability?

A
  • 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
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8
Q

what are examples of inflammatory arthritis?

A 
ankylosing spondylitis 
gout
pseudogout 
lymes disease
lupus
psoriatic arthritis
rheumatoid arthritis
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9
Q

what is a seronegative spondyloarthropathy?

A

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

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10
Q

what are examples of seronegative spondyloarthropathies?

A 
ankylosing spondylitis 
psoriatic arthritis 
inflammatory bowel disease associated arthritis
reactive arthritis
undifferentiated SpA.
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11
Q

what is enthesitis?

A

inflammation of the ‘enthesis,’ which is where a tendon or ligament attaches to bone

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12
Q

what is ankylosing spondylitis?

A

chronic inflammatory disease of intervertebral and facet joints of the spine which leads to damage of joints

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13
Q

why can ankylosing spondolytisis make the spine immobile?

A

fibroblasts replace damaged joint tissue with fibrin

osteoblasts are activated and ossify this fibrous tissue making the spine immobile

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14
Q

what gene is most commonly associated with ankylosing spondylitis?

A

HLA_B27

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15
Q

when does ankylosing spondylitis tend to develop?

A

in teenagers and young adults

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16
Q

what are symptoms of ankylosing spondylitis?

A

back pain
pain and swelling in other parts of the body caused by arthritis and enthesitis
fatigue

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17
Q

what would be seen on an x-ray of a spine of someone with ankylosing spondylitis?

A

a bamboo spine appearance due to ossification of annulus fibrosus
narrowing of joint spaces

18
Q

what is gout?

A

a form of inflammatory arthritis that is caused by the deposition of monosodium urate crystals in joints

19
Q

outline how monosodium urate crystals come about in gout?

A

at a pH of 7.4, uric acid loses a proton and instead binds a Na+, forming monosodium urate

20
Q

what are the symptoms of gout?

A

intense joint pain - often the big toe
lingering discomfort
infammation and redness
limited range of movement

21
Q

what is the underlying cause of gout?

A

hyperuricaemia or under excretion of uric acid

22
Q

outline some ways in which hyperuricaemic states can come about?

A

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

23
Q

what is the indication for xanthine oxidase inhibitors?

A

treatment and prevention of gout

24
Q

whats are some exampes of xanthine oxidase inhibitors?

A

oxypurinol
allopurinol
febuxostat

25
Q

what are some examples of uricosuric medications?

A

Sulphinpyrazone

26
Q

whats the difference between gout and pseudo gout?

A

gout is deposition of monosodium urate crystals and pseudogout is deposition of calcium pyrophosphate crystals

27
Q

what is lyme disease?

A

an infectious, blood-born ebacterial disease caused by borrelia burgdorferi species which are transmitted by ticks
it causes swelling, damage and dysfunction around synovial joints and nerves

28
Q

what are symptoms of Lyme disease?

A

erythema migrans
achy
tired
weak

29
Q

what is erythema migraines?

A

red bump at the site which expands but leaves only the site of the bite and the outer ring red - creating a bullseye effect

30
Q

what happens in lyme disease is left untreated?

A

neurological and cardiac complications occur

31
Q

what is lyme disease typically treated with?

A

antibitoics like amoxicillin and doxycycline

32
Q

what is lupus?

A

an autoimmune disease caused by a combination of genetics and environment

33
Q

what are some environmental triggers for lupus?

A 
exposure to solvents
UV light
air pollution
heavy metals
pesticides
34
Q

what are symptoms of lupus?

A 
fever
joint pain,
arthritis
rash in women of a cild bearing age 
mouth and nose ulcers
serositis 
fatigue 
renal disorders
haemtological disorders
35
Q

what is psoriatic arthritis?

A

inflammatory response leads to proliferation of keratinocytes and fibroblasts which cause the formation of a psoriatic plaque. T cells also activate osteoclasts and osteoblasts leading to joint erosion and ossification which ultimately causes deformities.

36
Q

what are symptoms of psoriatic arthritis?

A

pain, swelling, stiffness, redness, heat in joints

psoriasis

37
Q

what are the 5 types of psoriatic arthritis?

A 
oligoarticular
polyarticular
spondyloarthritis
distal interphalangeal predominant 
arthritis mutilans
38
Q

what is oligoarticular psoriatic arthritis?

A

affects <5 joints
mild
assymetric

39
Q

what is polyarticular psoriatic arthritis?

A

> 5 joints affected

symmetrical

40
Q

what is spondyloarthritis in psoriatic arthritis?

A

affects spine and sacroiliac joint usually

asymetrical

41
Q

what is distal interphalangeal predominant psoriatic arthritis?

A

when it affects distal joints on fingers

42
Q

what is psoriatic arthritis mutilans?

A

extensive bone erosion that causes a telescropic digit appearance

xB12W3 (7 decks)

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