Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rheumatology > 367 Arthritides > Flashcards

367 Arthritides Flashcards

Chapter 367. Arthritis associated with Systemic Disease and other Arthritides

1
Q

Common feature of arthropathy of acromegaly

A

Osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does arthropathy of hemochromatosis occur

A

Occurs in 20-40% of patients at age 50 and may be the first clinical feature of hemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

First and most prominent joints affected in arthropathy of hemochromatosis

A

Second and third metacarpophalangeal joints of both hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What arthropathy are hook like osteophytes seen?

A

Arthropathy of hemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Early diagnosis of arthropathy of hemochromatosis is suggested by what

A

High serum transferring saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two ways iron damages articulate cartilage

A
  1. Iron catalyzed super oxide dependent lipid peroxidation which play a role in joint damage
  2. Ferric iron interfere with collagen formation leading to chondrocalcinosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

True or false. Repeated phlebotomy although a treatment of hemochromatosis, it has little effect on established arthritis and chondocalcinosis may progress still

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptom based treatment for arthropathy of hemochromatosis

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common problem of hemophilia and can lead to deforming arthritis

A

Spontaneous hemarthrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most affected joints of hemarthrosis

A 
Knees
Ankles
Elbows
Shoulders
Hip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In hemarthrosis, joint function usually returns to normal or baseline in how many weeks

A

Joint function usually returns to normal or baseline in about two weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What distinguishes bleeding into the iliopsoas from hip synovitis and hemarthrosis

A

In bleeding of iliopsoas, rotation of hip is preserved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What forms when bleeding involves the periosteum or bone

A

Painful pseudotumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True or false. Septic arthritis is common in hemophilia due to hemarthrosis

A

False. Septic arthritis is rare. But to distinguish clinically from hemarthrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment of musculoskeletal bleeding in patients with hemophilia

A

Immediate infusion of factor VII or IX at first sign of joint or muscle hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may be given to those hemophilia patient who developed factor inhibitors

A

Recombinant activated factor VII or activated prothrombin complex concentrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How should the joint be positioned in hemarthrosis

A

Joint should be rested in position of forced extension to avoid contracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What time of algesia is given to hemarthrosis or in patients with hemophilia

A

Non selective NSAIDs

COX-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Alternative treatment for hemarthrosis when surgical synovectomy is not practical

A

Radiosynovectomy with either yttroum 90 silicate or phosphorus 31

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Refers for the diffuse swelling tenderness and warmth of the hands and feet lasting for 1-3 weeks in patients with sickle cells disease

A

Sickle cell dactylitis or hand-foot syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes the dactylitis in sickle cell disease

A

Result from infarction of the bone marrow and cortical bone leading to periostitis and soft tissue swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

True or false. Sickle cell dactylitis is seen in patient of all age groups.

A

False. Rarely seen beyond 5 years old as hematopoeisis ceases in small bones of hand and feet after age 5.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In sickle cell crisis, which joints are commonly affected

A

Knees and elbows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

True or false. Patient with sickle cell disease are predisposed to osteomyelitis

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In osteomyelitis affected sickle cell disease, which bones are commonly affected

A

Long tubular bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the common pathogen for osteomyelitis in patients with sickle cell disease

A

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

True or false. Clinical distinction between osteomyelitis and bone infarction can be difficult without imaging.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does sickle cell disease lead to bone infarction

A

Resulting from vaso occlusion from sickling of the cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A vascular necrosis of the head of the femur occurs in 5% of patient with sickle cell disease

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

True or false. Septic arthritis is occasionally encountered in sickle cell disease

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Common pathogen for septic arthritis in sickle cell disease

A

Staph aureus
Streptococcus
Salmonella

32
Q

True or false. Acute gouty arthritis is uncommon in sickle cell disease despite hyperuricemia

A

True

33
Q

True or false. Bone and joint abnormalities are common in thalassemia major and intermedia group

A

True

34
Q

True or false. Avascular necrosis is common in thalassemia just like sickle cell disease.

A

False. No sickling of cells in thalassemia that leads to thrombosis and infraction

35
Q

About 50% of patients with thalassemia have this kind of arthropathy

A

Symmetric ankle arthropathy

36
Q

Onset of ankle arthropathy in thalassemia

A

Second or third decade of life

37
Q

Soft cutaneous masses located over the extensor surfaces of the elbows, knees, and hands as well as on the buttocks

A

Tuberous xanthomas

38
Q

True or false. Patients given niacin may develop myositis more often than myalgias

A

True

39
Q

True or false. Patients taking HMG-Co reductase inhibitor may experience myalgias

A

True

40
Q

Progressive destructive arthritis associated with loss of pain sensation, proprioception or both

A

Neuropathic joint disease (Charcot joint)

41
Q

Most frequent cause of neuropathic joint disease

A

Diabetes mellitus

42
Q

In tabes dorsalis which joint are commonly affected in Neuropathic joint disease

A

Knees
Hips
Ankles

43
Q

In syringomyelia, which joint are commonly affected by neuropathic joint disease

A

Glenohumeral joint
Elbow
Wrist

44
Q

In diabetes mellitus, which joint are commonly affected by neuropathic joint disease

A

Tarsal and tarsometatarsal joints

45
Q

Pathologic changes in Neuropathic joint disease

A

Fragmentation and eventual loss of articular cartilage with eburnation of the underlying bone much like what is found in severe osteoarthritis joint

46
Q

Two mechanism involved in the pathogenesis of neuropathic joint disease

A
  1. Abnormal autoimmune nervous system responsible for dysregulated blood flow to the joint with subsequent resorption of bone
  2. Analgesics effect of glucocorticoids leads to overuse of an already damaged joint leads to accelerated cartilage damage
47
Q

Second most affected joints in Neuropathic joint disease among diabetic patients

A

Metatarsophalangeal and talotibial joints

48
Q

What is rocker foot

A

Downward collapse of the tarsal bones lead to convexity of the sole

49
Q

Destructive changes at the tarsometatarsal joints

A

Lisfranc fracture-dislocation

50
Q

Differentiate neuropathic arthritis from osteomyelitis

A

Joint margins in Neuropathic pain tend to be distinct while osteomyelitis they are blurred. Imaging may be helpful but culture of tissues from the joint is required to rule out osteomyelitis

51
Q

Further imaging that differentiate neuropathic joint disease from osteomyelitis

A

MRI and bone scans with indium 111-labeled white blood cells or indium 111- labeled with immunoglobulin G which will show increased uptake in osteomyelitis but not in Neuropathic joint disease

52
Q

Primary focus of treatment in Neuropathic joint disease

A

Stabilize the joint with braces and splints

Prohibition of weight bearing by the foot for at least 8 weeks

53
Q

Characterized by clubbing of digits and in more advanced stages by perioateal new bone formation and synovial effusions

A

Hypertrophic osteoarthropathy (HOA)

54
Q

True or false. Secondary hypertrophic osteoarthropathy is associated with intra thoracic malignancies, suppurativr and some hyooxemic lung disease and congenital heart disease

A

True

55
Q

Almost always a feature of HOA

A

Clubbing

56
Q

Other name for primary or familial HOA

A

Pachydermoperiositis

Touraine - Solente- Gole syndrome

57
Q

Prominent feature of primary HOA

A

Skin changes and periostitis

58
Q

Referred to thick corrugated scalp in familiar HOA

A

Cutis verticis gyrata

59
Q

True or false. Secondary HOA is more common than primary HOA

A

True.

60
Q

How clubbing objective measured

A

Diameter at base of nail and at the distal interphalangeal joint.
Sum of individual digital ratio is more than 10

61
Q

Progression of HOA is more rapid when associated with malignancies. Notably which cancer

A

Bronchogenic carcinoma

62
Q

True or false. Secondary HOA is not associated with excessive sweating and oiliness of skin or thickening of facial skin

A

True

63
Q

Clubbing of the toes but not the fingers has been associated with what disorders

A

Infected abdominal aortic aneurysm and patent ductus arteriosus

64
Q

Unilateral clubbing has been found in association with what disorders

A

Aneurysms of major extremity arteries, infected arterial grafts and with arteriovenous fistula of brachial vessels

65
Q

Refers to clubbing and periostitis of the bones of the hands and feet in hyperthyroidism

A

Thyroid acropachy

66
Q

characterized pain and swelling of a distal extremity accompanied by vasomotor instability, trophic skin changes and rapid development of bony demineralization

A

complex regional pain syndrome type 1

67
Q

manifested by painful swelling of one or more costochondral articulations

A

Tietze syndrome

68
Q

usual joint affected by Tietze syndrome

A

second or third costochondral joint

69
Q

differentiate Tietze syndrome and costochondritis

A

Age of onset. before 40 Tietze; after 40 costochondritis

affected joint. 3rd-5th in costochondritis; 2nd-3rd in Tietze

70
Q

characterized by multiple areas area of localized musculoskeletal pain and tenderness associated with tenderness on the muscle belly

A

myofascial pain syndrome

71
Q

characterized by the slowly progressive exuberant benign proliferation of synovial tissue, usually involving a single joint

A

pigmented villonodular synovitis (PVNS)

72
Q

Most commonly affected joint in PVNS

A

knee

73
Q

How is PVNS diagnosed

A

gradient echo MRI reveals a synovial mass lesion of low signal intensity typical of tissue containing hemosiderin

74
Q

What is the treatment of PVNS

A

complete synovectomy

75
Q

Disorder characterized by multiple focal metaplastic growths of normal appearing cartilage in the synovium or tendon sheath

A

synovial chondromatosis

76
Q

malignant neoplasm often found near a large joint of both upper and lower extremities being more common in the lower extremity

A

synovial sarcoma

77
Q

most common site of visceral metastatis of synovial sarcoma

A

lung

Rheumatology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions