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MSS 2 > Clinical Classification > Flashcards

Clinical Classification Flashcards

1
Q

What is the culprit for causing lyme disease?

A
  • Borrelia burgdorferi carried by the ixodes scapularis deer tick.
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2
Q

How do we classify rheumatic diseases?

A
  • MONOARTICULAR= 1 joint (crystal or infection induced)
  • POLYARTICULAR= 5 or more joints (connective tissue diseases or seronegative spondyloarthropathy).
  • NON-ARTICULAR= fibromyalgia
  • ENDOCRINE and METABOLIC
  • DEGENERATIVE= osteoarthritis
  • METABOLIC
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3
Q

What is the most common cause of septic arthritis (monarticular)?

A
  • Staph aureus
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4
Q

What is seronegative spondyloarthropathy (polyarticular)?

A
  • seronegative rheumatoid factor negative (aka it doesn’t show up in blood)= predilection for inflammation of the spine.
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5
Q

What is the most common NONinflammatory arthritis seen in the U.S.?

A
  • osteoarthritis (degenerative joint disease; DJD)
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6
Q

How do we approach a pt with joint pain?

A
  • Hx= ask “how long are your joints stiff in the morning?”
  • PE
  • Labs
  • x-ray
  • tissue diagnosis
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7
Q

What is the most common INFLAMMATORY arthritis seen in the U.S.?

A
  • gout (monoarticular)
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8
Q

How does RA differ from OA (DJD)?

A
  • morning stiffness= much longer in RA vs. maybe only 30 mins for OA.
  • Age of onset= 25-40 for RA vs. older than 40 for OA.
  • symmetry= RA (symmetry bilateral), OA (asymmetric)
  • constitutional symptoms= RA (yes), OA (no systemic component)
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9
Q

What does oligoarticular mean?

A
  • 2-4 joints involved
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10
Q

What is important to know about gonococcal dermatitis-arthritis syndrome?

A
  • infection with Neisseria gonorrhoeae causing the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis
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11
Q

What is the difference between arthralgia and arthritis?

A
  • arthralgia= symptom (complaint of pain in and around the joints).
  • arthritis= sign (objective evidence of a joint abnormality).
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12
Q

What are the rheumatology terms for heat, redness, swelling, pain, and loss of function, respectively?

A
  • heat= warmth
  • redness= erythema
  • swelling= joint effusion
  • pain= pain/dolar
  • loss of function= flexion contracture or ankylosis
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13
Q

What do we call swelling of the joints?

A
  • synovitis or synovial proliferation (often MCPs; metacarpophalangeal joints in RA)
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14
Q

Inflammation of the first carpometacarpal joint?

A
  • osteoarthritis
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15
Q

Are swan neck deformities specific to RA?

A
  • NO bc they can be seen in lupus, psoriatic arthritis, and reactive arthritis.
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16
Q

What are the 6 lab screening tests for connective tissue diseases?

A
  1. CBC
  2. UA
  3. CMP
  4. ANA (sensitive to SLE; not specific)
  5. RA-Latex
  6. ESR (nonspecific marker of inflammation in the blood).
17
Q

** What is the difference between sensitivity and specificity?

A
  • seNsitivity= few false Negatives (100 lupus pts in a room; 90 female, 10 male. You would expect 98% of these pts to have a positive ANA; aka good screening test.
  • sPecificity= few false Positives (if they have the antibody they have the disease; for lupus the best specific test is anti-smith antibody). However, it is not sensitive, bc this antibody is only found in 30% of lupus pts. So, we don’t use it to screen, bc we would be missing 70% of pts with lupus.
18
Q

** RULE OF THUMB in RHEUMATOLOGY: If your pt has a joint effusion, and you do NOT yet have a diagnosis, what should you do?

A
  • aspirate the joint and do a synovial fluid analysis.
19
Q

What will you have in a synovial fluid analysis?

A
  • WBC count
  • culture
  • crystal
  • glucose (low= infection)
20
Q

What is the radiographic hallmark of RA?

A
  • erosion (looks like someone took a bite out of the bone).
21
Q

What is the most common organism in septic bursitis?

A
  • Staph aureus
22
Q

What are the types of MONOarticular arthritis?

A
  • gout
  • pseudogout
  • septic arthritis
  • traumatic arthritis
  • mechanical derangement
  • bursitis/tendinitis

MSS 2 (15 decks)

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