Lecture 12 - Diseases of Joint

Question 1

Osteoarthritis is a degenerative disorder of ______ cartilage, whereby _____ matrix is broken down. Radiology will show bone on bone contact and possible osteophyte formation.

Answer 1

Articular cartilage

Chondroid matrix

Question 2

Areas of _______ describe describe small holes in the articular cartilage in Osteoarthritis patients. ________ cysts are also characteristic of osteoarthritis.

Answer 2

Eburnation

Subchondral cysts

Question 3

_____ _____ is a systemic inflammatory autoimmune disease (type II and IV hypersensitivity reactions) which principally attacks the joints via cytokine mediated inflammation. _____ T-cells are the principal source of these cytokines, and about 50% of patients have a mutation in the _____-____ gene locus. It causes a non-suppurative proliferative _____. Peak incidence is in the _____ to _____ decades of life, and it is 3-5 times more common in women.

Answer 3

Rheumatoid Arthritis

CD4+ T-cells

HLA-DR4

Synovitis

Second to Fourth

Question 4

Some of the hallmark histological findings for a Rheumatoid Arthritis diagnosis include chronic _____ synovitis, Rheumatoid ______ formed by proliferating synovial lining with central fibroid necrosis, and pannus (hypervascularized granulation tissue).

Answer 4

Papillary synovitis

Nodules

Question 5

What is one of the key differences between daily progression of pain in patients with Osteoarthritis vs Rheumatoid Arthritis (RA)?

Answer 5

Patients with RA tend to wake up achy and stiff, and they feel better throughout the day as they move. Osteoarthritis patients tend to experience more pain with more movement.

Question 6

Large crystalline aggregates called _____ are a hallmark of gout. Metabollically, there is an increase in hepatic breakdown of _____ and an increase in serum ____ ____. Histologically, gouty crystals appear _____-shaped and exhibit negative birefringence (crystals parallel to the lens are yellow and perpendicular are blue - PaY PeB).

Answer 6

Tophi

ATP

Lactic Acid

Needle-shaped

Question 7

Allopurinol, a treatment for chronic gout, acts by blocking ______ oxidase.

Answer 7

Xanthine

Question 8

Pseudogout is characterized by calcifications in overlaying cartilage of joints. Histologically, crystals are ______-shaped and exhibit POSITIVE birefrigence (opposite color-orientation relationship to Gout).

Answer 8

Rhomboid-shaped

Question 9

Seronegative spondyloarthropathies are characterized by an absence of ______ factor and the presence of _____-B27 in the vast majority of patients.

_______ _______ (one of the seronegative spondyloarthropathies) is typically characterized by lower back pain and spinal immobility. There is also an association with upregulation of ____-23 in these patients.

______ ______ typically presents with a triad of symptoms (Can’t pee, can’t see, can’t climb a tree). What are the sympotms, and which disease do patients also typically have?

Answer 9

Rhematoid factor

HLA-B27

Ankylosing Spondylitis

IL-23

Reactive Arthritis

Urethritis, Conjunctivitis, and Arthritis

HIV

Question 10

How long does Enteritis-associated arthritis typically last, and which bacteria are typically associated with it?

Answer 10

Lasts about a year and then clears up. It is associated with gram - bacteria.

Question 11

Psoriatic arthritis is associated with HLA-____ allele.

Answer 11

HLA-Cw6

Question 12

Infectious arthritis is a medical emergency and occurs via seeding of a joint with bacterial infection. Most common cause in general pop is __. ______, the most common cause among sickel cell patients is ______, and ______ is a common agent found in unpasteurized dairy. __. _______ is typically a culprit in young adults who are sexually active.

Answer 12

H. influenza

Salmonella

Brucella

N. gonnorhea