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Year2 MSK exam2 > Crystal Diseases and Keritoconjunctivitis, Told, Part I > Flashcards

Crystal Diseases and Keritoconjunctivitis, Told, Part I Flashcards

1
Q

what are the types of crystals that can cause crystal disease

A

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

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2
Q

do apatite crystals react to polarized light

A

no

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3
Q

terminal tuft calcification on tip of Distal phalanx

A

oxylosis from Ca oxylate cyrstals

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4
Q

which type of crystal high risk of nephrolythiasis

A

Ca oxalate

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5
Q

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

A

RA and chronic infection

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6
Q

what Ab do inflammatory cells produce that activate synovial fibroblasts

A

S100A4

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7
Q

MonoNa urate

A

gout

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8
Q

Ca pyrophosphate

A

pseudogout

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9
Q

risk factors for hyperuricemia and gout

A

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

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10
Q

hyperuricemia is a marker for

A

atherogenesis

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11
Q

Urate crystals in a joint activate what

A

IgG coating and Apo E coating

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12
Q

IgG coating of urate crystals stimulates what

A

inflammatory cells to secrete cytokines

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13
Q

Apo E coating on urate crystals ahs what effect

A

inhibits inflammatory cell secretion of cytokines

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14
Q

majority of hyperuriceima is due to what

A

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

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15
Q

what can increase urate production

A

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

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16
Q

when give cytotoxic drug to someone with Hx of gout

A

have to give something that shuts down urate production

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17
Q

best predictor of an acute gout attack

A

uric acid levels

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18
Q

what is the name of first gouty attack

A

podagra

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19
Q

begining of gout presents how

A

abrupt onset monoarticular changes to polyarticular with time

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20
Q

tophi gout

A

chronic urate overload

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21
Q
  • birefringent crystals
A

MSU yellow in direction of polarized light

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22
Q

Stage I gout

A

aSx no arthritis

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23
Q

Stage II gout

A

acute intermittent arthritis

24
Q

Stage III gout

A

chronic arthritis with acute excacerbations tophi- bone and cartilage

25
Q

what do tophi look like

A

boils on finger tips or cartilage of ear

26
Q

indications to lower urate level

A

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

27
Q

do you stop allopurinol during acute gout

A

no!

28
Q

do you start allopurinol during acute gout attack

A

no

29
Q

inflammatory arthritis rhomboid crystals

A

Ca phyrophosphate pseudogout

30
Q

pseudogout at risk for

A

chondrocalcinosis

31
Q

assoc medical conditions with pseudogout

A

hyperPTH hypothyroidism hemochromatosis wilsons disease OA

32
Q

management of crystal disease acute

A

NSAIDs corticosteroids colchicine biologics (IL1 inhibitor)

33
Q

Prophylaxis for crystal diseases

A

xanthine oxidase inhibitors (allopurinol) uricosurics (losartan) uricase

34
Q

does diet help with urate levels

A

no!!

35
Q

primary sjogren

A

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

36
Q

secondary sjogren

A

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

37
Q

criteria for sjogren

A

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

38
Q

what are the ocular signs fo sjogren

A

schirmers rose bengal

39
Q

anti Ro SS-A nucleolar pattern

A

dermatomyositis

40
Q

CBC sjogrens

A

anemia leukopenia eocinophelia

41
Q

Ig in sjogrens

A

hypergammaglobulinemia

42
Q

sjogrens RA or ANA

A

RA positive 70% ANA positive 95%

43
Q

common extraglandular manifestations of primary sjogren

A

constitutional Sx articular involvement raynauds phenomenon pulmonary involvement

44
Q

infected stensons duct

A

sjogrens

45
Q

salivary duct stone

A

sjogrens

46
Q

sialectasis submandibular gland

A

sjogrens

47
Q

infiltrates of lymphocytes with glandular and ductal atrophy from lip Bx

A

sjogrens

48
Q

schirmer

A

<5mm wetting of filter paper indicates reduced lacrimal secretions

49
Q

rose bengal staining

A

red= + indicates inflammation and irritation of conjunctival layer

50
Q

low trachiobronchial secretions leads to

A

nonspecific interstitial pneumonia and xyerotrachea

51
Q

Artificial tears for sjogren

A

methyl cellulose

52
Q

eye drops sjogren

A

cyclosporin

53
Q

drugs fro sjogren

A

pilocarpine and cevimeline

54
Q

watch for what neoplasm with sjogren

A

lymphoma

55
Q

explain the following finding

A

calcification from pseudogout

Year2 MSK exam2 (17 decks)

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