polyarthritis

Question 1

what pattern of ROM indicates articular issues (arthritis)?

Answer 1

pain w passive and active ROM

Question 2

what structures are moving with passive ROM?

Answer 2

joints, but no muscle/tendon

Question 3

what ROM pattern indicates non-articular issues?

Answer 3

pain on active, no pain on passive ROM

Question 4

what pattern of features indicate inflammatory arthritis?

Answer 4

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

Question 5

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

Answer 5

adults-blood

kids-contiguous (growth plate)

Question 6

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

Answer 6

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

Question 7

what is the epidemiology of gout?

Answer 7

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

Question 8

what risk factors predispose pt to gout?

Answer 8

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

Question 9

where does gout usually start?

Answer 9

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

Question 10

what crystals are implicated in pseudogout?

Answer 10

calcium pyrophosphate

Question 11

how does pseudogout happen?

Answer 11

calcium deposition in joints through trauma

Question 12

what percentage of seniors have chondrocalcinosis?

Answer 12

50%

Question 13

what factors increase risk of pseudogout?

Answer 13

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

Question 14

where does pseudogout likely happen?

Answer 14

knees

Question 15

what factors are needed to Dx pseudogout?

Answer 15

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

Question 16

what is the etiology of CREST?

Answer 16

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

Question 17

what is the etiology of diffuse scleroderma?

Answer 17

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

Question 18

what are the most common joints affected by RA?

Answer 18

MCP and wrist

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

Question 19

what is the evolution of RA?

Answer 19

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

Question 20

what are the extra-articular diseases associated w RA?

Answer 20

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

Question 21

what ethnicities are prone to SLE?

Answer 21

african and asian

Question 22

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

Answer 22

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

Question 23

what is the defining factor of seronegative arthritis?

Answer 23

rheumatoid factor negative

Question 24

what is the typical onset age of AS?

Answer 24

late teens-early 20s (males)

Question 25

what population has a high prevalence of AS?

Answer 25

native american

Question 26

what are the clinical features of AS?

Answer 26

alternating butt pain (SI) inflammatory back pain (3mo, >1hr, worse w rest) peripheral joint disease (hips, shoulders, knees)

Question 27

in psoriatic arthritis, psoriasis usually ____ the arthritis

Answer 27

precedes

Question 28

What even usually precedes reactive arthritis?

Answer 28

infectious diarrhea (salmonella, yersinia, shigella, campylobacter) urogenital infections

Question 29

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

Answer 29

False. Due to local immune response to systemic infection

Question 30

what is the typical onset age of reactive arthritis?

Answer 30

20s, men

Question 31

what are the symptoms of reactive arthritis?

Answer 31

arthritis, conjunctivitis, urethritis asymmetric additive oligoarthritis in lower body oral ulcers, circinate balanitis, keratoderma balanitis

Question 32

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

Answer 32

proximal

Question 33

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

Answer 33

blindness

Question 34

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

Answer 34

worse w stress