Ankylosing Spondylitis Diagnosis Quiz and Pain Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following is NOT a pathologic change seen in degenerative joint disease (DJD)?

Formation of osteophytes

Erosion of articular cartilage

Thickening of subchondral bone

Thickening of synovial membrane (correct)

What is the primary feature of degenerative joint disease (DJD) in terms of symptoms?

Numbness and tingling sensation

Swelling and redness in the joint

Sharp, stabbing pain

Deep aching in the joint (correct)

Which term is used to describe articular cartilage affected by degenerative joint disease (DJD)?

Red and swollen

Blue and shiny

Yellow and opaque (correct)

Transparent and soft

What is the most common cause of lower back pain related to degenerative joint disease (DJD)?

OA of the spine Signup and view all the answers

Which of the following is a common physical finding associated with degenerative joint disease (DJD)?

Joint instability Signup and view all the answers

What does loss of articular cartilage in degenerative joint disease (DJD) lead to?

Joint subluxation and deformity Signup and view all the answers

What is the most common cause of death in persons with lupus?

Kidney failure Signup and view all the answers

Which medication is effective in treating lupus nephritis but is associated with significant toxicity?

Cyclophosphamide Signup and view all the answers

What is the characteristic skin rash seen in dermatomyositis?

Heliotrope rash Signup and view all the answers

What is the initial symptom of both polymyositis and dermatomyositis?

Fever, swelling, malaise, and fatigue Signup and view all the answers

Which of the following medications is an alternative to cyclophosphamide for treating lupus while preserving reproductive function?

Azathioprine Signup and view all the answers

Which of the following is NOT a characteristic of inclusion body myositis?

Sudden onset of muscle weakness Signup and view all the answers

What is the most common chronic inflammatory disease of the axial skeleton affecting the sacroiliac joints and spine?

Ankylosing spondylitis Signup and view all the answers

What is the primary site of pathologic findings in ankylosing spondylitis?

Enthesis Signup and view all the answers

What is the cause of the characteristic "bamboo" appearance of the spine in ankylosing spondylitis?

Calcification of the spinal ligaments Signup and view all the answers

What is the significance of the HLA-B27 genetic marker in ankylosing spondylitis?

It is a risk factor for developing the disease Signup and view all the answers

Which of the following is NOT a goal of treatment for ankylosing spondylitis?

Prevent weight gain Signup and view all the answers

Which of the following medications is used to control pain and inflammation in ankylosing spondylitis, but does not retard disease progression?

Aspirin and NSAIDs Signup and view all the answers

Which of the following is NOT a common complication of rheumatoid arthritis?

Osteoarthritis Signup and view all the answers

Which of the following is a Disease-Modifying Anti-Rheumatic Drug (DMARD) used in the treatment of rheumatoid arthritis?

Methotrexate Signup and view all the answers

What is the primary function of misoprostol in the treatment of rheumatoid arthritis?

Reducing the incidence of gastric ulcers Signup and view all the answers

Which of the following supplements is NOT mentioned as potentially beneficial for rheumatoid arthritis patients?

Glucosamine Signup and view all the answers

What is the most common cause of osteoporosis?

Unknown Signup and view all the answers

What is the primary mechanism of action of adalimumab in the treatment of rheumatoid arthritis?

Blocking TNF-alpha Signup and view all the answers

Which of the following diagnostic tests is NOT mentioned in the text for rheumatoid arthritis?

Positive antinuclear antibody (ANA) test Signup and view all the answers

Which type of osteoporosis is more common?

Postmenopausal osteoporosis (type I) Signup and view all the answers

Which of the following is not a factor that contributes to the development of osteoporosis?

Increased bone formation Signup and view all the answers

What is the earliest manifestation of osteoporosis?

Acute onset of back pain in the middle to lower thoracic region Signup and view all the answers

Which of the following best describes the pathophysiology of osteoporosis?

Bone resorption exceeds bone formation gradually after menopause Signup and view all the answers

Study Notes

ANKYLOSING SPONDYLITIS (Marie-Strumpell disease)

Chronic inflammatory disease of the axial skeleton affecting the sacroiliac joints and spine
Etiology is UNKNOWN; HLA-B27 genetic marker is present
Pathophysiology: inflammation of the spine, leading to fibrous scar tissue and new bone growth, causing vertebrae to fuse together
Enthesis: primary site of pathologic findings where ligaments, tendons, and joint capsule enter the bone
Patient may experience chest pain that worsens during inspiration
The spine loses its normal lordotic curve, and the patient may have a "poker back" deformity or kyphosis at the cervicodorsal junction with knees flexed in an attempt to move the head upright
Goals of treatment: relieve pain and stiffness, achieve and maintain best possible alignment of spine, strengthen paraspinal muscles, and prevent complications

COMPLICATIONS OF ANKYLOSING SPONDYLITIS

Compression neuropathy like carpal and tarsal tunnel syndromes and ulnar nerve palsy
Atlantoaxial (C1 and C2) subluxation and cervical subluxation
Rheumatoid vasculitis: inflammation and blockage of small blood vessels
Pericarditis
Pulmonary complications

COLLABORATIVE CARE MANAGEMENT FOR ANKYLOSING SPONDYLITIS

Diagnostic tests: elevated ESR, C-reactive protein positive, anemia, and positive rheumatoid factor
Medications: NSAIDs, DMARDs, steroids, and biologics like Anakinra and Adalimumab
Health promotion and prevention: use of supplements like DHEA, fish oil, flaxseed, and gamma-linoleic acid, and a diet rich in calcium and vitamin D

OSTEORARTHRITIS (DEGENERATIVE JOINT DISEASE)

Primary (idiopathic): most common type of non-inflammatory joint disease
Secondary joint disease: caused by any condition that damages cartilage, subjects joints to chronic stress, or causes joint instability
Pathophysiology: erosion of articular cartilage, thickening of subchondral bone, and formation of osteophytes
Pain: primary feature, described as deep aching in the joint, relieved by rest
Loss of articular cartilage causes decreased joint motion and subluxation and deformity
Effusion causes joint laxity
Muscular atrophy and crepitus are present
Varus deformity is common in OA

COLLABORATIVE CARE MANAGEMENT FOR OSTEORARTHRITIS

Diagnostic tests: LE cell test
Medications: NSAIDs, corticosteroids, and methotrexate
Health promotion and prevention: use of supplements like fish oil, flaxseed, and gamma-linoleic acid, and a diet rich in calcium and vitamin D

POLYMYOSITIS AND DERMATOMYOSITIS

Most common inflammatory muscle diseases
Rheumatic connective tissue disease
Idiopathic inflammatory myopathies
Inclusion body myositis: characterized by an insidious onset of progressive proximal and distal muscle weakness
Myositis overlap syndrome: myositis in association with cancer, connective tissue disease like RA, SLE, or scleroderma
Pathophysiology: inflammation of muscle fibers and connective tissue, leading to extensive tissue necrosis and destruction of muscle fibers
Fever, swelling, malaise, and fatigue: initial symptoms of both disorders
Heliotrope rash: dusky red lesion found in the periorbital region along with periorbital edema
Gottron's papules: scaly, erythematous lesions over the MCP or IP joints, knees, elbows, or medial malleoli
Calcinosis: a condition in which calcium salts are deposited in the skin and subcutaneous tissue

COLLABORATIVE CARE MANAGEMENT FOR POLYMYOSITIS AND DERMATOMYOSITIS

Diagnostic tests: elevated serum enzymes such as creatine kinase, aldolase, lactate dehydrogenase, and transaminases
Goals of treatment: relieve pain and stiffness, achieve and maintain best possible alignment of spine, strengthen paraspinal muscles, and prevent complications
Medications: NSAIDs, corticosteroids, and methotrexate

OSTEOPOROSIS

Most common bone disorder
Classified as either: Senile – type II, Postmenopausal- type I, or Idiopathic
Cause is UNKNOWN, results from loss of calcium in the bone
Pathophysiology: imbalance between bone resorption and bone formation, leading to osteopenia and osteoporosis
Low bone mass: critical element in the diagnosis of osteoporosis
Osteoporosis is usually asymptomatic until fractures occur
Risk factors: loss of natural estrogen at menopause, chronic calcium deficiency, diets high in fat, and glucocorticoid use

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Learn about Ankylosing Spondylitis (Marie-Strumpell disease), a chronic inflammatory disease of the axial skeleton affecting the sacroiliac joints and spine. Explore its etiology, pathophysiology including spondylitis and enthesitis, genetic marker HLA-B27, and more.

Ankylosing Spondylitis Overview

Choose a study mode