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Year2 MSK exam2 > Rheumatology and RA, Told, Part I > Flashcards

Rheumatology and RA, Told, Part I Flashcards

1
Q

what are the seronegative spondylarthropathies

A

ankylosing spondylitis
psoriatic arthritis
reactive arthritis

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2
Q

what arthritis is not inflammatory

A

osteo

it is degenerative

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3
Q

what are the cardinal signs of inflammation

A

pain
heat
redness
swelling

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4
Q

what are the additional cardinal signs of inflammation for arthritis

A

tenderness, stiffness, crepitation, functional impairment

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5
Q

monoarthritis

A

one joint

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6
Q

olig arthritis

A

2-4

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7
Q

pauci arthritis

A

<5 joints

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8
Q

poly arthritis

A

6+

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9
Q

what is the enthesis

A

where muscle jionts bone

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10
Q

what is an example of diarthrodial joint

A

knee

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11
Q

general characteristics of RA

A 
chronic
systemic
non suppurative
inflammatory
arthropathy
diarthrodial joints
extra aticular
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12
Q

what are the acute phase reactants in inflammation

A

APR and CRP

fibrinogen

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13
Q

The greater inflammation what happens to plasma

A

less viscous

cells fall out of suspension

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14
Q

What occurs in diarthrodial joint in RA

A

bursitis, tendinitis, synovitis

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15
Q

what are initial lab signs of RA

A

FR +
anti CCP +
increased CRP

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16
Q

disease onset of RA Sx

A

pain, inflammation, fatigue and damage, usually 10 years brewing

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17
Q

types of autoAb that RF is

A

IgM

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18
Q

what type of autoimmune reaction is RA

A

localized immune complex from the RF produced and C’ consumed

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19
Q

What immune cell is responsible for damage in RA

A

T cells, CD8 CTL kill everything, MAC complex

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20
Q

what are the main pro inflammatory cytokines

A

TNF a

IL 1

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21
Q

what are the main anti inflammatory cytokines

A

IL4 IL10 IL11 IL13

22
Q

when does RA peak age

A

25-45

23
Q

pregnancy and RA

A

improves during pregnancy

24
Q

mortality from RA

A

infection! and heart disease, malignancy

25
Q

ACR classification for RA

A

4 of these for more than 6 weeks*

morning stiffness >1 hour*
swelling in 3+ joints*
swelling in hand joints*
symmetric joint swelling*
rheumatoid nodules
rheumatoid factor
erosions or osteopenia on hands x rays
26
Q

RA attacks what joints commonly

A

MCPs PIPs, knee, ankle, subtalar, MTPs

27
Q

OA attacks what joints commonly

A

medial knee, DIP

28
Q

loss of what cells in synovium from RA knee

A

loss of goblet cells

29
Q

ulnar deviation

A

RA

30
Q

joint space narrowing and erosions in fingers

A

RA

31
Q

what imaging is most useful with Dx of RA

A

US!! MRI, plain radiographs

32
Q

what imaging study shows inflammation

A

US

33
Q

best imaging for detecting tenosynovitis

A

US MRI

34
Q

synovitis hallmark

A

increased synovial volume

35
Q

what is boutonniere deformity

A

rupture extensor retinaculum
DIP stuck in extension
PIP in flexion
MCP in extension

36
Q

what is swan neck deformity

A

rupture of extensor digitorum profundus
MCP and PIP extended
DIP flexed

37
Q

extra articular manifestations of RA

A 
rheumatoid nodules
sjogrens syndrome
feltys syndrome
vasculitis
rheumatoid lung
cardiac disease
neuromyopathy
lab tests
inflammatory eye Dx
osteoporosis
lymphadenopathy
hyperviscosity
cryoglobulinemia
dermatologic
amyloidosis
38
Q

what sign of RA is always indicative of a RF+ patient

A

rheumatoid nodules

39
Q

what ligament can be dangerously compromised in RA

A

transverse ligament of atlas keeps C1 on C2

40
Q

what are alarming signs of spinal cord damage in RA

A 
diminished motor power in arms and legs
severe neck pain often radiating to occiput
dysesthesias of fingers and feet
marble sensation in limbs and trunk
jumping legs from spinal automatism
disturbed bladder function
41
Q

what does scleritis look like

A

swelling of sclera

assoc with RA

42
Q

what is scleromalacia

A

blue spots seen in sclera

43
Q

What are Sicca Sx

A

dry eyes
dry mouth
vaginal dryness
tracheo-bronchial dryness

44
Q

primary sjogrens syndrome is assoc with what

A

SSA (Ro) and SS-B (La) Ab

45
Q

Tx sjogrens

A

Tx symptoms

46
Q

shirmers test

A

eye strips to lower eyelid to see if lacrimal fluid comes out

47
Q

lab findings in RA

A 
\+RF
\+anti CCP
\+ ANA
elevated ESR or CRP
anemia
thrombocytosis
hyperglobulinemia
leukopenia, granulocytopenia
glucose in body fluids- very low
48
Q

goals of therapy in RA

A 
control disease activity
alleviate pain
slow rate of joint damage
maintain function
maximize quality of life
reduce premature mortality
49
Q

non Rx Tx RA is usefule when

A

early and late phase RA

50
Q

limitations to RX Tx for RA

A

cost

toxicity- corticosteroids, NSAIDs, DMARDs, biologic agents

51
Q

biologic agents risk factor

A

opportunistic infections

Year2 MSK exam2 (17 decks)

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