Investigating the inflamed joint Flashcards

1
Q

What is the difference in history for mechanical and inflammatory joints?

A

Worse with rest
Better with use= Inflammatory

Other way round- mechanical

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2
Q

What are inflammatory markers for joint pain?

A

PV- plasma viscosity
CRP- C reactive protein
ESR- Erythrocyte sedimentation rate

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3
Q

What happens to the body when there is an inflammation?

A

In inflammation there is increased production of antibodies by B cells, increased cytokine production by other white cells (locally or systemically) and increased protein
production by the liver

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4
Q

What is plasma viscosity

A

measure of how much protein there is in the serum

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5
Q

What is C reactive protein

A

an acute phase response produced by the liver

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6
Q

How is ESR measured?

A
  • it takes longer for cells to settle in inflammation
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7
Q

What does high neutophils with inflammation usually mean?

A

Bacterial infection

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8
Q

What does high eosinophils with inflammation usually mean?

A

Parasites

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9
Q

Low lymphocytes common in what ?

A

SLE- lupus

Viral infections

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10
Q

What is main cause of normocytic anaemia in inflammation?

A

anaemia of chronic disease

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11
Q

What is the main cause of microcytic anaemia?

A

Iron deficiency anaemia

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12
Q

Why is rheumatoid arthritis associated iron deficiency

A

Non-steroidal anti-inflammatories used for pain relief of RA

They cause iron deficiency anaemia

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13
Q

What drugs cause iron deficiency anaemia?

A

NSAID’s

Non-steroidal anti-inflammatories

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14
Q

What is the main cause of macrocytic anaemia?

A

B12 and folate deficiency
Alcohol
Thyroid problems

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15
Q

What is the main cause of folate deficiency

A

Methotrexate- dihydrofolate reductase inhibitor

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16
Q

What are common causes of hyperuricaemia?

A

Diuretic medications
Increasing age
Diet

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17
Q

What are kidney function tests?

A

GFR

18
Q

What are liver function tests?

A

ALP ALT Bilirubin Albumin

19
Q

What is the levels of (CRP,PV, ESR), WCC, Hb, Plt of Osteoarthritis?

A

Normal
Normal
Normal
Normal

20
Q

What is the levels of (CRP,PV, ESR), WCC, Hb, Plt of Rheumatoid arthritis or psoriatic?

A

Somewhat Raised 30-70
Somewhat Raised 12-13
Low
Raised

21
Q

What is the levels of (CRP,PV, ESR), WCC, Hb, Plt of SLE?

A

Somewhat Raised 30-70
Low
Low
Raised

22
Q

What is the levels of (CRP,PV, ESR), WCC, Hb, Plt of Gout?

A

Raised- 200
Raised-15-16
Low
Raised

23
Q

What is the levels of (CRP,PV, ESR), WCC, Hb, Plt of Infection?

A

Raised- 400
Raised-20-25
Low
Raised

24
Q

What does transparent yellow synovial fluid mean

A

Non-inflammatory

25
Q

What does pale yellow translucent synovial fluid mean?

A

inflammatory

26
Q

What does yellow with red bits or green synovial fluid mean?

A

Septic

27
Q

What does red synovial fluid mean?

A

Haemorrhage

28
Q

What is the viscosity of synovial fluid?

A

Consistency of egg-white

29
Q

What is the viscosity of inflammatory synovial fluid?

A

Consistency of water

30
Q

What is the protein content and glucose uric acid levels of inflammation of synovial fluid?

A

Higher protein
Lower glucose
Uric acid higher in gout

31
Q

What is the most common gram positive cocci?

A

Staphylococcus aureus

32
Q

What is the most common gram negative cocci?

A

Neisseria gonorrhoeae

33
Q

What shape are crystals in synovial fluid if someone with gout?

A

Needle shaped

34
Q

What shape are crystals in synovial fluid if someone with pseudogout?

A

Brick shaped

35
Q

What is the diagnosis of finding crystals in synovial fluid shaped as needle?

A

gout

36
Q

What is the diagnosis of finding crystals in synovial fluid shaped as brick?

A

pseudogout

37
Q

Is it + or - birefringence of gout crystals in synovial fluid?

A

Negative

38
Q

Is it + or - birefringence of pseudogout crystals in synovial fluid?

A

Positive

39
Q

What has + birefringence of the crystals in synovial fluid?

A

Pseudogout

40
Q

What has - birefringence of the crystals in synovial fluid?

A

Gout

41
Q

What is haemarthrosis?

A

Bleeding into a joint

42
Q

Causes of haemarthrosis

A

Trauma

  • injury - sports, RTC
  • postoperative
  • ‘traumatic’ arthrocentesis procedure (not blood, to start, but becomes bloody during the procedure)
  • Bleeding disorders e.g haemophilia, excess warfarin use and minor trauma
  • Vascular disorders
  • Tumours