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Rheumatology > SpA > Flashcards

SpA Flashcards

(43 cards)

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1
Q

Seronegative Spondyloarthropathies

A

A group of overlapping disorders that share certain clinical features and Genetic associations

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2
Q

Spondyloarthritis (SpA)

A

Axial manifestations
Peripheral manifestations

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3
Q

Classification of spondyloarthritis

A

Ankylosis spondylitis
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis
Acute Anterior uveitis
Juvenile idiopathic arthritis
Undifferentiation spondyloarthropathy

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4
Q

SpA is seronegative meaning

A

Rf negative

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5
Q

Axial spondyloarthritis may be

A

Non-Radiographic Axial-SpA (no Xray finding for Sacroiliitis)
Radiographic Axial-SpA ( Ankylosing Spondylitis)

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6
Q

Predominantly axial SpA

A

Non radiographic SpA
AS

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7
Q

Predominantly peripheral SpA

A

Reactive arthritis
Psoaritic arthritis
Enteropathic arthritis
Undifferentiated

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8
Q

Male to female ratio of axial SpA

A

2-9: 1

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9
Q

Familial aggregated associated with

A

HLA B27

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10
Q

Patho genesis of AS

A

Non genetic and genetic risk factors
Altered gut micro biome
Lymphoid cells released IL 17 and IL 22
Mechanical stress leading to inflammation

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11
Q

AS mainly affects

A

Sacroiliac joints and enthesis

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12
Q

In spine of AS inflammatory granulation tissue found at junction of

A

Annulus fibrosis and vertebral bone

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13
Q

In AS the outer annular fibers are

A

Eroded and replaced by bone forming syndesmophyte

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14
Q

Berlin criteria for inflammatory back pain (AS)

A

Morning stiffness >30 mins
Improvement with exercise
Awakening at night due to pain
Alternating buttock pain

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15
Q

Median age of axial SpA

A

23

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16
Q

Initial sx of ax-SpA

A

Dull aching pain
Insidious
Deep in lower lumbar or gluteal region alternating left and right
Back pain inflammatory

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17
Q

Modified New York criteria for AS

A

Low back pain and stiffness more than 3 months improve w exercise
Limitations of motion of lumbar spine
Limitation of chest expansion
Sacroilitisis grade 2 bilaterally or 3-4 unilaterally

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18
Q

Examinations for AxSpA

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A

Fabertest
Schober test
Chest expansion
Occipital wall distance

19
Q

Present in 60-90% of pt with AxSpA

20
Q

Age of onset of Ax SpA

21
Q

SpA features

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A

Inflammatory back pain
Arthritis
Enthesitis
Uveitis
Dactylitis
Psoriasis
Crohn’s
Good response to NSAIDs
FH of SpA
HLA B 27
Elevated CRP

22
Q

Spine changes

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A

Squaring vertebral bodies
Loss of lumbar lordosis
Syndesmophyte ossification
Bamboo spine

23
Q

Neck pain and stiffness from involvement of cervical spine in AxSpA

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A

Late manifestation

24
Q

Enthesis commonly involved

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A

Achilles tendinitis.
Plantar fasciitis.
At the tibial tuberosity.
Superior and inferior poles of the patella.
Iliac crests.

25
Extra articular manifestations
Anterior uveitis Inflammatory ulceration of bowel Aortitis,AR, conduction ab. Secondary amyloidosis Bladder or bowel incontinence
26
Highly reliable tool for diagnosing AS
MRI
27
1st line for AS
NSAIDS
28
Biological preferred for AS
TNF inhibitors (2nd line)adalimumab, infliximab
29
Third line for AS
IL17 inhibitors
30
Reactive arthritis
Can’t see (conjunctivitis) Can’t pee (urethritis) Can’t climb (arthritis)
31
Etiology of reactive arthritis
Gut pathogens like shigella, salmonella, campylobacter, chlamydia
32
Clinical manifestations of reactive arthritis
Asymmetrical inflammatory arthritis of lower limb Dactylitis or sausage digit Tendo Achilles tendinitis or plantar fasciitis Urethritis Uveitis
33
Tests for ______ are positive in 75% of patients with sacroillitis
HLA B 27
34
Treatment of reactive arthritis
High dose NSAIDS ANTIBIOTICS INTRALESIONAL GLUCOCORTICOIDS DMARDS IN REFRACTORY
35
Psoriatic arthritis
Inflammatory arthritis in ppl with psoriasis
36
In 60-70% of psoriatic arthritis
Psoriasis precede joint disease
37
Nail changes such as pitting occur in
90% of patients with psoriatic arthritis
38
Radiographic class deformity for psoriatic arthritis
Pencil in cup deformity
39
Treatment of psoriatic arthritis
NSAIDs for arthritis DMARDS like methotrexate or biological in severe resistant arthritis IL 12 and 23 inhibitors
40
Enteropathic arthritis
UC and CD are asssociated with SpA
41
Two types of involvement of Enteropathic arthritis
Peripheral arthritis Axial
42
Treatment of IBD in Enteropathic
Sulfasalazine Biological
43
Undifferentiated SpA
patients who do not meet the definitive classification criteria of any other SpA subtypes. About 50% are HLA-B27-positive, who eventually progress to classical AS. Management same other SpA subtypes.

Rheumatology (3 decks)

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