Polyarticular Arthritis Flashcards
3 most common symptoms of most arthritis
Pain
Joint stiffness
Swelling of joints
Rarely seen warmth/redness
Periungual erythema =
swelling/redness around nails
When you see arthritis in children, you must rule out ___
Rheumatic fever
Differential for fever, rash and polyarthritis (5)
SLE Dermatomyositis Systemic vasculitis Rheumatic fever Infections
Anti-cyclic citrullinated peptide used to diagnose ___
Rheumatoid arthritis
T/F: Features of non-inflammatory synovial fluid include opaque yellow colored, low viscosity, low neutrophils.
False. Features of non-inflammatory synovial fluid include TRANSPARENT yellow colored, HIGH viscosity, low neutrophils (less than 25)
Inflammatory or non-inflammatory arthritis?
Worse in AM
Improves with activity
Inflammatory
Inflammatory or non-inflammatory arthritis?
Minimal or no AM stiffness
Non-inflammatory
Inflammatory or non-inflammatory arthritis?
Worse in PM
Worse after activity
Non-inflammatory
Inflammatory or non-inflammatory arthritis?
Synovial fluid > 2,000 WBC
Inflammatory
Polyarthritis = arthritis affecting ___ joints simultaneously
> 5
Oligoarthritis = = arthritis affecting ___ joints
2-4
Which of the following is NOT on the differential for MONOarthritis? A. Psoriatic arthritis B. Juvenile chronic arthritis C. Lyme disease D. Undifferentiated Spondyloarthropathy
D. Undifferentiated Spondyloarthropathy: asymmetric lower limb, knee, ankles oligoarthritis
A. Psoriatic arthritis (red hot joint)
B. Juvenile chronic arthritis (chronic monoarthritis)
C. Lyme disease (infectious chronic monoarthritis)
Asymmetric DIP, PIP, MCP oligoarthritis =
Psoriatic arthritis
Which of the following is NOT a cause of inflammatory polyarthritis? A. RA B. Juvenile chronic arthritis C. Undifferentiated polyarthritis D. Post infectious arthritis
ALL are correct
T/F: Positive rheumatoid factor is diagnostic of Rheumatoid arthritis.
False. Not specific or sensitive.
Other causes of + RF:
Age
Bacterial endocarditis
Hepatitis C
Duration of symptoms:
Self-limiting (acute) = lasting ___
Chronic = lasting ___
up to 4-6 weeks
more than 6 weeks
Which of the following does NOT have a sudden ONSET? A. Gout B. Rheumatoid arthritis C. Rheumatic fever D. Reactive arthritis
B. Insidious onset
Name 3 ADDITIVE arthritis
Polyarticular OA
RA
Reactive arthritis
Name 1 MIGRATORY arthritis
Rheumatic fever
Name 1 INTERMITTENT arthritis
Crystal-induced arthritis
Also Palindromic rheumatism (cause I totally now what that is…)
Symmetric or Asymmetric? Rheumatoid arthritis Osteoarthritis Systemic lupus Psoriatic arthritis Chronic sarcoidosis
Rheumatoid arthritis: symmetric Osteoarthritis: asymmetric Systemic lupus: symmetric Psoriatic arthritis: asymmetric Chronic sarcoidosis: asymmetric
Axial joint arthritis seen in ___
ankylosing spondylitis
Which of the following is a characteristic of rheumatoid arthritis?
A. MCP, DIP joint involvement
B. Unilateral
C. Symmetric
C
A. MCP, PIP joint involvement
B. BI-lateral
MCP and PIP joint involvement seen in all EXCEPT: A. Systemic Lupus B. Systemic sclerosis C. Rheumatoid arthritis D. Psoriatic arthritis
D. DIP joint involvement in psoriatic arthritis
Acute sternoclavicular joint involvement seen in ___
IV drug users w/ septic arthritis
Acute bilateral shoulder and hip pain is suggestive of ___
polymyalgia rheumatica
1st MTP of the big toe suggests
acute gout
also: pseudo-gout, osteoarthrtis, psoriatic arthritis
Asymmetric involvement of knees and ankles suggests
late Lyme disease
Periungual erythema + polyarthritis is suggestive of ____
polymyositis
Heberdens nodes associated with ___
OA
Hederdens nodes = hard/bony swellings in DIP
