Rheumatology Conditions week 3

Question 1

Systemic Lupus Erythematosus basic definition:

Answer 1

A chronic autoimmune disease whereby the body’s tissues are attacked by it’s own immune system, causing multi-system inflammation and clinical manifestations

Question 2

Common dmeographic of SLE?

Answer 2

Women of childbearing age - 15-35years

Question 3

Typical symptoms of SLE?

Answer 3

joint, skin and mucosal symptoms

Question 4

Basic pathophysiology of SLE?

Answer 4

recurrent activation of the immune system
&
production of antibodies and protein products leading to inflammation and tissue destruction

Question 5

What are some environmental risk factors for SLE?

Answer 5

UV over exposure
EBV
Drug induced lupus

Question 6

What are some hormonal risk factors for SLE?

Answer 6

high oestrogen
OCP use
pregnancy (may increase flare ups)

Question 7

3 classes of risk factors for SLE?

Answer 7

Genetic
hormonal
environmental

Question 8

Most common clinical manifestations of SLE:

Answer 8

cutaneous and arthritis

Question 9

examples of SLE cutaneous manifestations?

Answer 9

oral ulcers
malar and/or discoid rash
urticarial
raynauds phenomenon

Question 10

Raynaud’s phenomenon is an example of clinical feature from what rheumatological condition?

Answer 10

SLE

Question 11

SLE arthritis characteristics?

Answer 11

bilateral and symmetrical

hands, wrists, knees

Question 12

diagnosis of SLE involves?

Answer 12

blood testing - ANA

Question 13

Management of SLE:

Answer 13

reduce environmental triggers: UV, HT
NSAIDs
Antimalarials
corticosteroids
immunosuppressive drugs

Question 14

Reactive arthritis basic definition:

Answer 14

a seronegative spondyloarthropathy secondary to a bacterial infection in the GI or GU tract

Question 15

what does seronegative mean?

Answer 15

giving a negative result in a test of blood serum, e.g. for the presence of a virus

Question 16

what type of arthritis does reactive arthritis typically present?

Answer 16

acute monarthritis (affecting one joint)

Question 17

reactive arthritis have a HLA-B27 correlation?

Answer 17

yes

Question 18

What infections can trigger reactive arthritis?

Answer 18

chlamydia
salmonella
shigella
E-coli

Question 19

basic pathophysiology of reactive arthritis?

Answer 19

infection causes:
T-cell activation
leading to synovitis
monoarticular arthritis

Question 20

reactive arthritis clinical manifestations:

Answer 20

‘can’t pee, can’t see, can’t climb a tree’
occular
penile lesions
asymetrical oligoarthritis

Question 21

management of reactive arthritis?

Answer 21

infection with antibiotics
NSAIDs
DMARDs

Question 22

Gout definition:

Answer 22

an abnormality of uric acid metabolism that results in hyperuricaemia and urate crystal deposition

Question 23

Sites of urate crystal deposition?

Answer 23

joints
soft tissue
urinary tract

Question 24

typical demographic of gout:

Answer 24

Men between 40-50 or women over 60

Question 25

what is uric acid?

Answer 25

byproduct of xanthine breakdown that is usually filtered out by the kidneys

Question 26

risk factors for gout?

Answer 26

``` Genetic long term renal disease long term medication use: diuretics high alcohol high purine diet ```

Question 27

4 stages of gout?

Answer 27

1. asymptomatic hyperuricaemia 2. acute gouty arthritis 3. intercritical gout 4. chronic tophacious gout

Question 28

diagnosis of gout?

Answer 28

synovial fluid aspirate elevated serum uric acid x-ray

Question 29

management of gout?

Answer 29

lifestyle changes: obesity, alcohol NSAIDs corticosteroids allopurinol

Question 30

CPPD?

Answer 30

calcium pyrophosphate deposition disease

Question 31

CPPD definition:

Answer 31

form of arthritis thagt results from deposits of calcium pyrophosphate crstals in the joints

Question 32

crystal shapes?

Answer 32

gout: rod | CPPD rhombus

Question 33

what does CPPD mainly affect?

Answer 33

articular cartilage

Question 34

risk factors for CPPD?

Answer 34

OA previous joint trauma diabetes family history

Question 35

clinical features of CPPD?

Answer 35

acute attacks much like gout. 1 or multiple joints - pain, swelling, swollen knee most common

Question 36

diagnosis of CPPD:

Answer 36

synovial fluid analysis | xray - hyperwhite line alng cartilage

Question 37

first line of treatment for CPPD?

Answer 37

cortisone injection