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ICM - Infectious Disease > Introduction to Rheumatology > Flashcards

Introduction to Rheumatology Flashcards

1
Q

Cartilage collagen fibers are anchored in…

A

Subchondral bone

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2
Q

Purpose of the cartilage collagen fibers?

A

They form a meshwork that entraps the larger proteoglycan aggregates

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3
Q

What are cartilage proteoglycan aggregates?

A

Very large, hydrophilic molecules. They are made of glycosaminoglycans. The pressure of the bound water gives cartilage its elasticity.

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4
Q

Vascularity of Cartilage?

A

Its avascular.

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5
Q

All components of articular cartilage are produced by…

A

chondrocytes

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6
Q

Nutrition for chondrocytes come from…

A

Synovial fluid

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7
Q

Where is synovial fluid generated

A

Synovial membrane

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8
Q

How big is a normal synovial membrane?

A

1-3 cells thick with an underlying delicate connective tissue network (adipose, capillaries, fibrous parenchyma)

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9
Q

Name the rheumatic disease associated with the joint site.

Joint Space

A 
Joint Infection
Microcrystaline arthritis (Gout)
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10
Q

Name the rheumatic disease associated with the joint site.

Muscle

A

Myositis

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11
Q

Name the rheumatic disease associated with the joint site

Synovial Membrane

A

RA/Synovitis

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12
Q

Name the rheumatic disease associated with the joint site.

Enthesis

A

Enthesopathy

Ankylosing spondylitis

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13
Q

Name the rheumatic disease associated with the joint site.

Cartilage

A

Cartilage Degeneraion

Osteoarthritis

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14
Q

Name the rheumatic disease associated with the joint site.

Bony End-Plate

A

Avascular Necrosis

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15
Q

Five details important to gather in a rheumatology patient history

A
  1. Time, Rapidity of Onset
  2. Determine # of joints
  3. Constitutional Symptoms
  4. Response to Therapy
  5. Functional Status
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16
Q

Typically few joints are involved in…(3)

A

Gout
Seronegative spondyloarthropathies
OA

17
Q

Typically many joints are involved in…(4)

A

RA
SLE
Seronegative spondyloarthropathies
Fibromyalgia

18
Q

Gout responds remarkably well to…

A

NSAIDs

19
Q

Fibromyalgia responds very well to…

A

Exercise

20
Q

What three things did he recommend to score in the physical exam?

A

Swelling 0-3
Tenderness 0-4
Limitation 0-4

21
Q

Four Types of Labs one might ask for as a rheumatologist

A

Routiene CBC/Chemistries
ESR/CRP/Hemoglobin/Albumin (Acute Phase Reactants)
Rheumatoid Factor + Antinuclear Antibodies
Joint Aspiration

22
Q

Why look at ESR, CRP, Hemoglobin, etc.?

A

To assess systemic inflammation

23
Q

When should you do a Joint Aspiration

A

Monoarthritis
Undiagnosed Polyarthritis
One joint swelling out of proportion with the others

24
Q

What are you looking for on an X ray

A

Ankylosing spondylitis, Calcium pyrophosphate deposition disease, OA

25
Q

What does he mean when he says rheumatism?

A

Pain around the joint but not in the joint

26
Q

Common Rheumatology treatments

A
  • Exercise
  • Physical Therapy, Occupational Therapy
  • NSAIDS
  • Corticosteroids
  • DMARDS
27
Q

Risks of chronic NSAID use?

A

GI bleeds, Renal Insufficiency, High BP, Stroke

28
Q

How are corticosteroids delivered?

A

Intraarticular injections in arthritis

Can be used systemically in inflamm. arthritis and autoimmune conditions

29
Q

What are DMARDS?

A

Disease Modifying Anti-Rheumatic Drugs

These drugs try to treat underlying immune defect in many of the autoimunes.

30
Q

Examples of DMARDS

A

Hydrocychloroquin
Gold
Methotrexate

31
Q

Musculoskeletal complaints that are nonarticular include…

A

Trauma

Rheumatism – Bursitis, Tendonitis, Fibromyalgia

32
Q

Musculoskeletal complaints in a joint less than 6 weeks old

A

Crystal induced arthritis
Septic arthritis
Viral arthritis
Early chronic arthritis presentation

33
Q

Musculoskeletal complaints in a joint over 6 weeks old with NO INFLAMMATION

A

Osteoarthritis

Internal Derangement

34
Q

Musculoskeletal complaints in a joint over 6 weeks old with Inflammation of many joints

A

RA
SLE
PA

35
Q

Musculoskeletal complaints in a joint over 6 weeks old with Inflammation of few joints

A 
Seronegative spondyloathropathy (AS, Reiter's, Psor.)
Juvenile Rheumatoid
Crystal Induced
Septic
Early Polyarthritis

ICM - Infectious Disease (11 decks)

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