Rheumatology

Question 1

What are the diseases that show polyarticular symmetric involvement?

Answer 1

Polyarticular symmetric involvement is characteristically seen with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), parvovirus B19, and hepatitis B.

Question 2

What are the conditions that show monoarticular arthritis?

Answer 2

On the other hand, monoarticular arthritis is consistent with osteoarthritis, crystal-induced arthritis (gout, pseudogout), septic arthritis (gonococcus), trauma, and hemarthrosis.

Question 3

What is migratory arthropathy and where does it occur?

Answer 3

Migratory arthropathy (inflammation and pain migrates from joint to joint, while the previous involved joints improve) is caused by rheumatic fever, disseminated gonococcal infec- tion, and Lyme disease.

Question 4

Oligoarticular asymmetric arthritis?

Answer 4

Oligoarticular asymmetric arthritis is common with the spondyloarthropathies (ankylosing spondylitis) and osteoarthritis involving the small joint of the upper extremities and rarely as a presentation of polyarticular gout.

Question 5

What are some common manifestations of SLE?

Answer 5

SLE presents with lung (pleural effusions), kidney (proteinuria and renal failure), CNS (vasculitis, strokes, and change in personality), skin (malar and photosensitivity rash), and hematologic (immune-mediated anemia, thrombocytopenia) manifestations.

Question 6

Wegener granulomatosis presents?

Answer 6

Wegener granulomatosis presents with upper respiratory (sinusitis and rhinitis), lower respiratory (lung nodules and hemoptysis), and renal (necrotizing glomerulonephritis) involvement.

Question 7

What are some evidence of joint inflammation?

Answer 7

Evidence of joint inflammation includes: joint stiffness in the morning >1 hour, joint erythema and warmth, and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein

Question 8

What are the 3 Cs you look for in synovial aspiration?

Answer 8

cell count
crystals
cultures

Question 9

What is the cell count in trauma or OA?

Answer 9

200-2000 WBCs

Question 10

What is the cell count in inflammatory diseases like RA, gout?

Answer 10

5,000- 50,000 WBCs

Question 11

What is the cell count in septic arthritis?

Answer 11

> 50,000 WBCs

Question 12

What is the DJD cell count?

Answer 12

<2,000

Question 13

What happens if you give antibiotics to someone who had septic arthritis before you do aspiration?

Answer 13

cell count will be less than 50,000

Question 14

What do you look for if you see someone with gout or pseudogout with a cell count of 50,000?

Answer 14

look for crystals

Question 15

Culture of gonococcal arthritis is positive - how often?

Answer 15

50% of the time

Question 16

What are ANAs? what are the diseases that have them?

Answer 16

antibodies against nucleus of a cell 
SLE
Sjogrens
systemic sclerosis
5% of normal people test +