Crystal Diseases and Keritoconjunctivitis, Told, Part I

Question 1

what are the types of crystals that can cause crystal disease

Answer 1

monosodium urate calcium pyrophosphate dihydrate basic Ca PO4 Ca oxalate Cholesterol Crystals Monoclonal Proteins

Question 2

do apatite crystals react to polarized light

Answer 2

no

Question 3

terminal tuft calcification on tip of Distal phalanx

Answer 3

oxylosis from Ca oxylate cyrstals

Question 4

which type of crystal high risk of nephrolythiasis

Answer 4

Ca oxalate

Question 5

lipid crystals(cholesterol) are seen in joint effusions with what

Answer 5

RA and chronic infection

Question 6

what Ab do inflammatory cells produce that activate synovial fibroblasts

Answer 6

S100A4

Question 7

MonoNa urate

Answer 7

gout

Question 8

Ca pyrophosphate

Answer 8

pseudogout

Question 9

risk factors for hyperuricemia and gout

Answer 9

age and body mass degree of duration of hyperuricemia middle age male post menopausal women

Question 10

hyperuricemia is a marker for

Answer 10

atherogenesis

Question 11

Urate crystals in a joint activate what

Answer 11

IgG coating and Apo E coating

Question 12

IgG coating of urate crystals stimulates what

Answer 12

inflammatory cells to secrete cytokines

Question 13

Apo E coating on urate crystals ahs what effect

Answer 13

inhibits inflammatory cell secretion of cytokines

Question 14

majority of hyperuriceima is due to what

Answer 14

decreased renal excretion from impaired fuction, dehydration, acidosis, diuretics, low dose ASA, etc

Question 15

what can increase urate production

Answer 15

ethanol myeloproliferative disorders ineffective erythropoiesis widespread psoriasis cytotoxic drugs glycogen storage disease G5PD defieincy HGPRTase deficiency

Question 16

when give cytotoxic drug to someone with Hx of gout

Answer 16

have to give something that shuts down urate production

Question 17

best predictor of an acute gout attack

Answer 17

uric acid levels

Question 18

what is the name of first gouty attack

Answer 18

podagra

Question 19

begining of gout presents how

Answer 19

abrupt onset monoarticular changes to polyarticular with time

Question 20

tophi gout

Answer 20

chronic urate overload

Question 21

• birefringent crystals

Answer 21

MSU yellow in direction of polarized light

Question 22

Stage I gout

Answer 22

aSx no arthritis

Question 23

Stage II gout

Answer 23

acute intermittent arthritis

Question 24

Stage III gout

Answer 24

chronic arthritis with acute excacerbations tophi- bone and cartilage

Question 25

what do tophi look like

Answer 25

boils on finger tips or cartilage of ear

Question 26

indications to lower urate level

Answer 26

trophaceous disease with erosions nephrlithiasis from urate recurrent attacks even wtih prophylaxis

Question 27

do you stop allopurinol during acute gout

Answer 27

no!

Question 28

do you start allopurinol during acute gout attack

Answer 28

no

Question 29

inflammatory arthritis rhomboid crystals

Answer 29

Ca phyrophosphate pseudogout

Question 30

pseudogout at risk for

Answer 30

chondrocalcinosis

Question 31

assoc medical conditions with pseudogout

Answer 31

hyperPTH hypothyroidism hemochromatosis wilsons disease OA

Question 32

management of crystal disease acute

Answer 32

NSAIDs corticosteroids colchicine biologics (IL1 inhibitor)

Question 33

Prophylaxis for crystal diseases

Answer 33

xanthine oxidase inhibitors (allopurinol) uricosurics (losartan) uricase

Question 34

does diet help with urate levels

Answer 34

no!!

Question 35

primary sjogren

Answer 35

occurs in isolation predominently in women 40-60 years dry eyes, mouth and resp tract exocrine gland dysfunction RA and other autoAb

Question 36

secondary sjogren

Answer 36

association with other rheumatic disease RA SLE primary biliary cirrhosis scleroderma polymyocitis hashimoto polyarteritis interstitial pulmonary fibrosis

Question 37

criteria for sjogren

Answer 37

minimum of 4 -autoimmune exocrinopathy -ocular Sx -oral Sx -ocular signs -characteristic histopath features -salivary gland involvement by testing -autoAb RF+ SS-A SS-B

Question 38

what are the ocular signs fo sjogren

Answer 38

schirmers rose bengal

Question 39

anti Ro SS-A nucleolar pattern

Answer 39

dermatomyositis

Question 40

CBC sjogrens

Answer 40

anemia leukopenia eocinophelia

Question 41

Ig in sjogrens

Answer 41

hypergammaglobulinemia

Question 42

sjogrens RA or ANA

Answer 42

RA positive 70% ANA positive 95%

Question 43

common extraglandular manifestations of primary sjogren

Answer 43

constitutional Sx articular involvement raynauds phenomenon pulmonary involvement

Question 44

infected stensons duct

Answer 44

sjogrens

Question 45

salivary duct stone

Answer 45

sjogrens

Question 46

sialectasis submandibular gland

Answer 46

sjogrens

Question 47

infiltrates of lymphocytes with glandular and ductal atrophy from lip Bx

Answer 47

sjogrens

Question 48

schirmer

Answer 48

\<5mm wetting of filter paper indicates reduced lacrimal secretions

Question 49

rose bengal staining

Answer 49

red= + indicates inflammation and irritation of conjunctival layer

Question 50

low trachiobronchial secretions leads to

Answer 50

nonspecific interstitial pneumonia and xyerotrachea

Question 51

Artificial tears for sjogren

Answer 51

methyl cellulose

Question 52

eye drops sjogren

Answer 52

cyclosporin

Question 53

drugs fro sjogren

Answer 53

pilocarpine and cevimeline

Question 54

watch for what neoplasm with sjogren

Answer 54

lymphoma

Question 55

explain the following finding

Answer 55

calcification from pseudogout