Spondylarthropathies, polyarthritis rheumatica, fibromyalgia Flashcards

1
Q

What antibodies are associated with spondyloarthropathies?

A

HLA B27 antibodies

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2
Q

Inflammation of sites where tendons and ligaments attach to bone

A

enthesitis

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3
Q

Chronic inflammatory disease of the joints of the axial skeleton. Changes seen in sacroiliac joints and hips

A

ankylosing spondylitis

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4
Q

Extra-articular manifestations of ankylosing spondylitis

A

anterior uveitis, aortic valvular disease, restricted chest expansion

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5
Q

How long must a patient have low back pain to be classified as ankylosing spondylitis?

A

3 months

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6
Q

Describe the stiffness/back pain associated with ankylosing spondylitis?

A

awakend by pain during 2nd half of night, morning stiffness, and pain that improves with excercise

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7
Q

Characteristic radiographic finding for ankylosing spondylitis

A

“bamboo spine”

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8
Q

What should always be ordered for any patient suspected of having ankylosing spondylitis?

A

AP view of the pelvis

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9
Q

Acute inflammatory arthritis occurring 1-3 weeks after infectious event

A

reactive arthritis

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10
Q

Triad of reactive arthritis

A

arthritis, urethritis, conjunctivitis

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11
Q

Most common cause of reactive arthritis

A

post-veneral onset (Reiter’s)

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12
Q

Chronic inflammatory arthropathy in setting of psoriasis

A

psoriatic arthritis

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13
Q

Nail changes often noted in psoriatic arthritis

A

pitting, dystrophy, onyholysis

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14
Q

Characteristic inflammatory changes associated with psoriatic arthritis

A

Arthritis in DIPs, sausage digits, and no rheumatoid nodules

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15
Q

Effective for inflammatory back pain, spinal stiffness, peripheral arthritis, enthesopathy. Doesn’t inhibit disease progression

A

NSAIDs

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16
Q

Considered when antiinflammatory therapy is insufficient to control symptoms. Progression of inflammatory axial disease noted. Active persistent polyarthritis or uncontrolled extra-articular disease

A

DMARDs

17
Q

What needs to be supplemented for when a patient is prescribed methotrexate?

A

folate

18
Q

Characterized by aching & stiffness in the shoulder and pelvic girdles and the neck. Usually responds to low doses of steroids

A

polymyalgia rheumatica

19
Q

Age that polymyalgia rheumatica occurs

A

> 50yrs

20
Q

Describe pain pattern associated with polymyalgia rheumatica

A

aching, morning stiffness that lasts 30 minutes. Is bilateral and worse w/movement

21
Q

Exam findings of polymyalgia rheumatica that can differentiate it from other arthritides

A

little evidence of proximal joint swelling or tenderness

22
Q

Treatment for polymyalgia rheumatica

A

Corticosteroids are drugs of choice (10-20mg/day) for 1-2 yrs.

23
Q

How soon does polymyalgia rheumatica resolve after intitiation of treatment?

A

Complete or nearly complete resolution of sx is seen in a few days. absence of improvement should cause one to question diagnosis

24
Q

Chronic vasculitis of medium and large vessels. Symptoms are due to end-organ ischemia. More common at age > 50

A

Giant cell arteritis

25
Q

Most frequent symptom of giant cell arteritis

A

headache

26
Q

Complications of giant cell arteritis

A

blindness, aortic aneurysms, stroke

27
Q

Should be performed in all patients with suspected giant cell arteritis (GCA)

A

temporal artery biopsy

28
Q

Initial treatment for GCA

A

high dose 40-60mg prednisone. IV pulse methylpresnisolone 1000mg x 3days if vision loss present

29
Q

A clinical syndrome characterized by widespread muscular pain (usually chronic), fatigue and muscle tenderness

A

Fibromyalgia Syndrome (FMS)

30
Q

What is thought to be the underlying pathology of fibromyalgia (FMS)?

A

abnormal sensory processing in CNS that causes them to be extremely sensitive to pain

31
Q

Associated symptoms include: poor sleep*, HA, IBS, cognitive/memory problems, and paresthesias in fingers/toes

A

fibromyalgia (FMS)

32
Q

important in transmission and amplification of pain signals to and from brain

A

substance P

33
Q

Patients with what other rheumatologic disorders are more likely to develop FMS?

A

Rheumatoid arthritis and SLE (Lupus)

34
Q

How many positive tender points are generally needed to make the diagnosis of FMS?

A

11 of 18

35
Q

T/F fibromyalgia co-aggregates with somatoform disorder in families

A

false, it co-aggregates with major mood disorders in families

36
Q

What are the levels of inflammatory markers (ESR, CPR) in FMS?

A

normal

37
Q

What is the first-line approach for patients with moderate to severe pain due to FMS?

A

Trial with low-dose TCAs, SSRI, SNRI, or antiseizure medication