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Emma Rheumatology > Random (Mostly Quizzes) > Flashcards

Random (Mostly Quizzes) Flashcards

1
Q

septic arhtritis synovial fluid wbc

A

> 50,000 suggestive

> 100,000 septic until proven otherwise

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2
Q

low glucose in synovial fluid is most exaggerated in _____ and _____

A

rheumatoid arthritis and a septic joint

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3
Q

synovial membrane components

A

2 layers

1: myofibrils, proteoglycans, capillaries, lymphatics, nerve endings
2: synovial cells (macrophage-like, and fibroblast-like)

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4
Q

joint capsule components

A

Type I Collagen, Type III Collagen, mechanoreceptors, and free nerve terminals

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5
Q

articular cartilage

A

Type II Collagen, Proteoglycans, and Chondrocytes

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6
Q

path of nutrients –> articular cartilage

A

capillaries→ diffusion through FENESTRATED capillaries →synovial fluid → hyaline cartilage

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7
Q

healthy joint wbc

A

<2,000

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8
Q

RA joint protein levels

A

inc due to inc permeability of synovium

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9
Q

RA joint glucose level

A

dec due to impaired active transport into synovial fluid and inc consumption due to inflammation

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10
Q

bacterial arthritis protein levels

A

inc

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11
Q

bacterial arthritis glucose levels

A

dec

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12
Q

traumatic effusion joint wbc

A

non-inflammatory range (<2000)

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13
Q

penetrating path into knee joint

A

Muscle/tendon, joint capsule, synovial tissue (membrane), joint space and cartilage

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14
Q

joint capsule collagen

A

almost exclusively of densely packed type I collagen separated by thin sheets of fibrillar type III collagen.

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15
Q

RF

A

IgM Ab against the Fc portion of IgG

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16
Q

__ is more specific for RA than RF

A

CCP

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17
Q

major components of RA tx

A
  • NSAIDs
  • corticosteroids
  • disease-modifying anti-rheumatics (methotrexate)
  • biologics
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18
Q

Mycophenolate mofetil

A

SLE

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19
Q

HLA-DR4

A

RA

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20
Q

HLA-B27

A

spondyloarthropathies

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21
Q

ESR in RA

A

elevated

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22
Q

CRP in RA

A

elevated

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23
Q

A warm swollen knee or wrist are the most common presentations of

A

a pseudogout flare (calcium pyrophosphate crystal)

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24
Q

lyme wbc

A

tend to be in the typical inflammatory range of between 2,000 and 50,000

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25
Q

mean onset of lyme arthritis

A

6 mo after the initial infective transmission

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26
Q

post-tx lyme arthritis is thought to be a result of

A

an ongoing immune response against retained B burgdorgeri fragments in immunegenetically susceptible host

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27
Q

HLA-DRB1-0401

A

Associated with greater likelihood of post-tx Lyme arthritis

Great similarity to shared epitope of RA (but B burgdorfeti does NOT trigger RA)

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28
Q

Chondrocytes within the Hyaline Cartilage of an osteoarthritc joint become ________

A

hyperplastic

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29
Q

Chondrocytes ACTIVITY within the Hyaline Cartilage of an osteoarthritc joint

A

metabolically active in BOTH catabolic and anabolic functions

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30
Q

Normal cartilage chondrocytes

A
  • terminally differentiated
  • maintain steady state
  • glucose main energy source
  • cartilage turnover is slow
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31
Q

Synovitis in Osteoarthritis is ___ distributed

A

focally

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32
Q

T/F

The presence of synovitis in Osteoarthritic knee joints correlates with the degree of pain

A

T

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33
Q

synovial CK in OA

A

IL-1, IL-7, TNF-a

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34
Q

In OA, the extent of ___, measured histologically, correlates with the extent of cartilage damage, observed by arthroscopy

A

synovitis

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35
Q

____ is the most frequent reason for joint replacement.

A

Osteoarthritis

36
Q

____ is the most common joint disease in the world

A

Osteoarthritis

37
Q

OA

innate or systemic response?

A

innate

38
Q

Duloxetine

A

SNRI

FDA indicated for fibromyalgia, generalized osteoarthritis and depression

39
Q

Erosions are typical of ____ arthritis

A

inflammatory

40
Q

T/F

Asymptomatic hyperuricemia should not be treated with antihyperuricemic agents

A

T

41
Q

Uricosuric agents such as probenicid should not be used in anyone who

A

has had a uric acid kidney stone

42
Q

Allopurinol is an effective therapy for the treatment of an ___ attack of gout

A

acute

43
Q

NSAIDs use in gout

A

acute attack

44
Q

uric acid overproduction

A

HGPRT deficiency (lesch-nyhan)

45
Q

uric acid underexcretion

A

renal fialure
lead
drugs (diuretics, SA, TB, cyclosporin)
idiopathic

46
Q

EtOH and gout

A

xs EtOH –> inc urate production –> dec urate excretion due to lactic acid

47
Q

gout <30 y/o, suspect

A

enzyme defect in purine metab

48
Q

Tophi

A

acid crystals that can be found in joints, bursae, tendons, and extensor surfaces of forearms, as well as in the pinna of the ear, and rarely other tissues such as cornea, sclera, and heart valves

49
Q

all non-allergic pt w/ tophi should take an

A

XO inhibitor

50
Q

pathogenesis of gout

A

phagocytosis of uric acid crystals by PMNs witin the synovial fluid

–> initiates inflammatory cascade

–> WBC recruitment and release of lysosomal enzymes, IL-1, and TNF

51
Q

T/F

high dose aspirin contributes to gout occurrence

A

F

low dose aspirin = uric acid retaining in kidney

52
Q

high dose aspirin ____ renal excretion of uric acid

A

promotes

53
Q

lead and gout

A

lead poisoning

–> decreased renal excretion of uric acid

–> decrease the solubility of uric acid in the joint space, causing the precipitation of uric acid crystals

54
Q

conditions w/ inc cell turnover leading to gout

A

leukemia
lymphoma
psoriasis
polycythemia

55
Q

chondrocalcinosis

A

linear calcifications in the cartilage

seen in X-rays of affected joints with “pseudogout”

56
Q

OA flare wbc

A

non-inflammatory

<2000

57
Q

low joint glucose

A

septic arthritis

RA

58
Q

moonshine

A

lead –> gout –> renal underexcretion of uric acid

59
Q

uric acid exposure induces…

A 
lysosomal enzymes
TNF
IL-1
mast cell activation
complement
PMN oxidative burst
60
Q

CPPD associated conditions

A 
hypERparathyroidism
hemochromatosis
hypOMg
hypOphosph
familial hypOcalciuric hypERcalcemia
61
Q

CPPD - acquired or inherited?

A

usually sporadic, can be inherited AD

62
Q

gout closely linked to

A 
hypERtriglyceridemia 
low HDL-CHL
insulin resistance
obesity
HTN
63
Q

Hyperparathyroidism and hemochromatosis lead to

A

CPPD

64
Q

T/F

TMJ is frequently experienced by patients with Fibromyalgia.

A

T

65
Q

fibromyalgia abnormalities in central pain processing

A

dec NE
dec serotonin
inc substance P

66
Q

MRI of Fibromylagia pts has shown increased BF to the __ and __, two pain-sensitive areas of the brain.

A

Amygdala and Anterior Insula

67
Q

T/F

NSAIDS are helpful in fibromyalgia

A

F

68
Q

shown to improve overall fibromyalgia outcome

A

exercise and tricyclics

69
Q

T/F

The HLA-DR4 alleles are seen w inc freq in fibromyalgia

A

F

70
Q

Polymorphisms seen with increased frequency in fibromyalgia

A

5HT
COMT
DA

71
Q

An example of a chronic strain injury is

A

carpal tunnel syndrome

72
Q

Chronic strain injuries are characterized by chronic degenerative changes in ____ structure reflecting failed healing resonses and scarring

A

cartilage

73
Q

JIA has an onset before y/o

A

16 y/o

74
Q

JIA peak onset

A

1-3 y/o

75
Q

Overall, JIA is more common in M or F

A

F

exceptions: systemic, enthesitis-related

76
Q

most frequent rheumatic disease of children

A

JIA

77
Q

ANA in systemic onset JIA

A

negative

78
Q

clinical labs for MAS

A

dec ESR
dec wbc
dec PLT

79
Q

T/F

ibuprofen is a disease-modifying NSAID used in JIA

A

F

only relieves pain/inflamm

80
Q

dx criteria SLE

A

molar rash
photo sensitivity
arthritis
cerebritis

81
Q

The classification system for Lupus Nephritis is based upon…

A

histopathologic findings of renal glomeruli in SLE

NOT GFR

82
Q

T/F

anti-smith correlates well with level of lupus activity

A

F

very specific but doesn’t correlate w/ activity

83
Q

hormonal fx in lupus pathogenesis

A

higher estrogen, greater risk of developing SLE

*klinefelter’s males at risk (XXY)

84
Q

C3 C4 levels in SLE

A

low, indicate complement consumption from active lupus

85
Q

anti-scl-70

A

found in pt w diffuse disease and assoc w scleroderma renal crisis

86
Q

+ ANAs

anti-centromere abs

A

CREST syndrome

87
Q

anti-mitochondrial Abs

A

pillory primary cirrhosis

Emma Rheumatology (8 decks)

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