Miscellaneous Flashcards
6 factors in evaluating rheumatology cases?
- articular? (in a joint?)
- acute or chronic
- inflamamtory?
- distribution/demographic
- pattern
- symmetrical?
rheumatology
study of disease of joints
swelling and pain in fingers, three years, worsens through day, symmetric in PIPs and DIPs, NON inflammatory
osteoarthritis
PIPs and DIPs pain, IS INFLAMMATORY, chronic
rheumatoid arthritis
what are the crystal forming diseases?
gout
CPPD
pseudogout
osteoarthritis is primarily a disease of______
cartilage -
asymmetric cartilage loss
osteoarthritis
rheumatoid arthritis is primarily a disease of ___
bone
extremity bends away from midline
valgus
bends toward midline
varus
morning stiffness is less than 30 min; more than that
osteoarthritis; inflammatory arthritis
worse with activity
osteoarthritis
better with activity
RA
acute intermittent arthritis, mono arthritis, asymmetric, very high wbc and high esr, pain of several joints
peudogout
women vs men - who gets tumors in bones more easily vs arthritis
women - arthritis
men - tumors
CPPD
calcium pyrophostphate dihydrate in cartilage
calcification in cartilage
lab: Ca, Mg, ferritin, Iron
CPPD
how to treat CPPD?
corticosteroid injection
gout vs pseudogout site of infection
gout - smaller distal joints (ankle, phalanges, olecranon etc)
pseudogout larger proximal (knee, back wrist)
urate in serum
gout
yellow needle like vs blue rhomboid like
CRYSTALS
yellow needleis gout and blue rhomboid is pseudogout
RA: which is first, skin or bone?
skin
sausage digits
reactive or psoriatic arthritis
multinucleate and resorbs bone
osteoclast
mononuclear in stroma, usedto be osteoblasts
osteocytes
woven bone
produced rapidly (fetal/fracture repair), haphazard collagen fibers, less sturdy, ALWAYS PATHOLOGIC IN ADULTS
osteoblastic rimming
mononucleate cells around surface of bone being produced
synovial fluid analysis:
if infectious?
if gout?
if pseudogout?
infection - neutrophils
gout - needles
pseudogout - rhomoids
OA vs RA - hand joints
oa is more distal
ra is more proximal (MCP)
fast growing tumor (onion skin) with low mitotic index
ewing sarcoma
what differentiates PNET from ewing sarcoma?
homer wright rosettes
RANKL
protein on osteoblasts that activates osteoclasts!
