Bones, Joints, ST - Joe

Question 1

R.A. Produces autoantibodies to what?

Answer 1

CCPs/Self antigens (alpha enolase, vimentin, fibrinogen, type 2 collagen)

Question 2

Rheumatoid cutaneous nodules show what morphology?

Answer 2

Fibrinoid necrosis w/palisading histiocytes

Question 3

Pts w/gout may have a polymorphism in what?

Answer 3

URAT1 and GLUT9

Question 6

What is a mass of edematous synovium, inflammatory cells, granulation tissue, fibroblasts that grows over articular cartilage and causes erosion?

Seen in what?

Answer 6

Pannus

R.A.

Question 9

Hereditary variant of pseudogout is what inheritance?

Mutation in what?

Answer 9

AD

Pyrophosphate channel

Question 10

What shows the radiology of juxta-articular bone erosion caused by osteoclastic bone resorption and loss of joint space?

Answer 10

Gout

Question 11

Long term complications of R.A.?

Answer 11

Systemic amyloidosis
Caplan syndrome
ACD
Felty syndrome

Question 13

Inflamed joints show which inflammatory mediators in R.A.?

Answer 13

TNF from Th17
IL-17 from Th17
IFN-G from Th1

Question 14

CFs of OA?

Answer 14

Asymmetric joint involvement
Bow legged
Joint space narrowing
Prominent osteophytes

Question 17

What shows pathologic change in ligamentous attachments not synovium?

What association?

Answer 17

Ankylosing spondylitis (Marie-Strumpell)

HLA-B27 and IL-23R gene

Question 18

What causes episodes of arthritis that wax and wane for weeks to 6 months?

CFs?

Answer 18

Reactive arthritis

Synovitis of digital tendon sheath

Question 19

What is Caplan syndrome?

Answer 19

R.A.
Intrapulmonary nodules w/in lungs
Pneumoconiosis

Question 20

What has morphology of chondrocytes form clusters (cloning), form loose bodies, fibrillation of articular cartilage, eburnation of articular surface?

Answer 20

Osteoarthritis (OA)

Question 21

What is Felty syndrome?

Answer 21

R.A.
Splenomegaly
Neutropenia

Question 22

Pseudo-Gout is called what else?

Occurs in whom?

Morphology?

What joint most commonly affected?

Answer 22

Chondrocalcinosis (CPPD)

Older than 50, 60% older than 85

(+) birefringence, rhomboid shaped crystals

Knee

Question 24

What are 2 specific findings in R.A.?

Answer 24

1 antibodies against citrullinated peptides (fibrinogen, type II collagen, vimentin)

RF (serum IgM or IgA autoAbs that bind to Fc portion of their own IgG)

Question 25

CF of R.A.?

Answer 25

Pain and stiffness in morning, improves w/use
Symmetric
Small joints affected first

Question 26

What is the swan-neck deformity?

Answer 26

Hyperextension of PIP joints

Flexion of DIP joints

Question 27

What can trigger autoimmune reactions in R.A.?

Answer 27

Smoking

Infection

Question 28

What causes arthropathy in the peripheral and axial joints, ligaments and tendons?

What special sign?

Answer 28

Psoriatic arthritis

Pencil in cup

Question 29

What are pathognomonic for gout?

Answer 29

Tophi - large aggregates of urate crystals surrounded by intense inflammatory rxn

Question 30

What GU infection can activate reactive arthritis?

GI?

Answer 30

Chlamydia

Shigella, salmonella, Yersenia, Campylobacter

Question 32

What are RF for gout?

Answer 32

Thiazide diuretic

Tumor lysis syndrome

Question 34

Common age group and sex for R.A.?

What allele?

gene mutation?

Answer 34

20-40, women

HLA-DRB1

PTPN22

Question 36

What is boutonnière deformity?

Answer 36

Flexion of PIP joints

Hyperextension of DIP joints

Question 38

Positive ANA in what?

CF?

Answer 38

Juvenile idiopathic arthritis

Large joints