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DT 1 Test 1 > Joints > Flashcards

Joints Flashcards

1
Q

What joints predominate in osteoarthritis in men and women?

A

Men - hips

Women - Knees and hand

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2
Q

What is bone eburnation?

A

Exposed bone on surface, cartilage is bone

Underlying bone sclerosis

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3
Q

What are joint mice?

A

Loose bodies of cartilage

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4
Q

What are osteophytes?

A

Extra bone at joint edge

Bone spurs

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5
Q

How does osteoarthritis present?

A

Achy pain

Morning stiffness, gets worse with use

Crepitus of joint

Limited RoM

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6
Q

What are Heberden nodes?

A

Osteophytes at DIP in women

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7
Q

What is Rheumatoid arthritis?

A

Systemic autoimmune inflammatory disease

Synovitis often destroying carilage with later ankylosis of the joint

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8
Q

What is a pannus?

A

Exuberant inflamed synovium

Chronic inflammatory cells (Mostly CD4+ T cells)

Granulation tissue

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9
Q

What is the pathogenesis of RA?

A

Ag exposure in a susceptible host creating an ongoing autimmune process

80% have Rheumatoid Factor

Ab to Citrullin-modified peptides

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10
Q

Describe the synovial fluid in RA?

A

High protein content

Low mucin content

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11
Q

What joints does RA typically affect?

A

PIP, MCP, MTP (more proximal than OA)

Wrists, ankles, elbow, knees

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12
Q

What is a major presentation difference between RA and OA with regards to movement?

A

RA - feels better with movement

OA - gets worse

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13
Q

Describe hand deviation in RA.

A

Radial deviation of the wrist

Ulnar deviation of the fingers

Swan neck deformity

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14
Q

What do you see on an xray of RA?

A

Juxta-articular osteopenia

Bone erosions with narrowing of joint space

Joint effusions

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15
Q

What are Rheumatoid nodules?

A

Most common cutaneous manifestation of RA

Fibrinoid necrosis surrounded by macrophages

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16
Q

What is Juvenile idiopathic arthritis?

A

Heterogeneous group by definition before age 16 and present 6 weeks

Oligoarticular, Polyarticular, Systemic

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17
Q

What are seronegative spondyloarhtropathies?

A

Immune mediated pathology in ligamentous attachments

Many are HLA B27 +

RF negative

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18
Q

What joints are common in ankylosing spondyloarthritis?

A

Sacroiliac joints

Apophyseal joints of the spine

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19
Q

What is Ankylosing spondyloarthritis?

A

Inflammation of tendon/ligament insertion

Ossification of inflammation

Fibrous and boney ankylosis

20
Q

What do you see on an xray of ankylosing spondylitis?

A

Bamboo spine

Ossification of the SI joint

21
Q

What is reiter syndrome?

A

Reactive arthritis

Appendicular noninfectious arthritis

Occurs after a primary infection

HLA B27 +

22
Q

What is the classic triad associated with reiter syndrome?

A

Arthritis

Urethritis or cervicitis

Conjunctivitis

23
Q

What is enteritis-associated arthritis?

A

GI infection: Salmonella, shigella, campylobacter

Most often abrupt in knees and ankles

Generally clears in < 1 year

24
Q

What is psoratic arthritis?

A

Insidious

Involves the DIP joint

Pencil cup deformity

25
Q

How is infectious arthritis acquired?

A

Hematogenous spread

26
Q

What is the most common pathogen that causes infectious arthritis in <2 year old patients?

A

H. influenzae

27
Q

What is the most common pathogen that causes infectious arthritis in Adolescent/young adults?

A

Gonococcus

28
Q

What is the most common pathogen that causes infectious arthritis in Elderly and children > 2 years?

A

S. aureus

29
Q

What is the most common pathogen that causes infectious arthritis in sickle cell disease?

A

Salmonella

30
Q

How does infectious arthritis present?

A

Predisposing conditions: ID, drug abuse

Swollen hot joint

31
Q

How does infectious arthritis from lyme disease present?

A

Remitting/migratory arthritis in large joints knees>shoulders?elbows?ankles

32
Q

What is gout?

A

Uric acid from purine metabolism

Crystals are negative birefringent

End point of hyperuricemia

33
Q

What are the causes of primary gout?

A

Uknown

HGPRT defect

34
Q

What are the causes of secondary gout?

A

Increased nucleic acid turnover from AML treatment

Chronic renal disease

35
Q

What is the pathogeneis of gout?

A

Monosodium urate precepitates out from supersaturated synovial fluid

Negative birefringence

Low temperatures

Crystals initiate inflammation

36
Q

What are the phases of gout?

A

Asymptomatic

Acute arthritis

Intercritical gout

Chronic tophaceous gout

37
Q

What are tophi?

A

Large deposits of urate that are pathognomic of gout

38
Q

What are the risk factors for gout?

A

Age

Genetics

Heavy drinking

Obesity

Thiazides

Lead toxicity

39
Q

What is calcium pyrophosphate crystal deposition disease (CPPD)?

A

Pseuodgout

Crustals first seen in articular matrix, menisci, and intervertebral disc

Positive birefringent

40
Q

What is a ganglion cyst?

A

Cyst near joint or tendon sheath

Wrist is most common

No communication with joint space

41
Q

What is a synovial cyst?

A

Connected to joint capsule or bursa

42
Q

What is a baker cyst?

A

Politeal synovial cyst often in setting of RA

43
Q

What is a tenosynovial giant-cell tumor?

A

Macrophages and giant cells with hemosiderin and lipid vacuoles

44
Q

What is diffuse tenosynovial giant cell tumor?

A

Pigmented Villonodular Synovitis

Red/brown to yellow from hemosiderin

Mostly knee

Locking or swelling

45
Q

What is a localized tenosynovial giant-cell tumor?

A

Well circumscribed

Slow growing, painless

Fingers and wrists

Most common soft tissue tumor of the fingers

DT 1 Test 1 (18 decks)

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