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Clin Med Lab > rheumatology > Flashcards

rheumatology Flashcards

1
Q

what are characteristics of normal synovial fluid

A
  • highly viscous (high hyaluronic acid)
  • clear
  • essentially acellular
  • protein conc 1/3 of plasma
  • glucose conc similar to that in plasma
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2
Q

what are the categories of joint effusions

A
  • noninflammatory
  • inflammatory
  • septic
  • hemorrhagic
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3
Q

differentiate color in normal, non-inflammatory, inflammatory, and septic joint fluid

A
  • normal: clear
  • non-inflammatory: yellow
  • inflammatory: yellow to opalescent
  • septic: yellow to green
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4
Q

differentiate WBC in normal, non-inflammatory, inflammatory, and septic joint fluid

A
  • normal: <200
  • noninflammatory: <2000
  • inflammatory: 2000 - <100,000
  • septic: 15,000 - >100,000
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5
Q

differentiate PMN% in normal, non-inflammatory, inflammatory, and septic joint fluid

A
  • normal: <25%
  • noninflammatory: <25%
  • inflammatory: > or = 50%
  • septic: > or = 75%
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6
Q

differentiate culture in normal, non-inflammatory, inflammatory, and septic joint fluid

A

septic joint would give the only positive culture

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7
Q

synovial fluid crystals that show negative birefringent; needle shaped crystlas is consistent with

A
  • monosodium urate -> Gout
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8
Q

synovial fluid crystals that show positive birefrigent; rhomboid shape is consistent with

A
  • calcium pyrophosphate ->pseudogout
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9
Q

what is the gold standard for evaluating crystals

A
  • polarized light microscopy
  • birefringent: particular material’s ability to refract light rays
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10
Q

clinical presentation

  • morning stiffness
  • symmetric polyarthritis
  • fatigue
  • erythema, warmth and edema of joints: PIP and MCP
  • ulnar deviation of MCP joints
A

RA

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11
Q

rheumatoid factor is associated with

A

SEVERAL diseases, poor specificity

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12
Q

what systemic autoimmune conditions are associated with a positive ANA

A
    • results -> titer and nuclear staining pattern
  • the higher the titer, the higher the likelihood of presence of disease
  • conditions
    • RA
    • SLE
    • sjogren syndrome
    • diffuse schleroderma
    • CREST syndrome
    • polymyositis/Dermatomyositis
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13
Q

what antinuclear antibodies are associated with SLE

A
  • anti-ds DNA
  • anti-smith
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14
Q

what antinuclear antibodies are associated with Sjogren syndrome

A
  • anti-Ro/SSA
  • anti-La/SSB
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15
Q

what antinuclear antibodies are associated with Systemic sclerosis

A

anti-scleroderma-70

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16
Q

what antinuclear antibodies are associated with CREST

A

anticentromere (ACA)

17
Q

Positive results indicate what condition

  • ANA
  • RF
  • anti-CCP
A

RA

18
Q

Positive results indicate what condition

  • ANA
  • Anti-sm
  • Anti-dsDNA
A

SLE

19
Q

Positive results indicate what condition

  • ANA
  • Anti-Ro/SSA
  • Anti-La/SSB
A

sjogren

20
Q

Positive results indicate what condition

  • ANA
  • Anti-SCL-70
  • ACA
A

systemic sclerosis (Scleroderma)

21
Q

Positive results indicate what condition

  • ANA
  • ACA: anticentromere
A

CREST

  • (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia)
22
Q

anti-dsDNA antibodies are found in patients with

A

active SLE (65-80%)

  • higher titers are characteristic of SLE
23
Q

anti-smith antibodies are found in patients with

A
  • subtype of ANA specific for SLE
  • present in about 30% of patients with SLE
24
Q

Anti-Ro/SSA are consistent with

A
  • used to diagnose Sjogren syndrome
  • present in 60-70% of patients with primary Sjogren syndrome
25
Q

Anti-La/SSB are consistent with

A
  • sjogren syndrome
  • 50-60% of patients
26
Q

Anticentromere is used to diagnose

A

used to support diagnosis of CREST syndrome

27
Q

Anti-scl-70 is used for

A
  • diagnostic for systemic sclerosis (scleroderma)
  • present in 45% of patients
    • absence of antibody does not exclude diagnosis
28
Q

list antiphospholipid antibodies

A
  • anticardiolipin antibodies
  • lupus anticoagulant
  • anti-beta2-glycoprotein antibodies
29
Q

describe ESR/CRP

A
  • nonspecific inflammatory marker
30
Q

elevated ESR > or = 40 is indicative of

A
  • polymyalgia rheymatica (PMR)
  • associated with giant cell temporal arteritis
31
Q

What is human leukocyte antigen (HLA)-b27 used for

A
  • sensitivity for ankylosing spondylitis
  • seen in
    • reactive arthritis
    • psoriatic arthritis
    • arhtritis with IBD
32
Q

what is antiphospholipid antibodies used for

A
  • presents in patients with antiphospholipid syndrome
    • ​occurence of venous or arterial thrombosis or of specific pregnancy morbidity
    • primary condition or associated with underlying disease, like SLE
33
Q

clinical presentation

  • polyarthritis
  • rash
  • nephritis
  • serositis
A

SLE

34
Q

clinical presentation

  • acute onset of proximal myalgia
  • morning stiffness
  • over age 55
  • high ESR
  • prompt improvement with low dose corticosteroids
A

polymyalgia rheumatica

Clin Med Lab (6 decks)

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