Extra Conditions Flashcards
(125 cards)
0
Q
Red meat and alcohol can be risk factors for what condition due to purine emphasis?
A
Gout
1
Q
What condition is an abnormal purine metabolism leading to uric acid accumulation?
A
Gout
2
Q
When uric acid accumulates in gout, what do they become?
A
Monosodium urate crystals (tophus/tophi)
3
Q
What occurs with gout?
A
Recurrent acute joint inflammation leading to destruction and fibrosis
4
Q
Over 90% of the cases of gout is what kind?
A
Primary - hyperuricemia
5
Q
What is the hypothesized cause of primary gout?
A
Enzyme defects
6
Q
With primary gout, what accumulates in the blood?
A
Uric acid
7
Q
What is secondary gout?
A
Gout that is secondary to another disease or from drug exposure
8
Q
What are examples of some causes of secondary gout?
A
Renal disease leukemia, multiple myeloma, diuretics
9
Q
What is the cause of the inflammation of gout?
A
Failed crystal phagocytosis
10
Q
What is the usual age of those with gout?
A
Over 30
11
Q
Gout usually occurs among which gender?
A
Males
12
Q
What is the most common location for gout inflammation?
A
Hallux (MTP) aka podagra
13
Q
About what percent of the population is affected by gout?
A
1%
14
Q
The historical name, “Kings Disease”, is associated with what condition?
A
Gout
15
Q
Monoarticular inflammation is characteristic of what condition?
A
Gout
16
Q
What is the first stage of gout?
A
Asymptomatic hyperuricemia
17
Q
What is the second stage of gout?
A
Acute gouty arthritis causing erythema
18
Q
What is the third stage of gout?
A
Repeated chronic tophaceous arthritis that fails to resolve itself between cycles
19
Q
20% of those with gout die from what issue?
A
Renal failure (gouty nephropathy)
20
Q
What are other names for pseudogout?
A
Chondrocalcinosis or Calcium Pyrophosphate Deposition Disease (CPDD)
21
Q
What causes pseudogout?
A
Altered pyrophosphate metabolism
22
Q
Are most cases of pseudogout inherited?
A
No, most commonly sporadic
23
Q
What is the usual location for pyrophosphate crystal deposition of pseudogout?
A
Knee, wrist, shoulder, hip, elbow, ankle
24
Only about how many cases of pseudogout lead to destruction of joints from inflammation?
50%
25
After what age is pseudogout seen among half of the population?
Over the age of 85
26
What is the usual onset age for pseudogout?
Over 50
27
What is the treatment for pseudogout?
Palliative medicine (NSAIDs or corticosteroids)
28
What specific location in the wrist is common for pseudogout to occur?
Triangular fibrocartilage complex
29
What is hydroxyapatite deposition disease usually called?
Calcific tendinitis
30
What is the sign of calcific tendinitis on X-ray?
Soft tissue opacities from ossification
31
What is the most common location for calcific tendinitis?
Rotator cuff muscles
32
What is the age of onset for calcific tendinitis?
40-70
33
What is the most common muscle affected by calcific tendinitis?
Supraspinatus
34
Adhesive capsulitis (frozen shoulder) and increased age are risk factors for what condition?
Calcific tendinitis
35
What is the other name for diffuse idiopathic skeletal hyperostosis?
Forestier disease
36
What ligament is affected in the cervical and thoracic spine in DISH?
Anterior longitudinal ligament (ALL)
37
What is the usual spinal location for DISH?
T7-T11
38
What is the most common age for DISH?
50-70
39
What are risks for DISH?
Diabetes and HLA-B27
40
Can we adjust patients with DISH?
Yes
41
What is the most common cause of infectious arthritis?
Bacteria
42
What occurs with infectious arthritis?
Rapid joint destructions within days
43
What is the treatment for infectious arthritis?
Based on microbial agent: IV antibiotics and analgesics
44
What is the name of the pus forming infectious arthritis?
Suppurative arthritis
45
What is the most common location for suppurative arthritis?
Knee
46
90% of suppurative arthritis involve how many joints?
Just one (monoarticular)
47
Which microbe is the most common agent involved with suppurative arthritis among children under 2 years of age?
Haemophilus influenzae
48
Which microbe is the most common agent involved in suppurative arthritis among children older than 2 years of age and adults?
Staphylococcus aureus
49
Which microbe is the most common agent involved in adolescents and young adults?
Neisseria gonorrhoeae
50
Who is at a higher risk for neisseria gonorrhoeae causing infectious arthritis?
Sexually active females
51
What is the most common microbe at fault for infectious arthritis among those with sickle cell anemia?
Salmonella spp
52
What is the frequency of Lyme arthritis in the US?
20,000 cases per year
53
What microbe is at fault for Lyme arthritis?
Borrelia burgdorferi
54
How is Lyme arthritis diagnosed?
Presence of IgM and IgG in serum
55
What occurs in the first stage of Lyme arthritis?
Red lesion with pale center, fever, lymphadenopathy, and is self resolving in weeks
56
What occurs in stage two of Lyme arthritis?
Secondary skin lesions, migratory joint pain, myalgia, meningitis, arrhythmias
57
What occurs in the third stage of Lyme arthritis?
2-3 years after infection, chronic polyarthritis of large joints and possible encephalitis
58
What are space occupying lesions?
SOL: pus, blood, tumor, or edema (things that are in an area where they shouldn't be potentially causing problems)
59
Are primary joint neoplasms rare or common?
Very rare and most commonly benign
60
Which is more common: tumor like lesions or neoplasia in joints?
Tumor like lesions
61
What are the two examples of tumor like lesions?
Ganglion or synovial cyst
62
What is the common location for a ganglion?
Wrist
63
What makes up a ganglion?
Degenerative connective tissue
64
What is the name of a synovial cyst in the popliteal region?
Baker's cyst
65
What is the difference between a ganglion and a synovial cyst?
Communication with the synovium is present in synovial cysts only
66
What is the typical age for tenosynovial giant cell tumors?
20-50 years
67
What joint condition involves an aggressive benign tumor?
Tenosynovial giant cell tumor (TGCT)
68
What is the type of TGCT that is larger?
Diffuse TGCT (pigmented villonodular synovitis)
69
Which type of TGCT is smaller and involved with the tendon sheaths?
Localized TGCT
70
What is the common location for diffuse TGCT?
Knee
71
What is the common location for localized TGCT?
Hand
72
What is the most common soft tissue tumor of the hand?
Localized TGCT
73
Tumors of adipose, fibrous, muscle, vessels, or the PNS are what kind of tumors?
Soft tissue tumors
74
Are soft tissue tumors usually benign or malignant?
Benign (100X)
75
If a soft tissue tumor is malignant, what is it called?
Soft tissue sarcoma
76
What is the most common area for a soft tissue tumor or sarcoma?
Thigh (but can occur anywhere)
77
What is the exception for a location where soft tissue tumors are more likely to be malignant than benign?
Skeletal muscle
78
What is a benign tumor of adipocytes?
Lipoma
79
What is a malignant tumor of adipocytes?
Liposarcoma
80
What is the most common type of soft tissue tumor of adults?
Lipoma
81
What type of soft tissue tumor is likely to be encapsulated?
Lipoma
82
What is the usual age range for liposarcomas?
40-50
83
What is the location for possible metastasis for a liposarcoma?
Lungs
84
What is the usual location for liposarcomas?
Retroperitoneum, thigh
85
What is the genetic factor of liposarcomas?
Degraded p53 resulting from a translocation of chromosomes 12 and 16
86
What is the term for a reactive fibroblastic mass?
Nodular fasciitis
87
What is the usual location for a nodular fasciitis?
Volar (Palm-side) of arm, chest, back
88
Nodular fasciitis tends to result from what kind of event?
Trauma (10-15%)
89
What is the term for reactive metaplastic bone?
Myositis ossificans
90
What is the most common location for myositis ossificans?
Proximal extremity muscles
91
A hard, painless mass is characteristic of what kind of fibrous tumor like mass?
Myositis ossificans
92
What condition should you attempt to rule out when suspicious of myositis ossificans due to their similarities in appearance?
Osteosarcoma
93
Myositis ossificans is common among what group of people?
Adolescent athletes
94
What type of fibrous like tumor mass is benign but locally invasive that tends to commonly recur?
Finromatosis
95
Dupuytren contracture and Peyronie disease are examples of what kind of fibromatosis?
Superficial
96
What is the most common age for superficial fibromatosis?
40-70
97
What another term for deep fibromatosis?
Desmoid tumor
98
Where are desmoid tumors or deep fibromatoses most commonly found?
Abdominal area
99
Which type of fibromatosis is associated with Gardner Syndrome?
Deep
100
What is the term for a slow growing, malignant fibrous like tumor mass?
Fibrosarcoma
101
What are the usual locations for fibrosarcomas?
Thigh, retroperitoneum, knee
102
What is the most common age for fibrosarcomas?
35-55
103
Neoplastic fibroblasts and anaplastic spindle cells are associated with what kind of fibrous like tumor mass?
Fibrosarcomas
104
25% of fibrosarcomas metastasize hematogenously to what location, most commonly,
Lungs
105
Herringbone pattern is associated with what fibrous like mass tumor?
Fibrosarcomas
106
What are skeletal muscle precursors?
Rhabdomyoblasts
107
What is the term for a malignant and aggressive skeletal muscle tumor?
Rhabdomyosarcoma
108
What is the most common location generally and specifically for rhabdomyosarcomas?
Generally in areas with little skeletal muscle. Specifically in the areas of the head and neck
109
What are other locations for rhabdomyosarcomas?
Genitourinary, extremities, trunk
110
What is the most common pediatric soft tissue sarcoma?
Rhabdomyosarcoma
111
What changes with the prognosis for adults with rhabdomyosarcomas?
Poor prognosis (2/3 of pediatrics will be 100% cured)
112
What is the term for a benign smooth muscle tumor?
Leiomyoma
113
What is the term for a malignant smooth muscle tumor?
Leiomyosarcoma
114
What is the most common location for a leiomyoma?
Uterus (often called fibroids)
115
What population is more at risk for leiomyosarcomas?
Adult females
116
What is a unique common area for leiomyosarcomas?
Inferior vena cava (retroperitoneum or extremities)
117
Spindle cells and cigar shaped nuclei are associated with what kind of smooth muscle tumor?
Leiomyosarcomas
118
What makes up 10% of all soft tissue sarcomas?
Synovial sarcomas
119
What is the most common age range for synovial sarcomas?
20-40 years
120
What is the unique pattern of growth associated with synovial sarcomas?
Cells grow in solid cords or aggregates
121
Why is synovial sarcoma an inappropriate name?
Only <10% of cases actually are intra-articular
122
What is the most common location for a synovial sarcoma?
Knee (60-70%)
123
What is the treatment for synovial sarcomas?
Limb-sparing surgery and chemotherapy
124
What is the usual survivability for those with synovial sarcomas?
10 year survivability of 10-30%
