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Musculoskeletal system > Osteoarthritis vs RA > Flashcards

Osteoarthritis vs RA Flashcards

1
Q

osteoarthritis: pathogenesis?

A

mechanical: wear and tear destroys cartilage

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2
Q

osteoarthritis: which cells are involved in pathogenesis? what do these cells mediate?

A

chondrocytes mediate degradation and inadequate repair

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3
Q

which one (osteoarthritis or RA) is a degenerative joint disorder?

A

osteoarthritis

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4
Q

Osteoarthritis: predisposing factors?

A

age
female
obesity
joint trauma

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5
Q

age, female, obesity and joint trauma. predisposing for what?

A

osteoarthritis

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6
Q

in which disease do chondrocytes mediate degradation and inadequate repair?

A

osteoarthritis

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7
Q

osteoarthritis: presentation?

A

pain in weight-bearing joints after use (end of the day), improves with rest

assymetric

no systemic symptoms

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8
Q

which disease causes pain in weight-bearing joint at the end of the day, and improves with rest

A

osteoarthritis

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9
Q

osteoarthritis: knee cartilage loss begins medially or laterally?

A

medially (bow-legged/genu varum/’O’)

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10
Q

does osteoarthritis cause systemic symptoms?

A

no

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11
Q

osteoarthritis: joint involvement symmetric or asymmetric?

A

asymmetric

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12
Q

osteoarthritis: joint findings x-ray

(4 total)

A

osteophytes (bone spurs)
joint space narrowing (asymmetric)
subchondral sclerosis
cysts

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13
Q

x-ray findings: osteophytes, joint space narrowing, subchondral sclerosis and cysts. suggestive of?

A

osteoarthritis

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14
Q

osteoarthritis: synovial fluid findings?

A

non-inflammatory
WBC < 2000/mm3

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15
Q

osteoarthritis: findings hands?

A

Heberden nodes at DIP
Bouchard nodes at PIP
Nodes at 1st cmc (thumb)

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16
Q

osteoarthritis: which fingers joints are involved?

A

DIP, PIP, CMC (thumb base)

DIP: heberden
PIP: bouchard

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17
Q

Heberden nodes: where?

A

DIP (in osteoarthritis)

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18
Q

Bouchard nodes: where?

A

PIP (in osteoarthritis)

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19
Q

What are nodes at DIP called in osteoarthritis?

A

Heberden nodes

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20
Q

What are nodes at PIP called in osteoarthritis?

A

Bouchard

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21
Q

Are MCP involved in osteoarthritis?

A

no

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22
Q

which fingers joints are NOT involved in osteoarthritis?

A

MCP

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23
Q

osteoarthritis: treatment?

A

activity modification
NSAID, acetaminophen
intra-articular glucocorticosteroids

24
Q

RA: pathogenesis?

A

Autoimmune and inflammation causes formation of pannus which erodes articular cartilage and joints

(pannus: proliferative granulation tissue)

25
Q

what is pannus?

A

proliferative granulation tissue

26
Q

formation of pannus which erodes articular cartilage. which disease?

A

RA

27
Q

RA: predisposing factors?

A

Female
HLA-DR4
tobacco smoking

28
Q

which disease is associated with HLA-DR4?

A

RA

29
Q

RA is associated with which HLA type?

A

HLA-DR4

30
Q

female, HL-DR4, tobacco smoking. predisposing factors for what?

A

RA

31
Q

Which antibodies are associated with RA?

A

Rheumatic factor
anti-cyclic citrullinated peptide

32
Q

which is more specific for RA: RF or anti-cyclic citrullinated peptide?

A

anti-cyclic citrullinated peptide

33
Q

which antibody is most specific for RA?

A

anti-cyclic citrullinated peptide

34
Q

which percentage of RA cases is positive for RF?

A

80%

35
Q

what kind of antibody is RF?

A

IgM

targets IgG Fc region

36
Q

RA: presentation?

A

pain, swelling and morning stiffness lasting >1hr, improving with use

systemic symptoms

extraarticular manifestations

37
Q

how long does the morning stiffness in RA last?

A

> 1 hr

38
Q

how do RA symptoms improve in the morning?

A

with use

39
Q

pain, swelling and morning stiffness lasting >1hr, improving with use. suggestive of?

A

RA

40
Q

does RA have systemic symptoms?

A

yes

41
Q

what are the systemic symptoms in RA

A

fever, fatigue, weight loss

42
Q

RA: joint findings on x-ray

A

erosions
osteopenia (juxta-articular)
joint space narrowing (symmetric)
cysts

43
Q

x-ray findings:
erosions
osteopenia (juxta-articular)
joint space narrowing (symmetric)
cysts

suggestive of what?

A

RA

44
Q

RA: which part of the body can be subluxated?

A

cervical spine

45
Q

cervical subluxation. suggestive of what?

A

RA

46
Q

RA: deformities?

A

cervical subluxation
ulnar finger deviation
swan neck (DIP flexed)
boutonniere (PIP flexed)

47
Q

ulnar finger deviation. suggestive of what?

A

RA

48
Q

swan neck deformities. suggestive of what?

A

RA

49
Q

boutonniere deformities. suggestive of what?

A

RA

50
Q

which joint is flexed in a swan neck deformity?

A

DIP

51
Q

which joint is flexed in a boutonniere deformity?

A

PIP

52
Q

which finger joint are involved in RA?

A

MCP, PIP

53
Q

which finger joints are NOT involed in RA?

A

DIP, CMC (thumb base)

54
Q

treatment RA?

A

NSAIDs
glucocorticosteroids

disease modifying agents: methotrexate, sulfasalazine

biological agents: TNF-a inhibitors

55
Q

biological agent used for RA?

A

TNF-a inhibitor

56
Q

disease modifying agents used for RA?

A

methotrexate (chemo/immuno-surpressive)

sulfasalazine (anti-inflammatoru)

57
Q

extra-articular manifestations RA?

(10 total)

A

rheumatoid nodules (skin and lung)
Interstitial lung disease
pleuritis
pericarditis
anemia
neutropenia + splenomegaly
amyloidosis
sjogren
scleritis
CTS

Musculoskeletal system (17 decks)

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