Spondyloarthropathies

Question 1

what makes something a seronegative spondyloarthropathies

Answer 1

arthritis but negative RF

Question 2

features are assoc with seronegative spondyloarthropathies

Answer 2

saroiliitis, enthesopathy (pain at joints), occular issues,, dacytlitis

Question 3

genes with seronegative spondyloarthropathies

Answer 3

HLA B27

Question 4

who normally gets Ank Spondy

Answer 4

males 20-30

Question 5

what is Ank Spondy

Answer 5

vertebral discs fuse together

Question 6

symptoms Ank Spondy

Answer 6

lower back pain, worse in the morning, better with exercise // peripheral arthritis

Question 7

o/e Ank Spondy

Answer 7

reduced lumbar flexion (Schobers test) // reduced chest expansion

Question 8

extra-articular features Ank Spondy (7)

Answer 8

Apical fibrosis // anterior uveitis // aortic regurg // achilles tendon // AV node block // Amyloidosis // atlanto subluxation

Question 9

bloods Ank Spondy

Answer 9

raised ESR/ CRP

Question 10

imaging findings Ank Spondy

Answer 10

Xray: sacroilitis (subchondral erosions, sclerosis), sqaure vertebra, bamboo spine, syndesmophytes // MRI

Question 11

lifetsyle mx Ank Spondy

Answer 11

exercise eg swimming + physio

Question 12

drug mx Ank Spondy (3)

Answer 12

1 = NSAIDS // 2 = DMARDS if peripheral jpints // 3 = anti-TNF eg etanercept

Question 13

what appears first in psoriatic arthropathy skin or arthritis

Answer 13

arthritis

Question 14

articular features of psoriatic arthropathy (4)

Answer 14

symmetric polyarthritis or asymmetric oligoarthritis // SI involvement // DIP joint // arthritis mutilans

Question 15

extra-articular features psoriatic arthropathy (3)

Answer 15

psoriasis // tenosynovitis + soft tissue eg achilles tendonitis, dactolyitis // nail changes

Question 16

imaging findings psoriatic arthropathy

Answer 16

Xray ‘pencil in a cup’

Question 17

mx psoriatic arthropathy (4)

Answer 17

NSAIDs, steroid injection, anti-TNF, PDE4i

Question 18

triad reactive arthritis

Answer 18

reiters: urethritis, uveitis, arthritis // can’t see, pee, or climb a tree

Question 19

organisms reactive arthritis (2 categories)

Answer 19

post dysentry: shigella, salmonella, campy // sti: chlamydia

Question 20

mx reactive arthritis

Answer 20

NSAIDs + intra-articular steroids // sulfalazine or methotrexate if needed

Question 21

when does reactive arthritis usually develop and how long does it last

Answer 21

4 weeks after 1st infection –> last 4-6 months

Question 22

what disease is enteropathic arthritis assoc with

Answer 22

IBD

Question 23

diagnostic test ank spondy

Answer 23

x ray

Question 24

skin changed reactive arthritis

Answer 24

circinate balanitis (painless vesicle on penis) // keratoderma blenorrhagica (painful papule on soles feet)