18.3 Joints

Question 1

What is articular cartilage made of?

Answer 1

Type 2 Collagen

Question 2

Degenerative Joint Disease

Answer 2

Progressive degeneration of articular cartilage most often due to wear and tear

Question 3

What is the major risk factor for degenerative joint disease?

Answer 3

Age

Question 4

How does degenerative joint disease present?

Answer 4

Joint stiffness in the morning that worsens during the day

Question 5

What joints of the hand does degenerative joint disease affect?

Answer 5

Both the DIPs and PIPs

Question 6

What HLA mutation is rheumatoid arthritis associated with?

Answer 6

HLA-DR4

Question 7

Who is the common patient seen with rheumatoid arthritis?

Answer 7

Middle-aged women

Question 8

What is the hallmark of rheumatoid arthritis?

Answer 8

Synovitis with formation of a pannus - thick layer of granulation tissue

Question 9

What is the presentation of rheumatoid arthritis in the morning?

Answer 9

Morning stiffness that improves with activity

Question 10

What joints of the hand are affected in rheumatoid arthritis?

Answer 10

Wrists and DIP but PIP is normally spared

Question 11

What Ab if found in rheumatoid arthritis?

Answer 11

IgM Ab against Fc portion of IgG

Question 12

What HLA are seronegative spondyloarthropathies associated with?

Answer 12

HLA-B27

Question 13

What bones do seronegative spondyloarthropathies tend to involve?

Answer 13

Axial Skeleton

Question 14

Ankylosing Spoondyloarthropathy

Answer 14

Involvement of the vertebral spine that can lead to fusion of the vertebrae - and can have uveitis and aortitis

Question 15

Reiter Syndrome

Answer 15

Arthritis, urethritis and conjunctivitis that arises after GI or C. trachomatis infection

Question 16

Who is the typical patient of Reiter syndrome?

Answer 16

Young Males

Question 17

Psoriatic Arthritis

Answer 17

Seen with psoriasis occasionally and can cause sausage fingers/toes

Question 18

What is the most common cause of infectious arthritis?

Answer 18

N. gonorrhea

Question 19

Gout

Answer 19

Deposition of monosodium rate crystals in joints due to hyperuricemia

Question 20

What are some causes of secondary gout?

Answer 20

• Leukemia
• Renal Insufficiency
• Lesch-Nyhan Syndrome

Question 21

Lesch-Nyhan Syndrome?

Answer 21

HGPRT enzyme deficiency that leads to increased levels of uric acid and has strange symptoms like self mutilation

Question 22

Tophi

Answer 22

White chalky deposits of uric acid

Question 23

Pseudogout

Answer 23

Deposition of calcium pyrophosphate

Question 24

What is the appearance of pseudo gout crystals?

Answer 24

Rhomboid shape with positive birefringence under polarized light

Question 25

What is the appearance of gout crystals?

Answer 25

Needle shaped