tomi1's version from 2017-01-28 17:21

Section 1

Question Answer
define spondyloarthopathyAUTOIMUNE inflammatory rheumatic joint disorder of vertebrae of spinal column
features of SPAenthesitis - synovitis - RF -ve - HLA B27
list different types of SPA AS, psoriatic, reactive, bechet's
list 4 features of inflammatory back pain back pain >3months with morning stiffness >30mins/alternate buttock pain/improves with exercise/worse on rest/pain wakes patient at night
list features of mechanical back pain<6wks/pain worse on movement
red flags SPASTD/ IBD/ eye pain or visual loss/ skin or nail changes
general investigations SPA - bloods + imaginginflammatory markers, genotyping (hla b27), serology for RF,
hla b27 nations scandinavian countries
general managementMDT + N SAIDs/TNF/MTX/sulfalsine

Section 2

Question Answer
syndesmophytes bony growth oringating from ligament inteveterbral
Radiograhic sign: bamboo spine vertebral body fusion due to ossification of intervertebral ligaments
extra-msk features of AS4As
most senstive test on exam for ASlateral lumbar flexion
schoeber testmidpoint dimple of venus- measure10cm-lumbar flexion- <15cm is abnormal
question mark posture ASgradual loss lumbar lordosis and increasingly cervical and thoracic kyphosis
appearance of AS patientSTOOPING POSTURE
pattern of joint diseaseSI joint pain, chronic LBP, achilles tendonitis

Section 3

Question Answer
prevelance of psoriasis1-3% population
prevelance psoriatic arthritis 10% of psoriasis patients
define psoriasiserythematous, patchy skin on extensor surfaces
nail changes pitting, onchyolysis, hyperkeratitis
radiographic signtelescoping digits- resorption bone at IP joints
pattern of joint diseasearthritis mutilans, IP arthritis, spondylitis, oligoarthritis

Section 4

Question Answer
septic arthritis is a medical emergencyuntreated >48hrs erosive joint damage
organisms septic arthritisS aureus/ H influenzae
Rx septic arthritisIV antibiotics (flucoxacillin)
organisms reactive arthritissalmonella, camplyobacter, chylamidia, gonorrhea
Rx reactive arthritisrx underlying infection otherwise symptomatic
Typical person with septic vs reactivechild/person with prosthesis vs young person STD/food poisioning ~1month

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