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MSK 2 > Serology and Lab Testing - Johnston > Flashcards

Serology and Lab Testing - Johnston Flashcards

1
Q

Diagnostic labs for arthritis (7)

A
  • RF
  • Anti-CCP
  • ANA
  • ESR
  • CRP
  • ASOT (anti-streptolysin titer)
  • Uric acid
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2
Q

RF + Anti-CCP = ____

A

RA (99.5% confidence)

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3
Q

ANA - means what alone?

A

Little - many people have them

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4
Q

ASOT - means what?

A

Previous streptococcal infection

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5
Q

List of acute phase reactants (7)

A
  • ESR
  • CRP
  • Leukocytosis
  • Thrombocytosis
  • Ferritin
  • Fibrinogen
  • Complement
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6
Q

Which one is higher in women?

Also higher in who?

Diseases that this is especially good for? (2)

A

ESR

Older

Polymyalgia rheumatica, giant cell arteritis

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7
Q

CRP is a good marker for ___

Made where?

Does what?

A

Any inflammation (pro-inflammatory cytokines)

Liver

Activates complement, promotes phagocytosis

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8
Q

**CRP vs. ESR levels over time

A

CRP – rises and falls faster than ESR

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9
Q

CRP > ___ = inflammatory

A

8

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10
Q

RF is MOST commonly what?

Produced by what?

A

IgM – against Fc of IgG

B cells in synovial joints

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11
Q

Patients with _____ will 100% have RF antibodies

A

RA subQ nodules

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12
Q

Other autoimmune diseases that can have RF

A

Sjogrens, SLE, Cryoglobulinemia, Primary Biliary Cirrhosis, MCT disease, Endocarditis, Sarcoidosis, malignancy

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13
Q

Patients w/ RF are most likely to have what antibody?

Associated with?

A

Anti-CCP

Aggressive, erosive disease

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14
Q

Homogenous pattern of ANA immunofluorescence

Which ones? (3)

A

Drug-induced

Phenytoin, Procainamide, Hydralazine

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15
Q

Anti-Smith antibodies

A

SLE ONLY

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16
Q

Criteria for SLE (11)

A 
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers - painless
Arthritis - 2+ peripheral joints
Serositis - pleuritis, pericarditis
Neurologic issue - seizure/psych
Renal issue - proteinuria or casts
***Blood disorder - HA + reticulocytosis, low WBC (under 4000), low platelets (under 100,000)
Immunologic issue - antibodies
ANAs
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17
Q

False positive RPR (test for syphilis)

A

SLE

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18
Q

ASO titer

A

Previous Group A strep infection

19
Q

Acute rheumatic fever - criteria

A

JONES criteria

  • Joints (arthritis)
  • Carditis
  • Nodules (subQ)
  • Erythema marginatum
  • Sydenham chorea
20
Q

Digital radiography is good for looking at what?

A

Joint erosions, osteopenia, etc.

21
Q

Ultrasonography is good for looking at what?

Aid in doing what?

A

Soft tissue abnormalities - synovitis, tendonitis, bursitis

Injecting/aspirating joint

22
Q

MRI is good for what?

Don’t use Gadolinium if…?

A

Soft tissue abnormalities - spine, SI, synovitis, tenosynovitis, erosions

Kidney disease - will cause nephrogenic systemic fibrosis

23
Q

CT is good for what?

A

Bony abnormalities, erosions, fractures, degenerative or inflammatory arthritis

24
Q

Pitting of nails

A

Psoriasis

Reactive arthritis

25
Q

Balantitis

A

Reactive arthritis

Reiter’s syndrome

26
Q

Erythema migrans

A

Lyme disease

27
Q

Erythema multiforme

A

Multiple causes

28
Q

Erythema nodosum

A

Hepatitis, Mono, Syphilis, Strep

Other stuff

29
Q

Discoid plaques on face

A

SLE

30
Q

Inflamed gut + sores in mouth + sores in genitals

A

Behcet’s disease

31
Q

Reactive arthritis - bugs

A

Campylobacter
Salmonella
Shigella
Yersinia

32
Q

Clubbing + arthritis + pulmonary disease

A

Hypertrophic pulmonary osteoarthritis (HPO)

33
Q

Nodules in lungs + arthritis

A

RA, Wegeners, Paraneoplastic

34
Q

Hilar nodes + arthritis

A

Sarcoidosis
RA
Lymphoma

35
Q

Pulmonary infiltrates + arthritis

A

Septic

Wegeners

36
Q

Charcot’s joint

A

DM – Neuropathic degeneration and distortion of a joint

37
Q

Cheiroarthropathy

A

DM – Thickened skin, limited joint mobility of hands and fingers, causing flexion contractures

38
Q

Hypothyroidism can present with what?

A

Carpal/Tarsal Tunnel Syndrome

39
Q

Arthritis + conjunctivitis

A

Seronegative spondyloarthropathies

40
Q

Arthritis + iritis

A

SNSA, Lyme, JRA, Sarcoid

41
Q

Arthritis + lacrimal enlargement

A

Sarcoid, RA

42
Q

Arthritis + xerophthalmia

A

Sjogren’s, Sarcoid

43
Q

Arthritis + Scleromalacia (softening/degeneration of sclera)

A

RA

44
Q

Arthritis + Episcleritis

A

RA

MSK 2 (20 decks)

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