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Session 4 CM Rheum-3
CM- Rheum -3- SNSA
| Question | Answer |
|---|---|
| What are the charachteristics of Seronegative Spondyloarthropathy | affects axial skeleton, inflammatory, RF negative, Genetic Predisposition, Enthesopathic, Mucocutaneous Features |
| name the common spondyloarthropathies | Ankylosing spondylitis, Psoriatic Arthritis, Reactive Arthritis, Enteropathic Arthritis (crohns disease, ulcerative colitis), Juvenile Ankylosing Spondylitis |
| What gene is often associated with spondyloarthropathies but is not necessary or sufficient to cause them | HLA-B 27 |
| What are the typical nonvertebral symptoms of spondyloarthropathies | Asymmetric Peripheral Arthritis, Arthritis of the toe IP joints, sausage digits, achilles tenosynovitis, plantar fasciitis, costochondritis, Iritis, Mucocutaneous Lesions |
| What are the major charachteristics of ankylosing spondylitis | inflammatory, insidious onset involving vertebra and SI intitially then pepheral joints, you will also have cardiac features 5-10% of the time and Iritis 10-20%. Male>F 4:1 with an age of onset of 15-40 |
| Who suffers from ankylosing spondylitis more | 4:1 M>F |
| When does ankylosing spondylitis usually start | ages 15-40 |
| What is the schobers test | where you have patient bend when they flex you should go from lordosis to kyphosis. A Person with ankylosing spondylosis will not have any movement in their back as they bend all the movement will come from the hip |
| What lab findings will you find in ankylosing spondylosis | ESR increased 85% of time, RF usually negative, Mild anemai, HLA B27 positive 90% |
| What x-ray finding is indicative of ankylosing spondylitis | Bamboo Spine |
| What eye finding are common in ankylosing spondylitis | inflammation of eye uveitis and iritis when it goes all the way to the limbus |
| What is the treatment for ankylosing Spondyltiis | physical and occupation therapy to maintain posture, exercise (key), stop smoking, NSAIDS, Sulfalsalazine and MTX, Anti-TNF agents |
| What are the essentials of dx Ankylosing Spondylitis | chronic LBP in young adults gen worse in morning, progressive limitation of back motion or chest expansion, transient or permanent arthritis, inflammatory eye disease, elevated ESR, neg RF, HLA-B27, SI ( Sacroiliac Joint) abnormalitis on x-ray |
| What are the classic characteristics of psoriatic arthritis | Nail pitting/onycholysis, inflamm arth DIPs, Asym Arthritis, Sausage digits, no Rheum Nodules, RF -, erosive arthritis w/o osteopenia, Sacroilitis, syndesmophytes, paravert ossification, enthesopathy |
| What are the patterns of arthritis in psoriatic arthritis | DIP arthritis with nail changes, Asymmetirc oligoarthritis, symmetric polyarthritis, asymmetric spondylitsi is possible, |
| What can be used to manage psoriatic arthritis | Topical agents, PUVA, NSAIDs, Methotrexate, leflunomide, sulfasalazine, anti-tnf agents, surgery |
| What are the essential to dx psoriatic arthritis | 80% of time psoriasis before the arthritis, asymmetric sausage appearance of fingers and toes, RF usually neg, SI involvement common with ankylosis, x-ray showing osteolysis, pencil in cup deformity, bony ankylosis, sacroiliitis, syndesmophytes |
| What is reactive arthritis | a seronegative asymmentric arthritis following urethritis or cervicitis or infectious diarrhea. |
| What conditions are often associated with reactive arthritis | enthesopathy (ligament or muscle abnromalities at where they attach to bone), Inflammatory eye disease, balanitis, Oral ulcers, or keratodermia and sacroiliitis |
| What venereal disease can lead to reactive arthritis | chlamydia trichomatis |
| What enteric diseases can lead to reactive arthritis | shigella flexneri, salmonella, yersinia enterocolitica, yersinia pseudotuberculcosis, campylobacter jejuni |
| What condition can intravesicular bacille calmette-guerin lead to | reactive arthritis |
| What arthritis sometimes presents with keratodermia blenorrhagica | Reactive arthritis |
| What would a clacaneal spur be termed using medico lingo | enthesopathy |
| What is your typical mangement of reactive arthritis include | antibiotics, NSAIDs, opthalmic RX, steroids, remittive agents MTX, SSZ, cytotoxic drugs and biologic agents |
| What are the essential of dx of reactive arthritis | 50-89% HLA B-27 +, oligoarthritis, conjunctivitis, urethritis and mouth ulcers are most common, usually follows hx of dysentery or sexually transmitted infection |
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smaxsmith
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