PAST EXAM ANSWERS Flashcards
LIST 5 THINGS IN A JOINT THAT CAN CAUSE PAIN (5 marks)
Joint capsule
Periosteum
Ligaments
Subchondral bone
Synovium
- LIST 4 PATHOPHYSIOLOGICAL DISEASE PROCESSES OF A JOINT (4 marks)
Infection
Crystal deposition
Enthesopathy
Structural/mechanical derangements
Synovitis
- LIST 4 KEY EVENTS OCCURRING IN SYNOVITIS (4 marks)
Neurovascularisation
Infiltration of synovium with lymphocytes, plasma cells, & macrophages
Synovial cell hyperplasia
Pannus formation: which leads to marginal bone & cartilage erosion
- DESCRIBE INFECTION
The synovium, and other joint structures, may become the seat of acute or chronic infections caused by bacteria, fungi, or viruses
Infections usually arise from septicaemia and may often be seen in systemic infections.
Synovial infections are characterised by:
- intense neurophillic infiltration (neutrophils usually target bacteria)
- synovial necrosis
- subsequent formation of granulation and scar tissue
Dense mass of fibrin, infiltrated by neutrophils form over synovial surface
Bacterial products released within joint are capable of producing rapid cartilage and bone destruction
- LIST 6 DESCRIPTORS TO HELP DIAGNOSE PAINFUL JOINT
Pain Stiffness Swelling Loss of ROM Weakness Fatigue
- LIST 4 TYPES OF CRYSTALS
Monosodium urate monohydrate = gout
Calcium pyrophosphate dihydrate = CPPD (pseudogout)
Calcium phosphate e.g. hydroxyapatite
Calcium oxalate
- 4 CONDITIONS WITH SKIN LESIONS (4 marks)
SLE - Malar rash
Dematomyositis —> Gottron’s papules, helliotrope rash
Scleroderma —> dermal induration due to fibrosis
Psoriatic arthritis —> psoriasis, preceding inflammation
- OCULAR LESION
RA - scleritis
AS - anterior uveitis
Reactive arthritis - conjunctivitis
- DEFINITIONS OF MONO, OLIGO & POLY-ARTHRITIS (3 marks)
Mono: arthritis of 1 joints
Oligo: arthritis of 2-4 joints
Poly: arthritis of 5 or more joints
- DEFINITION OF CRP (2 marks)
CRP is one of the acute phase reactants synthesized in the liver following the release of cytokines such as interleukins IL-1 and IL-6.
C-reactive protein is a test that detects the presence of inflammation due to:
– Tissue injury
– Autoimmune disease
– Infection etc
- DEFINE ESR (2 marks)
The ESR is rough measure of the abnormal concentrations of acute phase proteins and immunoglobulins in the serum.
The ESR is a measure of the height that erythrocytes fall through plasma in a Wintrobe tube over a period of 1 hour (i.e. mm/h)
- ESR False Positive
Nephrotic syndrome
Anaemia
Hypergammaglobulinaemia
conditions causing increased Plasma protein levels
conditions causing increased plasma Viscosity
- WHAT DOES CRP TELL YOU THAT ESR DOESN’T? (2 marks)
C is more sensitive, independent, better correlated and gets up earlier than C.
- Serum CRP levels are more sensitive for the evaluation and monitoring of inflammation than ESR
- CRP is independent of factors that affect ESR
- CRP correlates better with disease activity
- CRP level rise 4 to 6 hours after tissue injury (i.e. much earlier than other acute-phase reactants)
- DEFINE ANTI-RNP ANTIBODIES. WHAT CONDITION IS IT IN? (2 marks)
They are auto antibodies directed towards the ribonucleoproteins, which made up a complex or proteins and a small nuclear RNA called U1. They are found in MCTD, SLE, DLE, Scleroderma and RA
- DEFINE HLA B27 ANTIGEN & WHAT CONDITION IS IT FOUND IN? (2 marks)
The HLA complex is human leucocyte antigen complex which are genes that code for the synthesis of
the HLA proteins. The HLA proteins (=antigens) become
embedded in the cell membrane of all
nucleated cells and platelets
HLA proteins enable the immune system to recognise its own cells, by displaying self proteins and also allows it to bind & display pathological antigens for recognition by Tcells.
It is in 3-7% of normal people and also found in a range of seronegative spondylarthropathies i.e. AS.
