Final Exam question stems Flashcards
Which type of hypersensitivity is characterized by immune complex injury - antibody:antigen complex deposits in tissue and initiates complement?
Type 3 hypersensitivity
What is a chronic multisystemic inflammatory disease that has the characteristic triad of butterfly rash, joint pain and fever?
Systemic lupus erythematosus (SLE)
What diagnostic test is definitive for SLE?
Serum ANA
Scleroderma patients develop a combination of symptoms known as CREST syndrome. What does the T stand for?
Telangestasia which is groups of dilated vessels in the skin
What inflammatory disease damages skeletal muscles due to chronic inflammatory infiltrates and usually affects proximal muscles of the skeleton, sparing extraocular muscles?
Polymyositis
What inflammatory disease has both skin and muscle involvement and is characterized by butterfly rash, heliotrope eyelids and purple bumps on knuckles?
Dermatomyositis
Is primary osteoporosis inflammatory?
No
Decreased bone mass/loss of trabeculae in vertebrae associated with primary osteoporosis affects what population most?
Postmenopausal women
What are the three common spine deformities associated with loss of bone mass due to osteoporosis?
- codfish vertebrae
- schmorl’s nodes
- compression fracture (leads to hyperkyphosis)
What serological findings would be present in osteomalacia?
- Decreased calcium and phosphate
- Increased alkaline phosphatase
What musculoskeletal condition is characterized b pseudo fractures and “Looser’s zones” due to bone softening?
Osteomalacia
What are the 4 common skeletal deformities associated with rickets?
- rachitic rosary - enlarged costochondral junctions
- pigeon breast
- Harrison’s groove
- craniotabes - flat skull
What musculoskeletal disorder is associated with moth eaten X-ray appearance, brown tumors and skeletal deformities and fractures?
Von Recklinghausen’s disease of bone AKA osteitis fibrosis cystica
Von Recklinghausen’s disease of bone (AKA osteitis fibrosis cystica) is associated with what other condition?
Advanced hyperPTH
What serology would be seen with Paget’s disease?
- High serum alkaline phosphates
- normal calcium and phosphate levels
What musculoskeletal condition is associated with “tile-like mosaic” on X-ray, bowing of bones and gross thickening of bone that is porous and lacks strength?
Paget’s disease
What causes Paget’s disease?
An infectious agent activates osteoclasts, causing bone resorption
Scleroderma is due to an overproduction of ______.
Collagen
What would be seen on a bone scan in Paget’s disease?
Increased metabolic activity due to hyperosteolytic bone
What is the difference between tuberculous osteomyelitis and Pott’s disease?
PUlmonary TB can lead to lesions on the bone, causing tuberculous osteomyelitis. If those lesions develop on the spine, it is called Pott’s disease
An infection of the bone marrow and bone (usually due to bacteria) is called ______.
Osteomyelitis
Small interosseous abscess that is walled off by reactive bone in pyogenic osteomyelitis?
Brodie’s abscess
What is the differential diagnosis for Brodie’s Abscess?
Osteoid osteoma
Secondary (metastatic) disease of bone is ____% more common that primary bone tumors
70
What is the most common malignant bone tumor?
Osteosarcoma - 40% of primary bone cancer
Primary osteosarcoma is most common in what age group?
Children and young adults (10-25 years)
What malignant bone tumor can lead to erosion of the cortex which forms Codman’s triangle?
Secondary osteosarcoma
What malignant bone tumor can occur secondary to Paget’s disease?
Osteosarcoma
What is the differential diagnosis for Ewing’s sarcoma?
Infection
What age group is most commonly affected by Ewing’s sarcoma?
10-15 is peak incidence, which is the youngest age group of the malignant bone tumors
What percentage of giant cell tumors are malignant?
20%
What malignant bone tumor is characterized by “soap bubble” appearance on X-ray?
Malignant giant cell tumors
What inflammatory joint disease is usually unilateral/mono articular and tends to affect larger joints?
Infectious (septic/pyogenic) arthritis
What inflammatory joint disease is usually poly articular and tends to affect smaller joints in the the extremities?
RA
What is the most common joint disease?
Osteoarthritis
What are the signs of early DJD?
Fragments of cartilage are lost from the superficial layers
What are the common features of DJD?
- asymmetrical
- OSTEOPHYTES
- subchondral cysts
- subchondral sclerosis
- joint mice
Are bony erosions seen in RA?
Yes
Other than the type of joints affected, what is a key distinguished between infectious arthritis and RA?
Infectious has pus, RA does not
What is the mechanism of inflammation in RA?
Proliferative synovitis - contributes to erosion of articular cartilage and underlying bone that can lead to fusion of joints.
Are bony erosions seen in osteoarthritis (DJD)?
No
How is JRA different from RA?
No Rf factor or nodules
What is Felty’s syndrome?
A variant of RA with hematologists changes (anemia, leukopenia, splenomegaly)
What is another name of ankylosing spondylitis?
Mary strumpell disease
What population is most commonly seen with ankylosing spondylitis?
Young (19-35 years) men
What joint is always affected first in ankylosing spondylitis?
SI
“Bamboo spine” is characteristic in what condition?
Ankylosing spondylitis
What 3 conditions are seronegative spondylo-arthropathies commonly associated with HLA-B27?
- ankylosing spondylitis
- Reiter’s syndrome
- enteropathic arthropathy
What condition, in its early manifestations, present with morning stiffness and low back pain that is worse at rest?
Ankylosing spondylitis
What condition, in its advanced manifestations, shows spinal immobility, loss of lumbar lordosis and “bamboo-spine” on x-ray?
Ankylosing spondylitis
What are the three symptoms commonly associated with Reiter’s syndrome?
- urethritis
- conjunctivitis
- arthritis
What condition is similar to ankylosing spondylitis in its symptoms but also has a GI component?
Enteropathic arthropathy
What condition is characterized by hyperuricemia, tophi and will present with a red, hot, swollen joint when in the acute phase?
Gout
What are some contributing factors to the development of gout?
Alcohol and diets rich in purines
What is the treatment for gout?
Dietary adjustments (low purines and no alcohol) and well as anti inflammatories
What are alternate names for chondrocalcinosis?
CPPD
Pseudogout
What condition is characterized by deposition of calcium pyrophosphate crystals in joints?
chondrocalcinosis (AKA CPPD or pseudogout)
What joint condition is caused by excessive and repetitive joint trauma due to loss of peripheral sensation from DM, vitamin D deficiency or other neuropathy?
Charcot joint (neuropathic arthropathy)
What percentage of Reiter’s syndrome cases are related to HLA-B27?
80-90%
Distal weakness in skeletal muscle = ______ while proximal weakness in skeletal muscle = _____.
Distal = neuropathy Proximal = myopathy
What are the two chronic diseases of skeletal muscle?
Muscular dystrophy
Metabolic myopathy
Rapidly progressing muscle disease = ______
Myositis
Define myopathy?
diverse group of diseases that affect muscle fibers but are NOT due to neuronal disease or dysfunction of myoneural junction
Gower’s sign, winged scapula, scoliosis and pseudohypertrophy of calf muscles are associated with what condition?
Duchenne’s muscular dystrophy
What is the mechanism associated with Myesthenia Gravis?
Antibodies attack ACh receptors on postsynaptic membrane of myoneural junction to block its action
Who commonly is affected by Myesthenia Gravis?
Young women
What condition is characterized by weakness of extremity muscles, ptosis and thymic hyperplasia?
Myesthenia Gravis
NOTE: polymyocytis also affects muscles of extremities but does NOT affect the eyes
Type 1 collagen deficiency associated with a blue sclera?
Osteogenesis imperfecta
What condition causes dwarfism?
Achondroplasia
