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MSK- Rheumatology > Spondyloarthropathies > Flashcards

Spondyloarthropathies Flashcards

(41 cards)

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1
Q

Define Spondyloarthropathy

A

Family of inflammatory arthritides characterized by involvement of both the spine and joints, principally in genetically predisposed individuals

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2
Q

What predisposes you to Spondyloarthropathy?

A

HLA B27

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3
Q

What other disease is HLA B27 associated with?

A

Reactive Arthritis

Chron’s disease

Uveitis

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4
Q

What is the background prevelance of HLA-B27

A

around 25% so it is not useful to screen for.

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5
Q

What are the four Spondyloarthritis Disease subgroups?

A

REAP

Reactive Arthritis

Enteropathic Arthrisis

Ankylosing Spondylitis

Psoriatic Arthritis

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6
Q

What clincial feautes do all Spondyloarthropathies share?

A

Sacroiliac and spinal involvement

Enthesists

Dactylitis

Ocular inflamation

Mucocutaneous lesion

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7
Q

What is going on here?

A

Enthesitis

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8
Q

What is Ankylosing Spondylitis?

A

Chronic systemic inflammatory disorder primarily affecting the spine?

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9
Q

What is the hallmark of Ankylosing Spondylitis?

A

Sacroiliac joint involvement

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10
Q

Who gets Ankylosing Spondylitis?

A

Young Men

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11
Q

What is the diagnositc criteria for Ankylosing Spondylitis?

A

Sacroiliitis on X-ray plus at least one of:

  1. Limited Lumber Motion
  2. Lower back pain for 3 months
  3. Reduced Chest expansion
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12
Q

What are the extra articular features of Ankylosing Spondylitis?

A

Eyes and midline

Anterior Uveitis

CVS - aortic valve/root

RSP- Fibrosis of upper lobes

Mucosal inflamation

Amyloidosis

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13
Q

Why is Ankylosing Spondylitis known as the A disease?

A

Axial arthritis

Anterior Uveitis

Aortic Regurgitation

Apical Fibrosis

Amyloidosis

Achilles Tendinitis

Plantar Fasciitis

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14
Q

What happens to the spine in Ankylosing Spondylitis? (image)

A
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15
Q

What would you want to look at in the patient to diagnose Ankylosing Spondylitis?

A

Occiput to wall

Chest expansion

Schober’s test

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16
Q

What blood tests would you do in suspected Ankylosing Spondylitis?

A

HLA B27

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17
Q

What can you see here which is classic of Ankylosing Spondylitis?

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A

Change in bone density - Shiny corners

18
Q

Whats going on here and why?

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A

Bamboo spine due to Fusion

19
Q

What would you classicly see on a Xray of a spine with Ankylosing Spondylitis

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A

Bamboo spine

Fusion

Decreased bone density in late diease

Flowing Syndesmophytes

20
Q

How do you treat Ankylosing Spondylitis?

Study These Flashcards
A

NSAIDS

DMARDS

Anti TNF

21
Q

What DMARDs would you use in Ankylosing Spondylitis?

Study These Flashcards
A

Sulfasalazine

Methotrexate

22
Q

Define Psoriatic Arthritis

Study These Flashcards
A

Inflammatory Arthritis associated with Psoriasis

23
Q

Is psoriatic arthritis rheumatoid factor positive or negative?

24
Q

What are the 5 clincial features of Psoriatic Arthritis?

Study These Flashcards
A

Sacroiliitis

Nail involvement

Dactylitis

Enthesitis

Eye disease

25
What would you find in the blood tests of someone with Psoriatic Arthritis?
Negative Rheumatoid Factor Inflammatory permaeters raised
26
What are the classic X-ray signs of Psoriatic Arthrits?
Marginal erosions and whiskering Pencil in cup deformity Osteolysis Enthesitis
27
What drugs do you use to treat psoriatic arthritis?
NSAIDs Steroids DMARDs Anti TNF
28
Define Reactive Arthritis
Infection induced systemic illness
29
When do symptoms usually begin in reactive Arthritis?
1-4 weeks post infection
30
What the most common infections which cause reactive arthritis?
Urogenital:- Chlamydia Enterogenic:- Shigella, Salmonella, Versinia
31
Who gets Reactive Arthritis?
20-40yr olds Equal Sex distribution
32
What's up with Reiter?
He cant pee He cant move and he cant see
33
What is Reiter's Syndrome?
A form of Reactive Arthtitis with: Urethritis Conjuctivitis Arthritis
34
How do you treat reactive arthritis?
NSAIDs Corticosteroids Antibiotics DMARDs - if chronic
35
What is the prognosis for Reactive Arthritis?
Generally good 90% resolves within 6 months
36
What is Enteropathic Arthritis?
Associated with IBD
37
What precentage of patiets with Crohns also have Sarcoiliitis?
20%
38
What are the clincial features of Enteropathic arthritis?
IBD GI symptoms Weight loss Fever Uveitis Pyoderma Gangrenosum Enthesitis Apthous Ulcers
39
What investigations would you consider doing for Enteropathic Arthritis?
GI endoscioy to confirm IBD Joint aspiration should find no organisims or crystals X-ray showing sarcoillitis
40
How do you treat Enteropathic arthritis?
Treat IBD No NSAIDs parcetamol or Cocodamol instead Steroids DMARDs Biologics - Infiximab
41
How do you qualify for Anti-TNF?
Need to already have tried two DMARDs without success

MSK- Rheumatology (8 decks)

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