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Year2 MSK exam 1 > MSK path IX > Flashcards

MSK path IX Flashcards

1
Q

what is OA

A

degeneration of cartilage causing structural and functional failure of synovial joints
failure/disordered repair

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2
Q

what occurs in early OA

A

chondrocytes proliferate and the collagent II fibers cleaved causes fissures and clefts

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3
Q

what are joint mice

A

parts of cartilage that slough into joint in OA

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4
Q

what cap the osteophytes in OA

A

fibrocartilage and hyaline

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5
Q

what is eburnated articular surface in OA

A

friction on bone causing smoothign surface

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6
Q

Sx OA

A

deep achy pain that worsens with use
morning stiffness, crepitus
limited ROM
impingement on spinal foramina by osteophytes

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7
Q

what occurs with radiculopathy from OA

A

muscle spasms, radicular pain, muscle atrophy and neurologic deficits

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8
Q

joints commonly involved in OA

A

hips knees, lower lumbar and cervical vertebrae, PIPs DIPs, first CMC and first TMT

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9
Q

heberden nodes

A

prominent osteophyes at DIP joints

common in women

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10
Q

Dx OA

A

radiographically because can see osteophytes

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11
Q

red ragged bloody clots in joint capsule

A

RA

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12
Q

RA

A

chronic inflammatory disorder of autoimmune origin
may affect many tissues and organs principally attacks joints producing nonsuppurative proliferatice and inflammatory synovitis

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13
Q

what do hands look like in RA

A

ulnar deviation

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14
Q

What is common genetically in RA

A

HLA susceptibility

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15
Q

what cells are involved in RA

A

T ell B cell and Macrophages

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16
Q

What cells initiate immune response in RA

A

CD4 T cells

reacti with arthritogenic agent

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17
Q

what specified Tx is helpful in RA and why

A

TNF antagonists because TNF somehow involved in RA

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18
Q

What is in the synovium of RA

A

germinal centers with secondary follicles and many plasma cells (autoAb)

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19
Q

synovium in RA

A 
thick edema
hyperplastic
synovial cell hyperplasia, dense inflammatory infiltrates
increased vasculaity
fibrinopurulent exudate
osteoclastic activity in underlying bone
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20
Q

what is pannus

A

mass of edematous synovium, inflammatory cells, granulation tissue and fibroblasts that grows over articular cartilage and causes its erosion

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21
Q

what is it called when pannus bridges opposing bones

A

fibrous anklyosis leads to boney ankylosis when it fuses

22
Q

blue cells with hoff bodies

A

plasma cells

23
Q

are plasma cells normal in synovium

A

no

24
Q

what are RA subcutaneous nodules

A

parts of skin subject to pressure
firm nontender and round to oval
in subcutaneous tissue

25
Q

what do RA subcutaneous nodules look like microscopically

A

necrotizing granulomas with central zone fibrinoid necrosis with rim of macrophages, lymphocytes and plasma cells

26
Q

increased RF in RA patient

A

higher risk for vasculitis

27
Q

acute necrotizing vasculitis with RA involves what and can lead to what

A

small and large aa

neuropathies, ulcers and gangrene

28
Q

leukocytoclastic vasculitis can cause what

A

purpura, cutaneous ulcers, nail bed infarction

ocular changes like uveitis and keratoconjunctivitis

29
Q

palisade necrozing granuloma need to test for?

A

TB

can be rheumatoid nodule in lung

30
Q

Sx RA

A

slow malaise, fatigue, generalized MSK pain

31
Q

what mediates pain in RA

A

IL1 and TNF

32
Q

joint progression in RA

A

small joints first

symmetrically

33
Q

what part of skeleton is usually spared in RA

A

lumbosacral and hips

34
Q

Dx RA

A

characteristic radiographic finding
sterile turbid synovial fluid with poor mucin clot
combination of RF and anti CCP Ab

35
Q

ehy does the synovial fluid of RA joint have poor mucin clot

A

all the inflammatory products break it downw

36
Q

what are the inclusion breaing neutrophils in RA synovial fluid

A

tart cells

37
Q

anti CCP Ab is best used for what

A

RA screening!!

38
Q

What is Juvenile idiopathi arthritis

A

unknown cause arthritis before age 16 and persist for >6 weeks

39
Q

differences of RA and JIA

A 
JIA:
oligoarthritis
unilateral
systemic disease more frequent
large joints affected more
RF and nodules usually absent
ANA sero +
40
Q

ANA + means what

A

autoimmune

41
Q

seronegative spondylarthropathies have what

A

assoc with HLA B27
no RF
involve SI joints

42
Q

anklyosing spondylitis

A

destruction of cartilage and bony anklyosis of SI and apophyseal joints

43
Q

what are apophyseal joints

A

between tuberosities and processes

44
Q

when does anklyosing spondylitis become Sx

A

20-30 years because of low back pain and spinal immobility

45
Q

what peripheral joints are involved in anklyosing spondylitis sometimes

A

hips, knees, shoulders

46
Q

HLA with anklyosing spondylitis

A

B27

47
Q

What is reactive arthritis

A

reiter syndrome
arthritis, nongonococcal urethritis or cervicitis
conjunctivitis

48
Q

HLA assoc with reactive arthritis

A

HLA B27 and HIV individuals

49
Q

age of reactive arthritis

A

20s 30s

50
Q

prior infection that can trigger reactive arthritis

A

chlamydia, shigella, salmonella, yersinia, campylobacter

Year2 MSK exam 1 (26 decks)

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