Other Conditions

Question 1

Gout

Answer 1

deposition of monosodium urate crystals in tissues, especially joints

Question 2

Podagra

Answer 2

Acute gout arthritis of the great toe

Question 3

Tophi

Answer 3

white, chalky aggregates of uric acid crystals with fibrosis and giant cell rxn in the soft tissue and joints

Question 4

Pseudogout

Answer 4

deposition of calcium pyrophosphate dihydrate CPPD, synovial fluid shows rhomboid-shaped crystals with weakly positive birefringence under polarized light

Question 5

Features of polymyositis and dermatomyositis

Answer 5

focal inflammation, injury and death of myocytes, regeneration and hypertrophy, atrophy of myocytes, replacement of muscle by fibrosis and fat. Lymphocytes and macrophages.

Question 6

Increased expression of MHC Class I in myocytes

Answer 6

PM and dermatomyositis. Also increased IL1 and TNF alpha levels in active PM and DM

Question 7

Gottron papules

Answer 7

raised plaques over finger joints seen in Dermatomyositis

Question 8

anti-Jo1 antibodies

Answer 8

PM with arthritis that may lead to joint damage

Question 9

Calcinosis, alveolitis, dysphagia

Answer 9

DM

Question 10

Inclusion body myositis

Answer 10

causes distal weakness and is asymmetric

Question 11

Electromyography findings in DM/PM

Answer 11

spontaneous fibrillations, complex repetitive discharges, early recruitment. Abnormal findings in 90% of pts at presentation

Question 12

Tx DM/PM

Answer 12

corticosteroids high dose for first several months with slow taper over 9-12 months. Immunosupp like MTX and azathioprine for pts who fail tx with corticosteroids alone

Question 13

Polymyalgia Rheumatica

Answer 13

proximal symmetric limb girdle pain and stiffness, responds to low dose corticosteroids. Affects older pts W > M, whites of northern european and icelandic descent.

Question 14

HLA-DRB1*04 allele association

Answer 14

polymyalgia rheum and giant cell arteritis

Question 15

elevated CRP, normocytic normochromic anemia, thrombocytosis, and elevated Alk Phos may be seen in

Answer 15

polymyalgia rheumatica

Question 16

Tx polymyalgia rheumatica

Answer 16

low dose corticosteroids, relief within days, slow taper after about 1 month

Question 17

GCA

Answer 17

granulomatous inflammatory injury to medium sized and large arteries. Commonly extracranial branches of carotid arteries and vessels off aortic arch.

Question 18

Henoch-Schonlein Purpura

Answer 18

small vessel vasculitis seen in kids. Palpable purpura, arthritis, GI involvement, glomerulonephritis. May have antecedent URTI. self limiting often

Question 19

Tx HSP

Answer 19

Often self limiting, but glucocorticoids may decrease rates of complications especially GI manifestations like intussusception.

Question 20

Firm to fluctuant pea sized nodule

Answer 20

Ganglion. Usually located in the wrist. Small cyst located near a joint capsule or tendon sheath. Lack true cell lining. “Bible therapy” ruptures the cyst

Question 21

Baker’s cyst

Answer 21

synovial cyst in the popliteal fossa. Results from herniation of synovium through the joint capsule.

Question 22

Tumor cells resemble synoviocytes

Answer 22

pigmented villonodular synovitis (diffuse joint involvement) and giant cell tumor of tendon (single tendon sheath nodule)