Joint Diseases cont.

Question 1

Juvenile Idiopathic Arthritis

Answer 1

Arthritis before age 16 that persists for at least 6 weeks

Question 2

What is present and what is absent with Juvenile Idiopathic Arthritis?

Answer 2

(+) ANA

(-) Rheumatoid nodules

Question 3

Ankylosing Spondylitis is associated with what HLA?

Answer 3

HLA-B27

Question 4

Ankylosing Spondylitis is an autoimmune ___ cell response

Answer 4

T cell response

Question 5

Where do the changes occur with Ankylosing Spondylitis?

Answer 5

Ligamentous attachments

Question 6

What are the symptoms of Ankylosing Spondylitis?

Answer 6

Low back pain and spinal immobility

Question 7

Reactive Arthritis is associated with what HLA?

Answer 7

HLA-B27

Question 8

Reactive Arthritis often follows an ___

Answer 8

Infection

Question 9

What are the symptoms of Reactive Arthritis?

Answer 9

Conjunctivitis
Nongonoccoal urethritis/cervicitis
Arthritis

Question 10

What are the symptoms of Reactive Arthritis?

Answer 10

Conjunctivitis
Nongonococcal urethritis/cervicitis
Arthritis

Question 11

The Arthritis with Reactive Arthritis presents how?

Answer 11

Waxes and wanes

– Acute onset and Asymmetric

Question 12

Besides the triad of symptoms with Reactive Arthritis, what else can present?

Answer 12

Cardiac valvular disease

Question 13

Psoriatic Arthritis is associated with what HLA?

Answer 13

HLA-B27

Question 14

What DIP change can be seen with Psoriatic Arthritis?

Answer 14

Pencil in cup of DIP

Question 15

Where else are symptoms common for Psoriatic Arthritis?

Answer 15

Nails – thicken, rough and discolor

Question 16

The seronegative joint diseases are?

Answer 16

Psoriatic Arthritis
Reactive Arthritis
Ankylosing Spondylitis

Question 17

Infectious Arthritis organisms reach the joints how?

Answer 17

Hematogenously

Question 18

What is the most common cause of Infectious Arthritis?

Answer 18

Lyme Disease – Borrelia Burgdorferi

Question 19

What is diagnostic of the most common cause of Infectious Arthritis?

Answer 19

(+) anti-Borrelia Antibodies

– lyme disease

Question 20

If lyme disease goes untreated, what does it cause to occur?

Answer 20

Migratory Arthritis in large joints and obliterative endarteritis

Question 21

Suppurative Arthritis organisms reach the joints how?

Answer 21

Hematogenously

Question 22

If Suppurative Arthritis occurs in neonates, how did it likely arise?

Answer 22

Contiguous spread from osteomyelitis

Question 23

In adults, what are the common causes of Suppurative Arthritis?

Answer 23

Staph. Aureus
Gonococcus
Salmonella if sickle cell patient

Question 24

In adults, what are the common causes of Suppurative Arthritis?

Answer 24

Staph. Aureus
Gonococcus
Salmonella if sickle cell

Question 25

In what gender is Suppurative Arthritis more common?

Answer 25

Males

Question 26

Suppurative Arthritis is more common in men, except for when?

Answer 26

Sexually active women = Gonococcal Arthritis is more common in women

Question 27

Why is Gonococcal Suppurative Arthritis more common in women?

Answer 27

MAC deficient (c5,c6,c7) --> Disseminated Gonococcus

Question 28

What are the symptoms of Suppurative Arthritis?

Answer 28

Painful, swollen joint | Fever

Question 29

What lab changes will be present with Suppurative Arthritis?

Answer 29

Leukocytosis | Increased ESR

Question 30

IV drug users will likely get Suppurative Arthritis where?

Answer 30

Axial joints >> knees

Question 31

What is diagnostic of Suppurative Arthritis?

Answer 31

Joint aspiration

Question 32

What are 2 crystal induced arthritises?

Answer 32

Gout | Calcium Pyrophosphate Crystal Deposition

Question 33

Gout involves transient attacks of acute arthritis due to what?

Answer 33

Monosodium Urate Crystallization in and around joints

Question 34

What change will be seen in the plasma with Gout?

Answer 34

Hyperuricemia > 6.8

Question 35

In order to have symptomatic Gout, Hyperuricemia > 6.8 in the plasma must be present along with a few of the following?

Answer 35

``` Age and Male gender Alcohol Obesity Thiazide diuretics Lead toxicity ```

Question 36

What is the hallmark of Gout?

Answer 36

Tophi | = Urate crystal aggregates with foreign body giant cells

Question 37

What is the hallmark of Gout?

Answer 37

Tophi | = Urate crystal aggregations with foreign body giant cells

Question 38

Gout Acute Arthritis involves pain and warmth where and why?

Answer 38

BIG TOE | -- low temps help monosodium urate crystalize

Question 39

Gout Chronic Tophaceous Arthritis occurs about 10 years after the Acute. What characterizes it?

Answer 39

Urate forms visible deposits in synovium | -- Bone erosion too

Question 40

What shape are the monosodium urate crystals with Gout?

Answer 40

Needle shaped

Question 41

Calcium Pyrophosphate Crystal Deposition occurs in what joints and what does it look like?

Answer 41

Knees | = Chalky white friable deposits

Question 42

Calcium Pyrophosphate Crystal Deposition occurs in what joints and what does it look like?

Answer 42

Knees | = Chalky white friable deposits

Question 43

What shape are the Calcium Pyrophosphate crystals?

Answer 43

Rhomboid shape

Question 44

What aggregates are seen with Calcium Pyrophosphate Crystal Deposition?

Answer 44

Oval blue-purple aggregates

Question 45

What Crystal Induced Arthritis is POSITIVE BIREFRINGENT?

Answer 45

Calcium Pyrophosphate Crystal Deposition | -- Gout = Negative Birefringent