Immunolgoic Screening

Question 1

stiffness that begins in the morning but then is relieved with activity is called _______

Answer 1

gel phenomenon

-common with rheumatic disorders

Question 2

swelling needs to be distinguished as articular (______), periarticular (_____), entire limb (______), or in another area (_____).

Answer 2

• arthritis
• tenosynovitis
• lymphedema
• lipoma or palpable tumor

Question 3

Clinical Presentation of rheumatic disorders

Answer 3

stiffness, joint pain, swelling, weakness, Raynaud’s phenomenon, nail bed changes

Question 4

fever, sweats chronic diarrhea, fatigue, oral infections, HA, vaginal candidiasis, cough, SOB, cutaneous changes suggest ______

Answer 4

Early HIV

• these people are vulnerable to infection
• 25-44 is common age

Question 5

Prostitution, men & men sexual contact, injection use, blood recipients, dialysis recipients, organ recipient all are risk factors for ______

Answer 5

HIV

Question 6

those with HIV may remain asymptomatic for up to ______

Answer 6

10 years

Question 7

Kaposi’s sarcoma, HTN, opportunistic disease (persistent cough, fever, easy bruising, atrophy, weakness, back pain), poor wound healing, HIV dementia, distal symmetric polyneuropathy all suggest ________

Answer 7

Advanced Symptomatic HIV Infections

Question 8

Difficulty w/ concentration/memory, personality changes, HA, seizures, paralysis, motor dysfunction, gradual weakness of extremities, numbness, tingling, radiculopathy all suggest ________

Answer 8

HIV Neurologic Disease

Question 9

Type ____ Hypersensitivity refers to allergies, IgE, histamine

Answer 9

Type 1
-Anaphylaxis is the most dramatic and devastating form. Will appear w/ itching, edema, sneezing, hives, labored breathing, cramping, tachycardia, palpitations

Question 10

Type __ hypersensitivity is caused by production of autoantibodies against self cells or tissue that have some form of foreign protein attached to them

Answer 10

Type 2

Question 11

HA, back (flank) pain, chest pain, nausea, vomiting, tachycardia and hypotension, hematuria, urticaria suggest ______

Answer 11

type 2 hypersensitivity

Question 12

Type __ hypersensitivity results from formation or deposition of antigen-antibody complexes in tissues

Answer 12

Type 3

Question 13

fever, arthralgia, synovitis, lymphadenopathy, urticaria, visceral inflammation suggest _______

Answer 13

type 3 hypersensitivity

Question 14

itching, erythema, vesicular skin lesions, graft-versus-host disease, skin/GI/hepatic dysfunction suggest ________

Answer 14

type 4 hypersensitivity

Question 15

_____ is a noninflammatory condition appearing w/ generalized MS pain in conjunction w/ tenderness to touch in a large number of specific areas

Answer 15

Fibromyalgia

Question 16

The hallmark sign of myofascial pain syndrome is the _____

Answer 16

trigger point

Question 17

childhood trauma, family issues, and/or physical/sexual abuse, stress, illness, disease all are risk factors for _____

Answer 17

fibromyalgia

Question 18

aches and pain, stiffness, swelling in soft tissue, tender points, and muscle spasms/nodules all are symptoms of ____

Answer 18

fibromyalgia

-aggravated by cold, stress, excessive or no exercise, and physical activity

Question 19

additional symptoms of fibromyalgia include:

Answer 19

fatigue, restless leg syndrome, tendinitis, temperature dysregulation, morning stiffness, paresthesia, mechanical LBP, dry eyes/mouth, urinary urgency, depression, cognitive difficulties, weight gain, premenstrual syndrome

Question 20

_______ is a chronic, systemic, inflammatory disorder of unknown cause that can affect various organs but predominantly involves the synovial tissues of the diarthrodial joints

Answer 20

RA

• 2-3x more common in women
• unclear cause, maybe hormones

Question 21

SERIOUS
Swelling in one or more joints, early morning stiffness, recurring pain, inability to move joint normally, obvious redness/warmth, unexplained weight loss, symptoms lasting more than 2 weeks suggest ______

Answer 21

RA

• is Dx of exclusion
• elevation of C-reactive protein and WBCs

-treat w/ immunosuppresives, and DMARDs

Question 22

_____ is a systemic rheumatic inflammatory disorder of unknown cause w/ stiffness, sudden insidious onset, linked to temperal arteritis

Answer 22

polymyalgia rheumatic

Question 23

proximal muscle pain/ache, stiffness early morning, weak, fatigue, malaise, low grade fever, HA, weight loss, depression, vision changes suggest ________

Answer 23

polymyalgia rheumatic

Question 24

______ is a autoimmune rheumatic disease which is chronic characterized by injury to skin, joionts, kidneys, heart and blood-forming organs, nervous system, and mucous membranes

Answer 24

Systemic Lupus Erythematosus

• butterfly rash
• osteoporosis
• avascular necrosis
• women 10-15x as men

Question 25

Women, infections, antibiotics, medications, exposure to UV, extreme physical and emotional stress, pregnancy are risk factors for _______

Answer 25

systemic lupus erythematosus

Question 26

Constitutional symptoms, arthralgias, arthritis, skin rash, pulmonary involvement, anemia, kidney involvement, photosensitivity, hair loss, Raynaud's, nervous involvement, ulcers suggest _____

Answer 26

Systemic Lupus Erythematosus

Question 27

_____ is characterized by inflammation and fibrosis of many body parts including skin, blood vessels, synovium, skeletal muscle, and kidneys, lungs, heart, GI

Answer 27

Scleroderma - can be Limited or Diffuse - often have taut skin or taut internal organs

Question 28

CREST | Calcinosis, Raynaud's, Esophageal dysmotility, sclerodactyly, telangiectasia all suggest ______

Answer 28

Limited Cutaneous Sclerosis (ISSc)

Question 29

Raynaud's, skin changes, ulcerations, polyarthralgia, tendon friction rubs, flexion contractures, visceral involvement (lung disease, renal failure, GI, Myocardial, esophageal) suggest _______

Answer 29

Diffuse Cutaneous Sclerosis (dSSc)

Question 30

Insidious backache before age 30, episodes lasting months, pain increase after rest and decrease with movement, w/ family history suggests _______

Answer 30

spondyloarthropathy | -conditions include ankylosing spondylitis, Reiter's syndrome, PsA, arthritis w/ IBD

Question 31

_____ is a chronic progressive inflammatory disorder of undetermined cause. more o fibrous tissue

Answer 31

Ankylosing Spondylitis - insidious LBP more than 3 months - worse in morning - most severe the spine will become fused. prone to fracture - movement aggravates pain

Question 32

Intermittent LBP, sacroilitis, paravertebral spasm, lose lumbar lordosis, fever, fatigue, anorexia, anemia, painful C-spine motion suggests _____

Answer 32

early stage ankylosing spondylitis

Question 33

constant LBP, loss lumbar lordosis, ankyloses SI, muscle wasting, dorsocervical kyphosis, decreased chest expansion, arthritis of hips, hip flexion in standing suggests ______

Answer 33

advanced ankylosing spondylitis

Question 34

cauda equina syndrome, iritis or iridocysclitis, conjunctivitis, enthesitis, carditis, pericarditis, prostasis suggests _______

Answer 34

extraskeletal ankylosing spondylitis

Question 35

_______ is characterized by triad of arthritis, conjunctivitis, and nonspecific urethritis in the ages 20-40

Answer 35

Reiter's syndrome - HLA-B27 may be involved - LBP and buttock pain common in reactive arthritis

Question 36

polyarthritis, SI joint changes, LBP, buttock pain, small joint involvement, plantar fasciitis, low-grade fever, urethritis, conjunctivitis, skin involvement, bowel infection, anorexia, weight loss suggests ________

Answer 36

Reiter's Syndrome

Question 37

______ is a chronic recurrent, erosive, inflammatory arthritis associated w/ skin disease.

Answer 37

Psoriatic arthritis

Question 38

fever, fatigue, dystrophic nail changes, polyarthritis, psoriasis, sore fingers, DIP involvement, dactylitis, spondylitis, and iritis suggests _______

Answer 38

psoriatic arthritis

Question 39

______ is a disease which often occurs from deer tick infected w/ spiral bacterium. often see a bullseye rash, arthritis. neurologic involvement, and possibly cardiac involvement

Answer 39

Lyme Disease | -need fast treatment but its difficult to diagnose

Question 40

Red rash, flu symptoms, migratory MS pain, neuro symptoms, eye problems, heart abnormalities, arthritis, encephalopathy, neurocognitive dysfunction, peripheral neuropathy all suggest ________

Answer 40

Lyme Disease

Question 41

_______ is the most common inflammatory demyelinating disease of the CNS, ages 20-40, temperate climates

Answer 41

Multiple Sclerosis

Question 42

Unilateral visual impairment, paresthesias, ataxia, vertigo, fatigue, bowel/bladder, speech, optic neuritis, nystagmus, spasticity, hyperreflexia, Babinski, Lhermitte's sign all suggest _______

Answer 42

Multiple sclerosis

Question 43

_________ is an acute acquired autoimmune disorder w/ demyelination of peripheral nervous system w/ abrupt onset of paralysis

Answer 43

Guillain-Barre - progressive 3-7 days - typically bilateral, progressive, symmetrical, ascending - CN's can be involved

Question 44

Progressive/ascending/bilateral weakness, diminished deep tendon weakness, paresthesias, fever, malaise, and nausea suggest ______

Answer 44

Guillain-Barre

Question 45

______ develops for unknown reasons when antibodies produced by immune system block Ach receptors creating muscle dysfunction

Answer 45

Myastenia Gravis | -weakness and fatigue ability

Question 46

muscle fatigability, proximal weakness, ptosis, diplopia, dysarthria, bulbar involvement, alteration in voice quality, dysphagia, nasal regurgitation, choking, difficulty chewing all suggest _______

Answer 46

myasthenia gravis

Question 47

signs and symptoms of anaphylactic shock

Answer 47

immediate medical attention

Question 48

new onset of joint pain w/ recent history of surgery

Answer 48

immediate medical attention

Question 49

dusky blue discoloration w/ tenderness over septic joint

Answer 49

immediate medical attention