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Joint Pathology Flashcards

1
Q

Articular (hyaline) cartilage of a joint contains this type of collagen

A

Type II

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2
Q

Degeneration of articular cartilage caused by ‘wear and tear’

A

Osteoarthritis

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3
Q

This is also called degenerative joint disease

A

Osteoarthritis

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4
Q

Osteoarthritis involves this type of joint

A

Synovial joints

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5
Q

In Osteoarthritis, continued physical stress erodes cartilage and this is exposed

A

Subchondral bone

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6
Q

The earliest change in this condition is splits along the planes of vertical orientation of type II collagen

A

Osteoarthritis

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7
Q

In Osteoarthritis, the earliest change is splits along these planes

A

Vertical orientation of type II collagen

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8
Q

Joint Mice or Loose bodies are when pieces of cartilage break away from the surface, and are seen in this condition

A

Osteoarthritis

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9
Q

This describes when intact pieces of cartilage may break away from surface in Osteoarthritis

A

Joint Mice or Loose Bodies

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10
Q

Bony eburnation (no hyaline cartilage) is seen in this condition

A

Osteoarthritis

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11
Q

Fibrillation of cartilage and chondrocyte clustering is seen in this condition

A

Osteoarthritis

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12
Q

Friction causes eburnation in this condition

A

Osteoarthritis

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13
Q

Loss of articular cartilage causing eburnation is seen in this condition

A

Osteoarthritis

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14
Q

Crepitus may present in this condition

A

Osteoarthritis

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15
Q

Osteophytes may occur in this condition due to reactive bone formation at edges, leading to decreased ROM

A

Osteoarthritis

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16
Q

Reactive articular bone formation may cause sclerosis in this condition

A

Osteoarthritis

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17
Q

Subchondral bone cysts may form in this condition

A

Osteoarthritis

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18
Q

Osteophytes (bone spurs) may form in this condition and be palpable

A

Osteoarthritis

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19
Q

Loss of joint space may occur in these two conditions

A

Osteoarthritis and Rheumatoid arthritis

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20
Q

Osteophytes at DIP joints

A

Heberden nodes

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21
Q

Osteophytes at PIP joints

A

Bouchard nodes

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22
Q

Heberden nodes are seen in this joint

A

DIP

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23
Q

Bouchard nodes are seen in this joint

A

PIP

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24
Q

Heberden and Bouchard nodes are seen in this condition

A

Osteoarthritis
Due to osteophytes and interphalangeal joints

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25
Q

Autoimmune disorder of synovium resulting in joint damage

A

Rheumatoid arthritis

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26
Q

Are males or females more likely to have Rheumatoid arthritis?

A

Females 3:1

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27
Q

How old is the typical patient with Osteoarthritis?

A

Symptoms usually begin in 50’s
(middle age / older)

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28
Q

How old is the typical patient with Rheumatoid arthritis?

A

30-40 years
(middle age / younger)

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29
Q

These act as neoantigens in Rheumatoid arthritis

A

Citrullinated peptides (modified Arg residues)

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30
Q

Citrullinated peptides (modified Arg residues) may act as neoantigens in this condition

A

Rheumatoid arthritis

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31
Q

Rheumatoid arthritis is associated with this gene

A

HLA-DR4

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32
Q

HLA-DR4 gene is associated with this condition

A

Rheumatoid arthritis

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33
Q

In this condition, RF-IgG complexes deposit in synovium and CD4 cells stimulate macrophage release of TNF

A

Rheumatoid arthritis

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34
Q

In Rheumatoid arthritis, macrophage release of TNF stimulates these cells

A

Synovial cells = proteases degrade cartilage

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35
Q

Condition where synovitis is seen

A

Rheumatoid arthritis

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36
Q

IgM against Fc receptor of IgG

A

Rheumatoid Factor

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37
Q

This serologic marker for Rheumatoid arthritis is a specific type of citrullinated peptide that is found in 40% of patients

A

Anti-Sa

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38
Q

Anti-Sa is seen in about 40% of patients with this

A

Rheumatoid arthritis

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39
Q

This serologic marker for Rheumatoid arthritis is more specific and seen earlier than Rheumatoid Factor

A

Anti-cyclic citrullinated peptide antibodies

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40
Q

Proliferative synovitis results from this condition and forms a pannus

A

Rheumatoid arthritis

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41
Q

In Rheumatoid arthritis, proliferative synovitis results and forms this

A

Pannus
edematous synovium and granulation tissue

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42
Q

This is uncommon but may occur late in Rheumatoid arthritis when pannus becomes fibrotic or even ossifies

A

Joint fuses = fibrous or bony Ankylosis

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43
Q

Condition characterized by stiffness in the morning for <30 minutes

A

Osteoarthritis

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44
Q

Condition characterized by prolonged morning stiffness

A

Rheumatoid arthritis

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45
Q

Parts of the body that are most affected in Osteoarthritis

A

Men: hips
Women: hands, knees

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46
Q

Parts of the body most affected in Rheumatoid arthritis

A

Small bones of hands/feet

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47
Q

What joints are most affected in Rheumatoid arthritis, MP, PIP, or DIP?

A

MP and PIP
DIP is spared

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48
Q

Condition that is also associated with systemic signs/symptoms, such as serositis (SOB), amyloidosis, anemia, vasculitis

A

Rheumatoid arthritis

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49
Q

Severe form of RA that is characterized by anemia, leukopenia, splenomegaly

A

Felty syndrome

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50
Q

Felty syndrome is a severe form of this condition that is characterized by anemia, leukopenia, splenomegaly

A

Rheumatoid arthritis

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51
Q

Caplan syndrome is caused by patients with this condition having accelerated lung fibrosis with coal workers lung, silicosis, asbestosis

A

Rheumatoid arthritis

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52
Q

Condition in patients with RA involving accelerated lung fibrosis with coal workers lung, silicosis, asbestosis

A

Caplan syndrome

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53
Q

Soft tissue masses of forearm, elbows, occiput
Firm, non-tender subcutaneous masses
Central necrosis with palisading histiocytes (macrophages)

A

Rheumatoid nodules (seen in RA)

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54
Q

Idiopathic arthritis for more than 6 months in a child less than 16 years old

A

Juvenile rheumatoid arthritis

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55
Q

Serological tests for juvenile rheumatoid arthritis

A

Seropositive for ANA and/or RF

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56
Q

Most common pediatric rheumatic disorder
Usually polyarticular, large joints, associated with systemic disease

A

Juvenile rheumatoid arthritis

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57
Q

Group of RF negative arthritides in genetically susceptible individuals

A

Seronegative Spondyloarthropathies

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58
Q

Condition that causes enthesitis (inflammation of tendinous insertions)

A

Seronegative Spondyloarthropathies

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59
Q

Group of conditions including ankylosing spondylitis, reactive arthritis, and psoriatic arthritis

A

Seronegative Spondyloarthropathies

60
Q

Are Seronegative Spondyloarthropathies RF positive?

61
Q

Is Juvenile rheumatoid arthritis RF positive?

A

Yes, can be +/- ANA

62
Q

Vertebral and sacro-iliac joint inflammation with fusion

A

Ankylosing Spondylitis

63
Q

Is Ankylosing Spondylitis more common in males or females?

64
Q

What age do patients with Ankylosing Spondylitis present?

A

20-40 year old (young adult)

65
Q

Ankylosing Spondylitis involves inflammation and fusion of these joints

A

Vertebral and sacro-iliac

66
Q

Gene associated with Ankylosing Spondylitis

67
Q

HLA-B27 is associated with these 3 conditions

A

Ankylosing Spondylitis
Reactive Arthritis
Psoriatic Arthritis
(all are Seronegative Spondyloarthropathies)

68
Q

3 conditions that are Seronegative Spondyloarthropathies

A

Ankylosing Spondylitis
Reactive arthritis
Psoriatic arthritis

69
Q

A patient with severe hip/back pain and uveitis may have this condition

A

Ankylosing Spondylitis

70
Q

Does Ankylosing Spondylitis affect tendinous insertions or synovium?

A

Tendinous insertions

71
Q

Late stage patients with Ankylosing Spondylitis often have this disease

A

Restrictive lung disease
May also have aortitis or uveitis

72
Q

Nonseptic arthritis following GI/GU infection in genetically susceptible individual

A

Reactive arthritis

73
Q

Gene associated with Reactive arthritis (aka Reiter syndrome)

74
Q

This is also called Reiter syndrome

A

Reactive arthritis

75
Q

This condition may progress to ankylosing spondylitis type syndrome

A

Reactive arthritis

76
Q

Does Reactive arthritis affect tendinous insertions or synovium?

A

Synovial space

77
Q

Molecular mimicry mechanism is proposed for this condition, where bacterial particles and/or anti-bacterial antibodies are in synovial space

A

Reactive arthritis

78
Q

Condition involving arthritis and conjunctivitis following GI or urethral infections

A

Reactive arthritis

79
Q

A patient who just had a GI infection and now has sudden onset of joint pain and conjunctivitis may have this condition

A

Reactive arthritis

80
Q

Dysuria, arthritis, and conjunctivitis are the classic triad of this condition

A

Reactive arthritis

81
Q

What is the classic triad of Reactive arthritis?

A

Dysuria
Arthritis
Conjunctivitis

82
Q

Who is more likely to have Reactive arthritis, males or females?

83
Q

What parts of the body does Reactive arthritis most often effect?

A

Knees, ankles, feet
(“oligoarthritic”)

84
Q

Condition with sudden onset of arthritis, in knees, ankles and feet especially, that waxes and wanes and may be chronic

A

Reactive arthritis

85
Q

Psoriatic arthritis is associated with this gene

86
Q

Psoriatic arthritis affects this joint in particular

A

Sacro-iliac joints

87
Q

Arthritis caused by bacterial joint infection

A

Septic arthritis

88
Q

Most common source of spread in Septic arthritis

A

Hematogenous

89
Q

Most common organism that causes Septic arthritis in adults

90
Q

Most common organism that causes Septic arthritis in pediatrics

A

H. influenzae

91
Q

Most common site of Septic arthritis

92
Q

Patients with this have the highest risk of Septic arthritis

A

Rheumatoid arthritis

93
Q

Patients with RA may take TNF inhibitors, which causes an increase of infections with this, which could cause Septic arthritis

A

Mycobacterium tuberculosis

94
Q

Patients with Sickle Cell Anemia are more likely to get Septic arthritis from this organism

A

Salmonella

95
Q

Patients with primary immunoglobulin deficiency are more likely to get Septic arthritis from this organism

A

Mycoplasma

96
Q

Patients with alcoholism are more likely to get Septic arthritis from this organism

A

Pneumococcus

97
Q

Condition characterized by red, symmetric joint, swelling, joint effusion, pain, decreased ROM
Is an orthopedic emergency

A

Septic arthritis

98
Q

Immune complex mediated arthritis

A

Gonococcal arthritis

99
Q

Gonococcal arthritis mainly affects patients of this age

A

Young adults

100
Q

Who is more likely to get Gonococcal arthritis, males or females?

A

Females, 3:1

101
Q

Condition involving migratory polyarthritis, fever and rash on distal extremities, and negative blood and synovial culture

A

Gonococcal arthritis

102
Q

Acute episodic arthritis or chronic arthritis due to monosodium urate crystal deposition

103
Q

Gout is acute episodic arthritis or chronic arthritis due to deposition of this

A

Monosodium urate crystals

104
Q

Monosodium urate crystals are deposited in gout, and are formed during this process

A

Purine catabolism

105
Q

Rarely, cases of gout are due to overproduction of uric acid, such as during this

A

Tissue destruction (e.g. due to chemotherapy)

106
Q

Most causes of gout are due to this

A

Underexcretion of uric acid (decreased renal excretion)

107
Q

What reaction does xanthine oxidase catalyze?

A

Xanthine to Uric acid

108
Q

Condition involving rapid onset of warm, tender, red joints, MP joint of great toe is most common

109
Q

Most common site of arthritis in gout

A

MP joint of great toe

110
Q

Who is more likely to have gout, males or females?

111
Q

Type of drug that is a risk factor for gout

A

Thiazide diuretics

112
Q

Chronic gout may cause proliferative synovitis, leading to formation of this

113
Q

In acute gout episodes, MSU crystals deposit here

A

In periarticular tissues
Synovium, surrounding soft tissues

114
Q

Chronic gout may lead to joint destruction similar to this condition

A

Rheumatoid arthritis

115
Q

Collection of MSU crystals in soft tissues seen in chronic gout

A

Gouty tophus

116
Q

Chronic renal failure due to crystal deposition in interstitium seen in chronic gout
Nephrolithiasis due to uric acid stones

A

Urate nephropathy

117
Q

Gouty tophus and Urate nephropathy may occur in patients with this condition

A

Chronic gout

118
Q

This exhibits negative birefringence under polarized light
Yellow under parallel light

A

Gouty tophus

119
Q

Chalky material deposited in soft tissues, seen in chronic gout

A

Gouty tophus

120
Q

X-linked recessive HGPRT deficiency

A

Lesch-Nyhan syndrome

121
Q

What is the inheritance pattern of Lesch-Nyhan syndrome?

A

X-linked recessive

122
Q

Lesch-Nyhan syndrome is a deficiency of this

123
Q

Condition characterized by mild mental retardation, self-mutilation and spasticity

A

Lesch-Nyhan syndrome

124
Q

Calcium pyrophosphate deposition disease

A

Pseudogout
(aka chondrocalcinosis)

125
Q

Other name for Pseudogout

A

Chondrocalcinosis

126
Q

In this condition, degradation of articular cartilage produce calcium pyrophosphate crystals
These form crystal aggregates which deposit in tissues and damage joints

A

Pseudogout

127
Q

What is the typical age of a patient with Pseudogout?

A

Older/elderly

128
Q

Blue crystalline deposits with little inflammatory reaction are histologically seen in this condition

A

Pseudogout

129
Q

Rhomboid crystals with positive birefringence are seen in this condition

A

Pseudogout

130
Q

Condition involving acute arthritis lasting several days, limited to 1-2 joints, usually spares MTP joint

A

Pseudogout

131
Q

Pseudogout involves this many joints

A

Limited to 1 or 2 joints

132
Q

Does Gonococcal arthritis involve multiple joints?

A

Yes - migratory polyarthritis is seen

133
Q

Does Septic arthritis involve multiple joints?

A

No - is usually monoarticular

134
Q

In a synovial fluid analysis, a syringe lubricated with this is inserted into joint space to aspirate fluid

A

Anticoagulant

135
Q

Are leukocytes high in Osteoarthritis?

A

No - are non-inflammatory

136
Q

Are leukocytes high in Rheumatic arthritis?

A

Yes, is inflammatory

137
Q

Femoral head displacement relative to femoral neck
Often with mild trauma or unrecognized trauma

A

Slipped capital femoral epiphysis

138
Q

What is the typical age of a patient with Slipped capital femoral epiphysis?

A

10-16 years

139
Q

Is Slipped capital femoral epiphysis more common in males or females?

A

More common in boys - especially with obesity

140
Q

A teenage overweight male who presents with groin or knee pain could have this condition

A

Slipped capital femoral epiphysis

141
Q

Where might a patient experience pain in Slipped capital femoral epiphysis?

A

Pain at hip but often referred to groin or knee
Will have a limp

142
Q

Line along superior side of femoral neck that should cross plane of growth plate which is no longer seen in Slipped capital femoral epiphysis

A

Klein’s line

143
Q

Overuse injury at patellar insertion at tibial tuberosity

A

Osgood-Schlatter disease

144
Q

What age is the typical patient with Osgood-Schlatter disease?

A

Child / adolescent
With increased activity of knee

145
Q

Osgood-Schlatter disease is due to overuse of this action

A

Knee extension

146
Q

Osgood-Schlatter disease involves this part of the body

A

Patellar tendon insertion

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