MS Quiz #6 Flashcards
What fluid becomes more viscous from pressure? It also transports nutrients and waste.
synovial fluid
What is the motto for any acute mono arthritis?
Any acute mono arthritis is an infection until proven otherwise.
What is it called when 2-4 joints are involved?
pauciarticular
What are the joints of the hand that are more proximal than the PIPs?
MCP metacarpalphalangeal
What do you call a swollen digit?
dactalitis
What are some questions you can ask to get specifics about pain?
- Morning stiffness lasting how long?
- characteristics of pain? (stiffness)
- Pain at rest?
- Diurnal pattern of pain?
- activities of daily living impacted?
- other associated systems?
List 5 important PEs for joint pain
- Temp
- eyes for inflammation
- skin for rashes/vasculitis
- check shins for nodules
- nail changes
- lymph system
What are some categories of abnormality in joints?
- deformity
- swelling (hard/soft)
- color change
- muscle atrophy
- canges in ROM and gait
Labs for joint pain
ESR - systemic inflammation CRP - measures dz progression Serum Uric acid - gout Rheumatoid Factor - RA ANA - SLE (scleroderma, RA, Sjorgens) Vit D CBC Urinalysis (SLE)
What do you do when there is any suspicion of septic arthritis (mono arthritis)
immediately aspirate synovial fluid
List 5 causes of polyarthritis
- Viral infxn (parvo, entero, adeno, EBV)
- Direct bacterial (gonoc, staph, strep)
- Reactive to bacterial infxn (chlamydia, salmonella, shigella)
- Systemic hematological disease (RA, SLE)
- cyrstal arthropathy (gout)
RA (diffuse CT dz) hand symptoms
- soft synovial swelling
- MCP synovitis and volar
- subluxation
synovitis of wrists and PIP (swan neck)
broad differentials
cancer autoimmune infection exposure metabolic trauma
examples of amphiarthroses
pubic symphsis, SI joint, intervertebral discs
which type of joints have synovial fluid?
diarthrosis
stenosing
swelling of a tendon sheath causing triggering
Osteoarthritis hand sx
- hard boney enlargements
- Heberden’s nodes at DIPs
- Bouchard’s nodes at PIPs
- squared first CMC joint
swan neck deformity vs boutonniere deformity
Swan neck: PIP extension
DIP flexion
Boutonnierre: opposite
psoriatic arthritis sx
- sausage fingers
- inflammation of DIPs
- nail changes
- psoriatic patches
- arthritis may start before skin
SLE sx
interarticular dermatitis
periungal erythema
RA general sx
- variable, unrelenting onset of hand and foot swelling
- pain, stiffness, swelling joints
- symmetric MCPs, PIPs, wrists, MTP, elbows, knees, midfoot
- > 1 hr morning stiffness
- 1/3 have systemic myalgia, fatigue, fever, weight loss
labs for RA
CBC - anemia
CRP and ESR elevated
anti CCP 95%
synovial fluid clowdy
Juvenile Idiopathic Arthritis
- uveitis is most common bad sx
- dx of exclusion
- involves 1 or more joints for at least 6 weeks
- systemic onset: high fever, rashes, LA
complications of juvenile idiopathic arthritis
cardiac tamponade, vasculitis, marcrophage activation syndrome
