Term
| What factor is absent with SA? |
|
Definition
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|
Term
| What is the one genetic factor found in SA that has been identified? |
|
Definition
| HLA-B27 encoded by class 1 HLA-B locus within MHC. RR of 100 |
|
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Term
| Which sexually transmitted diseases can cause reactive arthritis? (2) |
|
Definition
1) Chlamydia trachomatis
2) Ureaplasma urealyticum |
|
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Term
| New York Criteria for Ankylosing Spondylitis? (3) |
|
Definition
1) low back pain >3 months relieved by exercise and not by rest
* Also need definitive x-ray appearance
2) reduced ROM of lumbar spine
3) decreased chest expansion |
|
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Term
| What is the clinical presentation of Ankylosing spondylitis? (5) |
|
Definition
1) low back pain and stiffness are presenting symptoms
2) insidious
3) >3 months
4) worse with inactivity
5) relieved by exercise |
|
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Term
|
Definition
1) sacroiliac joints are tender to palpation
2) paravertebral spasms common
3) schober test positive
4) peripheral arthritis - hips, shoulders, knees |
|
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Term
| Lab findings indicative of AS? (2) |
|
Definition
1) HLA-B27 antigen in 90%
2) elevated ESR and IgA often |
|
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Term
| What is the most specific x-ray finding with AS? |
|
Definition
|
|
Term
| What is the most specific x-ray finding with AS? |
|
Definition
|
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Term
| What is an ocular manifestation of AS that could be the presenting feature? |
|
Definition
| uveitis - ocular emergency |
|
|
Term
| What is a cardiovascular manifestation of AS? |
|
Definition
| fibrosing cardiovascular lesion - aortic regurgitation. may cause AV block |
|
|
Term
| Pulmonary, Renal, and Neurological manifestations of AS? |
|
Definition
pulmonary - severe kyphotic deformity - ILD
Neuro - spinal fractures w/cord compression at C6/C7
Renal - IgA nephropathy, secondary amyloidosis |
|
|
Term
|
Definition
1) indomethacin - bisphosphonates if ineffective
2) TNF antagonists - most effective
3) sulfasalazine
4) exercise and good posture |
|
|
Term
| Reactive arthritis triad? |
|
Definition
1) non-gonococcal urethritis
2) conjunctivitis
3) arthritis
* most only have arthritis |
|
|
Term
| What is the general clinical presentation of reactive arthritis? (5) |
|
Definition
1) after gastroenteritis or sexual exposure to verneral pathogen
2) oligoarticular, asymmetrical arthritis of lower extremities
3) sausage digits
4) low back pain
5) keratoderma blenorrhagica |
|
|
Term
| What is keratoderma blennorrhagica? |
|
Definition
| A skin rash with reactive arthritis characterized by papulosquamous skin rash that usually begins on the soles or palms as painless and non pruritic areas - similar to pustular psoriasis |
|
|
Term
| What is circinate balanitis? |
|
Definition
| A skin change with reactive arthritis characterized by scaling rash on the glans penis |
|
|
Term
| Lab results for reactive arthritis? (5) |
|
Definition
1) leukocytosis
2) thrombocytosis
3) anemia
4) elevated ESR
5) test for perneal diseases |
|
|
Term
| Treatment for reactive arthritis? (4) |
|
Definition
1) NSAIDs - indomethacin
2) self-limiting in 4-12 months
3) tx of GU infections w/antibiotics
4) TNF-a antagonists |
|
|
Term
| What is the pattern of joint involvement for psoriatic arthritis? (4) |
|
Definition
1) asymetrical oligoarthritis of small and large joints
2) sausage fingers and toes-DIP
3) Arthritis mutilans
4) psoriatic spondylitis in 20% |
|
|
Term
| What is the classic x-ray findings associated with psoriatic arthritis? |
|
Definition
| whittling of distal ends of phalanges "pencil-in-cup" |
|
|
Term
| treatment for psoriatic arthritis |
|
Definition
1) NSAIDs
2) Sulfasalazine
3) methotrexate
4) cyclosporine |
|
|
Term
| What skin disorders are seen with enteropathic arthritis with Chrohn disease and UC? |
|
Definition
Crohns-erythema nodosum
UC-pyoderma gangrenosum |
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