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msk and ct - step > pathology - arthritis > Flashcards

pathology - arthritis Flashcards

1
Q

etiology of osteoarthritis

A

mechanial joint wear and tear that destroys articular cartilage type II

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2
Q

etiology of rheumatoid arhtirits

A

autoimmune 0 inflammatory destruction of synovila joints

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3
Q

type of hypersensitivity of RA

A

type III and type IV

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4
Q

OA or RA? subchondral cysts

A

OA

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5
Q

OA or RA? pannus

A

RA

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6
Q

OA or RA? sclerosis

A

OA

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7
Q

OA or RA? osteophytes

A

OA

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8
Q

OA or RA? MCP and PIP

A

RA

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9
Q

OA or RA? no MCP, DIP and PIP

A

OA

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10
Q

OA or RA? eburnation

A

OA

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11
Q

OA or RA? synovitis

A

OA

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12
Q

OA or RA? subcutaneous nodules

A

RA

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13
Q

OA or RA? ulnar deviation of fingers

A

RA

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14
Q

OA or RA? heberden nodes

A

OA

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15
Q

OA or RA? bouchard nodes

A

OA

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16
Q

OA or RA? swan neck deformiton (extended at mcp and pip and flexed at dip)

A

RA

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17
Q

OA or RA? boutonniere deformint (extended at MCP and dip, flexed at pip)

A

RA

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18
Q

predisposing factors for OA

A

age
obesity
joint trauma

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19
Q

labs in RA

A

positive for rheumatoid factor = IgM anti IgG that froms complexes with IgG and deposits = Type III = screening
positive for anti-citrullinated peptide ab - more specfic

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20
Q

HLA of RA

A

HLA-DR4

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21
Q

describe classical presentation of OA

A 
pain in weight beirng joints after use
pain improves with rest
knee cartilage lose medially - bowlegged
noninflammatory
non systemic symptoms
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22
Q

pain in weight bearing joints after use
pain improves with rest
bowlegged

A

OA
non inflammatory
knee cartilage lsot medially first
no systemic symptoms

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23
Q

cxpx fo ra

A

females more than males
mornign stiffness lasting more than 30 minutes
stiffness improves with use
symmetric joint invovlement
systemic symptoms - fever, fatigue, weight loss, pleuritis, pericardtis

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24
Q

mornign stiffness that lasts more than 30 mins
stiffness improves with use
symmetrical joints

A

ra

systemic symptoms - fever, fatigue, weight loss, pleuritis and pericarditis

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25
Q

where does pannus form

A

granulation tissue in the MCP and PIP

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26
Q

how to treat OA

A

acetaminophen
nsaids
intraarticular glucocorticoids

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27
Q

how to treat RA

A

nsaids
glucocorticoids
disease modifires - methotrexate and sulfasalzine
biologics - tnfa inhibitors

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28
Q

what is sjogren syndrome

A

autoimmune disorder characterized by destruction fo exocrine glands - lacrimal and salivary especially by lymphocytic infiltrates

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29
Q

typically pat with sjogrens

A

female

40-60 years odl

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30
Q

cxpx of sjogrens

A

inflammatory joint pain
xerophthalmia - decrease tear production and subsequent corneal damage
xerostomia - decrease saliva - dental caries
bilateral parotid enlargement

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31
Q

labs in sjogrens

A

anti nuclear abs: SS-a/anti Ro and/or SS-B/anti La

32
Q

joint pain
dry eyes
dental caries
dry mouth

A

sjogrens

33
Q

what are the complications fo sjuogrens

A

dental caries

increased MALT - may present as parotid enlargement

34
Q

dental caries

increased MALT

A

sjogrens

35
Q

what autoimmune disease is associated with sjogrens

A

RA

36
Q

acute inflammatory monoarthtiris in males with acute onset

A

goutt

37
Q

pathogenesis of gout

A

hyperuricemia lead to ppt of monosodium urate crystals in joints that cause inflammation

38
Q

what can cause hyperuricemia

A

underexretion of uric acid = thiazides

overproduction (10% only) = lesch nyhan, PRPP xcess, increased cell tumovoer in tumor lysis and vongirke disease

39
Q

diseases that you can suspect gout in

A

lesch nyhan
thiazides - chf etc
von gierke
tumot cell lysis

40
Q

joitn aspirate in gout

A

negative birefringence = yellow in parallel and blue in perpendicular

41
Q

swllen, red, painful, asymmetric joint distribution

A

gout

42
Q

most common joint in gout

A

first metatarsal

43
Q

what is podagra

A

painful mtp joint gout

44
Q

common locations of tophi?

A

external ear
olecranon bursa
achilles tendon

45
Q

when do acute attacks of gout happen?

A

large meal or Oh consupmtoin - bc OH metabolites compete for same excretion sites in kidney as uric acid - decreased secretion and buildup in blood

46
Q

treat acute gout!

A

nsaids/indomethacin
glucocorticoids
colchicine

47
Q

treat/prevent chronic gout!

A

xanthing oxidase inhibtiors/allopurinol and febuxostate

48
Q

what is febuxostat

A

inhibts xanthine oxidase whatce out with thiopurines.

49
Q

what causes pseudogout

A

calcium pyrophosphate crystals deposited in joint

50
Q

what is the differnece between chondrocalcinosis and pseudogout?

A

chondrocalcinosis - linear depostiion fo calcium pyrophosphate in articular cartilage
pseudogout - acute pain with redness, swellign and pimited motion

51
Q

describe synovial fluid in pseudogout

A

calcium pyrophosphate forms basophilic rhomboid crystals that are weakly birefringent under polarized light.

52
Q

what joint typical in pseudogotu

A

usually large and KNEE

53
Q

typical patient in pseudogout

A

> 50 years odl male = female

54
Q

list the diseases associated with pseudogout and why please

A

hymochromatosis and hemosiderosis - pyrophase levels are increased
primary hyperparhtyroidism - icnrease calcium
osteoartihritis - i dont know

55
Q

disease associated with OA and disease associated with RA please

A 
pseudogout = OA
sjogrens = RA
56
Q

treat acute pseudogout

A

nsaids

57
Q

prevent pseudogout

A

dont have hemochromatosis, osteoartirhis, primary hyperparathyroidsim ;)
and give glucocorticoids and colchicine

58
Q

difference betwen gout and pseudogout crystals

A

@ paralelle light pseudo gout - blue and gout - yellow
@ perpendicular light gout = blue

hurah

calcium = blue

59
Q

bugs involved in infectious arthritis pelase

A

s aureus, strepto, n gonorrhoesa

60
Q

synovitis of one joint that is swollen, red, painful
tenosynovitis at hands/wrist
dermatitis = pustules on wrist and ankles

A

dissemiated gonoccoal arthritis

STD

61
Q

how does gonoccocal arthritis present?

A

migratory arthrutios with asymmetric pattern

62
Q

i say migratory arthritis with asymmetric pattern, you think?

A

gonococcal arthritis

63
Q

what are seronegative spondyloarthropaties

A

family of overlapping syndromes that are lines wtih disease manifestations and genetics

64
Q

HLA fo seroneg spondylos

A

HLA B27

65
Q

list the seronegative spondylos

A

psoriatic arthritis
anylosing spondylitis
inflammatory bowel disease
reactive arthirtiis/reiter syndrome

66
Q

asymmetric and patchy involvement
dactylitiis
pencilin cup on xray
erosive nails

A

psoriatir arhticitis

67
Q

ankylosis
uveitis
aortic regugitation

A

ankylosing spondylitis

68
Q

cxpx of ankylosing spondylitis

A

ankylosis
uveitis
aortic regurgitation

69
Q

bamboo spine

A

ankylosing spondylitis

70
Q

what type of arthritis associated with uc and chrons

A

ankylosing spondyltiis - aortic regurg, uveitis, ankylosis

71
Q

what is anklylosis

A

stiff spin due to fusion of joints

72
Q

conjunctivitis and anterior uveitis
urehtitis
arthritis
circinate balantitis

A

reactive arthritis/reiter syndrome

73
Q

bugs involved in reiter syndrome

A

post gi - shigella, salmonella, camplyobacteria, yersina

post uti - chlamydia

74
Q

compare and contrast presentation of chlamydia vrs gonorrhea when disseminated

A

chlamydia: conjunctivitis, anterior uveities, urethritis, arhtritis
gonorrhoea: septic arthitits - migratory arhtirits with asymmteri patther, tenosynovities, dermatitis

75
Q

asymmetric patchy invovlement

A

psoriatic athrtitis

76
Q

migratory arhtirits with asymmeter patterh

A

infetious arthritis

msk and ct - step (6 decks)

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