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Medical Lectures > 1- Diagnosis and Evaluation of Joint Problems > Flashcards

1- Diagnosis and Evaluation of Joint Problems Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the two clinical clues most helpful for diagnosis?

A
  • Joint Pattern

- Presence or absence of extra-articular manifestations

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2
Q

What does inflammation consist of?

A

redness, warmth, swelling, and morning stiffness of at least 30 min duration

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3
Q

What could fever be a result of?

A

Gout, Still disease

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4
Q

What could rash be a result of?

A

SLE, Psoriatic arthritis

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5
Q

What could nodules be a result of?

A

Rheumatoid arthritis

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6
Q

What could neuropathy be a result of?

A

Polyarteritis nodosa

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7
Q

If inflammation is present, what is the representative disease?

A

Rheumatoid arthritis, systemic lupus erythematosus, gout

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8
Q

If inflammation is absent, what is the representative disease?

A

Osteoarthritis

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9
Q

If the number of joints involved in monoarticular, what is the representative disease?

A

Gout, trauma, septic arthritis, Lyme disease, osteoarthritis

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10
Q

If the number of joints involved is oligoarticular (2-4 joints), what is the representative disease?

A

Reactive arthritis, psoriatic arthritis, inflammatory bowel disease

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11
Q

If the number of joints involved is polyarticular (>5 joints), what is the representative disease?

A

Rheumatoid arthritis, systemic lupus erythematosus

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12
Q

If the site of joint involvement is the distal interphalangeal joints, what is the representative disease?

A

Osteoarthritis, psoriatic arthritis (not rheumatoid)

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13
Q

If the site of joint involvement is the metacarpophalangeal joints or the wrist, what is the representative disease?

A

Rheumatoid arthritis, systemic lupus erythematosus, calcium pyrophosphate deposition disease (not osteoarthritis)

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14
Q

If the site of joint involvement is the first metatarsalphalangeal joint, what is the representative disease?

A

Gout, osteoarthritis

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15
Q

If diagnosis is uncertain, what should be examined?

A

synovial fluid

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16
Q

What precautions should one take with the aspirating needle when performing arthocentesis?

A

The aspirating needle should never pass through overlying cellulitis or psoriatic plaque.

17
Q

Normal Joint Fluid:

  • volume
  • color
  • clarity
  • WBC
  • polymorphonuclear leukocytes
  • culture
A
  • < 3.5
  • transparent
  • clear
  • < 200
  • < 25%
  • negative
18
Q

Group I (Inflammatory) Joint Fluid

  • volume
  • color
  • clarity
  • WBC
  • polymorphonuclear leukocytes
  • culture
A
  • Often > 3/5
  • transparent
  • yellow
  • < 2000
  • < 25%
  • Negative
19
Q

Group II (Inflammatory) Joint Fluid

  • volume
  • color
  • clarity
  • WBC
  • polymorphonuclear leukocytes
  • culture
A
  • Often > 3/5
  • translucent to opaque
  • yellow to opalescent
  • 2000-75,000
  • 50% or more
  • negative
20
Q

Group III (Purulent) Joint Fluid

  • volume
  • color
  • clarity
  • WBC
  • polymorphonuclear leukocytes
  • culture
A
  • Often > 3.5
  • opaque
  • yellow to green
  • > 100,000
  • 75% or more
  • usually positive
21
Q

When performing microscopic examination, what does monosodium urate represent?

A

gout, negatively birefringent

22
Q

When performing microscopic examination, what does calcium pyrophosphate represent?

A

pseudogout, positive birefringent

23
Q

Which group does this belong in?

Degenerative Joint Disease

A

Group 1 (Noninflammatory)

24
Q

Which group does this belong in?

Trauma

A

Group 1 (Noninflammatory)

25
Q

Which group does this belong in?

Rheumatoid Arthritis

A

Group II (Inflammatory)

26
Q

Which group does this belong in?

Acute crystal-induced synovitis (gout and pseudogout)

A

Group II (Inflammatory)

27
Q

Which group does this belong in?

Reactive Arthritis

A

Group II (Inflammatory)

28
Q

Which group does this belong in?

Pyogenic bacterial infections

A

Group III (Purulent)

Medical Lectures (13 decks)

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