Osteoarticular V

Question 1

events in single espisode connective tissue trauma

Answer 1

Healing by scar formation (non functional tissue

Question 2

Events in chronic repetative connective tissue trauma (3)

Answer 2

• neovascularization
• increased proteoglycan content
• impaired mvmt

(not full functionality)

Question 3

what is a ganglion cyst and how common is it

Answer 3

Cystic tumor developing on a tendon aponeurosis

60% of all benign tumors of hand

Question 4

Gender predominance in connective tissue diseases and which don’t follow

Answer 4

Femal morbitiy mainly

-(exeption polyarteritis nodosa, AS)

Question 5

Main clinical features of polymyositis and dermatomyositis

Answer 5

mm weakness, pain, tenderness

• skin rashes
• discoloration of upper eyelids

Question 6

What is neuropathic jt disease also called and what is it characterized by

Answer 6

Charcot jt.

-noninflammatory arthritis characterized by progessive jt destruction

Question 7

what does syringomyelia cause

Answer 7

destruction of shoulder or other upper extremity

Question 8

classic signs of ra

Answer 8

• diarthrodial jts symetrically and bilat
• early synovial changes (edema and accumulation of plasma cells, lymphocytes and macrophages)
• juxtaarticular bone loss

Question 9

Autoimmune findings in RA (3)

Answer 9

• • RF factor
• RF-IgM targeting Fc portion of IgG
• antinuclear antigen (+ in 30%)

Question 10

How is the pannus formed in RA

Answer 10

inflammatory synovium now contains mast cells, creeps over the surface of the articular cartilage and adjacent structures and is termed pannus

Question 11

How does the pannus affect the jt in RA

Answer 11

Pannus covers the articular cartilage and isolates it from the synovial fluid,
–lymphocytes aggregate and eventually develop follicular centers

=panus eventually erodes articular cartilage/adjacent bone

Question 12

what causes molecular mimicry with RA

Answer 12

EBV

Question 13

release of immune cells in RA for type IV hypersensitivity

Answer 13

Activation of CD4 which release TNF and IL1 (synovial inflammation)

-RF synthesis by b cells in response to synovial antigen

Question 14

What does RF and IgG and Th17 cause in RA

Answer 14

RF and IgG activate complement

IL 17 is released by th17 causing pannus formation (neutropholic infiltration, granulation tissue)

Question 15

Clinical signs of RA

Answer 15

> 6w

• morning stiff >1hr
• MCP, PIP jts
• Ulnar dev (esp. R hand)

Question 16

How often do Rhematoid nodules aappear in RA and where are they usually located

Answer 16

25% of pts

• ulnar aspect of forearm
• Viscera (lungsm pericardium, myocardium)

Question 17

When can you see radiographic findins in RA

Answer 17

50% of pts show jt space narrowing or erosions in the first 2 years after initial symptoms

Question 18

what are the 3 types of RA

Answer 18

1- Self limited= 5-20%

2. Minimally prog= 5-20%
3. Progrssive= 60-90%

Question 19

Main characteristics of juvenile RA (age, gnder, associated condition)

Answer 19

<16
2:1 F:M

-chronic fever and anemia typical for JRA

Question 20

3 classifications of JRA

Answer 20

Polyarticular- 40%, disabling arthritis

Pauciarticular- 4 or fewer jts involved

Still disease- 20%, fever,rash etc

Question 21

Differentiators of JRA vs RA

Answer 21

• less jts involved
• mc systemic onset
• more large jts
• RF and nodules negative
• ** extra articular manifestations: Pericarditis, myocarditis etc

Question 22

What % of ppl w psoriasis develop psoriatic arthritis

Answer 22

10%

Question 23

Symptoms of scleroderma

Answer 23

• raynauds
• Polyarthritis
• contraction of skin

Question 24

What is the symptoms of crest syndrome (5)

Answer 24

• calcinosis
• raynauds
• esophageal dysmotility
• sclerodactyly (thickening of skin)
• teleangioectasia

Question 24

What is the symptoms of crest syndrome (5)

Answer 24

• calcinosis
• raynauds
• esophageal dysmotility
• sclerodactyly (thickening of skin)
• teleangioectasia