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Course 2-rheum > polyarthritis > Flashcards

polyarthritis Flashcards

1
Q

what pattern of ROM indicates articular issues (arthritis)?

A

pain w passive and active ROM

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2
Q

what structures are moving with passive ROM?

A

joints, but no muscle/tendon

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3
Q

what ROM pattern indicates non-articular issues?

A

pain on active, no pain on passive ROM

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4
Q

what pattern of features indicate inflammatory arthritis?

A

stiffness >30min, systemic symptoms, specific joint patterns, nodules, rashes, organ involvement

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5
Q

how do the infection routes differ for kids and adults in septic arthritis?

A

adults-blood

kids-contiguous (growth plate)

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6
Q

what patterns indicate septic arthritis in regards to fluid appearance, volume, viscosity, WBC count, PMN?

A

opaque, high (5-50ml), low viscosity, WBC >50,000, PMN >75

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7
Q

what is the epidemiology of gout?

A

males (most common inflammatory arthritis in M>40), not in premenopausal females

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8
Q

what risk factors predispose pt to gout?

A
  • metabolic syndrome, obesity, HTN, diabetes, dyslipidemia
  • ETOH, meds, ASA, diuretics
  • renal insufficiency, concurrent illness, past kidney stone
  • FHx, myeloproliferative disorder
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9
Q

where does gout usually start?

A

big toe (monoarthritis) in 30s, spread to other joints (lower limbs first)

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10
Q

what crystals are implicated in pseudogout?

A

calcium pyrophosphate

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11
Q

how does pseudogout happen?

A

calcium deposition in joints through trauma

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12
Q

what percentage of seniors have chondrocalcinosis?

A

50%

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13
Q

what factors increase risk of pseudogout?

A

age, OA, neuropathic joints, hyperparathyroidism, hypothyroidism, hemochromatosis, hypo PO4/Mg, FHx

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14
Q

where does pseudogout likely happen?

A

knees

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15
Q

what factors are needed to Dx pseudogout?

A

birefringence in synovial fluid, rhomboid shaped crystals, XR shows chondrocalcinosis

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16
Q

what is the etiology of CREST?

A
  • skin thickening doesn’t go above knees/elbows
  • late/limited organ involvement
  • calcinosis, raynauds, esophageal dysmotility, sclerodactyly, telangiectasia, anti-centromere +
17
Q

what is the etiology of diffuse scleroderma?

A
  • skin thickening past elbows, knees, and on trunk/jaw/face
  • internal organ involvement (lung and kidney) early and severe
  • Scl-70+
18
Q

what are the most common joints affected by RA?

A

MCP and wrist

then PIP, knees, shoulders, ankles, elbows, hips

19
Q

what is the evolution of RA?

A

start as monoarthritis, then into small joint symmetrical polyarthritis in hands and feet

20
Q

what are the extra-articular diseases associated w RA?

A

sc nodules, pulmonary/cardiac involvement, eye involvement, neuro/renal/muscular atrophy, rheumatoid vasculitis

21
Q

what ethnicities are prone to SLE?

A

african and asian

22
Q

what are the common features of lupus? (SOAP BRAIN MD)

A 
serositis
oral ulcer
arthritis
photosensitivity
blood problems
renal problems
ANA+
immune test +
neuro problems
malar rash
discoid rash
23
Q

what is the defining factor of seronegative arthritis?

A

rheumatoid factor negative

24
Q

what is the typical onset age of AS?

A

late teens-early 20s (males)

25
Q

what population has a high prevalence of AS?

A

native american

26
Q

what are the clinical features of AS?

A

alternating butt pain (SI)

inflammatory back pain (3mo, >1hr, worse w rest)

peripheral joint disease (hips, shoulders, knees)

27
Q

in psoriatic arthritis, psoriasis usually ____ the arthritis

A

precedes

28
Q

What even usually precedes reactive arthritis?

A

infectious diarrhea (salmonella, yersinia, shigella, campylobacter)

urogenital infections

29
Q

T/F: reactive arthritis is due to bacterial infection in joints

A

False. Due to local immune response to systemic infection

30
Q

what is the typical onset age of reactive arthritis?

A

20s, men

31
Q

what are the symptoms of reactive arthritis?

A

arthritis, conjunctivitis, urethritis

asymmetric additive oligoarthritis in lower body

oral ulcers, circinate balanitis, keratoderma balanitis

32
Q

what muscle groups are more commonly affected by inflammatory muscle disease?

A

proximal

33
Q

what is the most severe consequence of temporal/giant cell arthritis?

A

blindness

34
Q

what is a common feature of all the symptoms associated with fibromyalgia?

A

worse w stress

Course 2-rheum (7 decks)

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