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WPP III Rheumatoid Flashcards

1
Q

True or False: Most rheumatic conditions involve pathological processes involving the immune system.

A

True

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2
Q

True or False: Many rheumatologic conditions are characterized by abnormal types or amounts of serum antibodies

A

True

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3
Q

What are the two antibodies that can contribute to rheumatic disease?

A
  1. Cytotoxic mechanism
    (a type II immune reaction) Antibodies are formed and bind to inappropriate antigen marking them for destruction. Cells coated with antibody are destroyed, cell functions are altered.
  2. Immune complex mechanism
    (a type III immune reaction) Antibody-antigen complexes are formed and are deposited in tissues (e.g. blood vessels), inflammatory response is initiated resulting in damage to the site.
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4
Q

True or False: Individuals with certain HLA types may have decreased risk of certain immune-mediated disease?

A

False

They have an increased risk

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5
Q 
The following are examples of 
A) Connective Tissue Disease 
B) or Vasculitides 
• Rheumatoid arthritis (RA)
• Systemic lupus erythematosus (SLE)
• Scleroderma
• Sjögren’s syndrome
A

A) Connective Tissue Disease

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6
Q

A) Connective Tissue Disease
or
B) Vasculitides

  • Polyarteritis nodosa (PAN)
  • Wegener’s granulomatosis
  • Giant cell arteritis
A

B) Vasculitides

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7
Q 
• Ankylosing spondylitis (AS)
• Psoriatic arthritis
• Inflammatory bowel disease (IBD)
These are all what kind of ideas??
A) Seronegative rheumatic diseases
B) Crystal-induced
C) Degenerative
D) Non-articular Rheumatism
A

A) Seronegative rheumatic diseases

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8
Q 
Fibromyalgia is what kind of arthritis?
A) Seronegative rheumatic diseases
B) Crystal-induced
C) Degenerative
D) Non-articular Rheumatism
E) Seropositive rheumatic disease
A

D) Non-articular Rheumatism

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9
Q 
• Polyarteritis nodosa (PAN)
• Wegener’s granulomatosis
• Giant cell arteritis
These are all what kind of disease?
A) Seronegative rheumatic diseases
B) Serapositive rheumatic diseases
B) Crystal-induced
C) Degenerative
D) Non-articular Rheumatism
A

B) Serapositive rheumatic diseases; Vasculitides

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10
Q

Age of onset is usually between 25 and 50 years. (peaks at age 35 to 45 years)?

A

RA

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11
Q

A blend of environmental and genetic factors?

A

RA

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12
Q

A blend of environmental and genetic factors?

A

RA

HLA-DR4 occurred in 70 percent of patients compared with 28 percent of controls

The most compelling example is in monozygotic twins, in whom the concordance rate is perhaps 30 to 50 percent when one twin is affected compared with 1 percent for the general population.

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13
Q

Hypertrophy of the synovial membrane indicative of which arthritic disease?
• Osteoarthritis
• Rheumatoid Arthritis

A

RA

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14
Q

The primary targets of inflammation from RA are what?

A

Synovial membranes and articular structures.

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15
Q 
• Rheumatoid arthritis (RA)
• Systemic lupus erythematosus (SLE)
• Scleroderma
• Sjögren’s syndrome
These are all what kind of disease?
A) Seronegative rheumatic diseases
B) Serapositive rheumatic diseases
B) Crystal-induced
C) Degenerative
D) Non-articular Rheumatism
A

B) Serapositive rheumatic diseases

Connective tissue disease

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16
Q

The most prevalent form of chronic inflammatory arthritis?

A

Rheumatoid Arthritis

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17
Q

Genetic predisposition HLA DR4? monozygotic twins

A

Rheumatoid Arthritis

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18
Q

A blend of environmental and genetic factors such as HLA DR4?

A

Rheumatoid Arthritis

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19
Q

A major symptom of this disease is hypertrophy of the synovial membrane

A

Rheumatoid Arthritis

Synovial Membranes and Articular Structures

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20
Q

What Disease?

Pannus formation results in destruction of articular cartilage and subchondral bone

A

Rheumatoid Arthritis

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21
Q

What Disease?
The joints most commonly involved are the metacarpophalangeal (MCP) joints of the hands [90-95%], proximal interphalangeal (PIP) joints. Larger joints generally become symptomatic after small joints.

A

Rheumatoid Arthritis

Also: nodules are found most often on extensor surfaces such as the olecranon process

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22
Q

What Disease?

Boutonnieres Deformity and Swan Neck

A

Rheumatoid Arthritis

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23
Q

Serum RF is a lab test for what disease?

A

Rheumatoid Arthritis; Serum Rheumatoid factor- also CRC / ESR / CBC

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24
Q

The American College of Rheumatology (ACR) mandates that there are 4/7 symptoms in order to be RA. Name them?

A
  1. Morning stiffness, 1 hour, 6 weeks
  2. Swelling in three or more joints,6 weeks
  3. Swelling in hand joints (MCP, PIP, wrist) 6 weeks
  4. Symmetrical joint swelling 6 weeks
  5. Erosions or decalcification (osteopenia) on x-ray of the hands
  6. Presence of rheumatoid nodules
  7. Elevated level of serum rheumatoid factor (RF)
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25
Q

Periods of increased disease activity — called flare-ups or flares — alternate with periods of relative remission in which disease?

1) Osteoarthritis
2) Osteoporosis
3) Psoriatic Arthritis
4) Rheumatoid Arthritis
5) Gout

A

3) Psoriatic Arthritis

4) Rheumatoid Arthritis

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26
Q

Treatment for RA includes what?

A
  1. Moist heat
  2. Paraffin
  3. Therapy
  4. Pain relief : NSAIDS / COX-2 Inhibitors
  5. DMARDS - Disease-modifying Anti-Rheumatic Drugs
  6. Immunomodulators
  7. Glucocorticoids / Corticosteroids
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27
Q

All under what category of drug?

  1. Methotrexate - MTX (Rheumatrex)
  2. Sulfasalazine (Azulfidine )
  3. Antimalarials (Hydroxychloroquine)
  4. Leflunomide (Arava)
  5. Gold
A

DMARD

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28
Q

Expected benefits of surgery for OA are?

A
  1. Pain Relief
  2. Motion
  3. Stability
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29
Q 
All treatments for which disease?
A. 	Synovectomy 
B. 	Joint Replacement
C. 	Joint Fusion 
D. 	Reconstruction - tendon repair
A

RA

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30
Q

Treatment for RA?

A
  1. DMARDS
  2. Pain relief
  3. Surgical therapy
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31
Q

True or False: Lupus presents WITH joint erosion?

A

False - WITHOUT joint erosion

32
Q 
A chronic, relapsing, inflammatory, and often febrile multi-systemic disorder of connective tissue, characterized principally by involvement of:
• Skin
• Joints
• Kidneys
• Serosal membranes.
A

Systemic Lupus Erymathosis (SLE)

33
Q

A medical subspecialty which focuses on the treatment of any painful disorder affecting the loco-motor system including joints, muscles, connective tissues, soft tissues around the joints and bones

34
Q

A classic autoimmune disease manifested by type III hypersensitivity.

A

SLE (Lupus)

35
Q

A disease that affects:

  • Skin
  • Joints
  • Kidneys
  • Serosal membranes.
36
Q

A disease more common in women, particularly african american, and strikes anywhere from age 15-40.

37
Q

What disease? Target tissue damage is caused primarily by pathogenic autoantibodies, and immune complex formation that induces a vasculitis in many organ systems. type III hypersensitivity

38
Q 
What disease does environmental triggers promote: antinuclear antibodies (ANA) and 
antiphospholipid antibodies (APLA).
39
Q

Risk factors of Lupus?

A
  • Estrogen
  • Genetics
  • Environment
  • Medications ie: Anticonvulsants (dilantin)
40
Q

Symptoms of Lupus are what?

A
  • Malar rash
  • swollen joints
  • extreme fatigue
  • Raynauds
  • Sensitivity to sun
  • Discoid Lesion:
  • Non erosive arthritis
  • glomerulonephritis
  • pericarditis
  • Pulmonary Pleuritis
41
Q

ANA- antibody test is best to detect what disease?

A

Lupus
Other tests:
- Anti-phospholipid antibodies
- Anti-dsDNA (anti-double-stranded DNA),

42
Q

Lupus triggers are what?

A
  • sunlight
  • stress
  • overwork
43
Q

These are therapies for what disease?

  • UV Protection
  • NSAIDs / COX-2 inhibitors
  • Antimalarials - hydroxychloroquine (Plaquenil)
44
Q

Drugs used for what disease? Corticosteroids
Immunosuppressives
Plasmaphoresis

A

Lupus when life threatening

45
Q

Sjögren’s Syndrome does what to the body?

A

A chronic inflammatory disease that primarily affects the lacrimal and saliva glands. Affects eye and mouth. Swollen cheeks by master muscle. Giant Cell

46
Q

Sjögren’s Syndrome affects who primarily?

A

Middle aged women

47
Q

Schirmer tests for what?

A

Sjögren’s Syndrome, tear test measure tear formation

48
Q

Autoantibodies (anti-Ro and –La) are indicative of what disease?

A

Sjögren’s Syndrome,

49
Q

Pilocarpine (Salagen) is a drug for what condition?

A

Sjögren’s Syndrome,

50
Q

Restatis is a drug for what condition?

A

Sjögren’s Syndrome,

51
Q

True or false there is joint pain with Sjögren’s Syndrome?

A

True

Antimalarials - Hydroxychloroquine (Plaquinel), help joint pain

52
Q

True or False: Sjögren’s Syndrome is a Seropositive Vasculitis?

53
Q

True or false: GCA is a vasculitis involving medium-to-large arteries originating from the aorta?

54
Q

Epidemiology of GCA (giant cell arteritis)

risk factors:

A
  • women
  • over 50
  • northern european
55
Q

Symptoms for what disease?

  • headache, which may be unilateral
  • scalp tenderness
  • jaw and/or tongue claudication
  • changes in vision, including blindness
  • increased erythrocyte sedimentation rate (>50 mm/h),
A

GCA (giant cell arteritis)

56
Q

What disease? visual changes with anterior ischemic optic neuropathy, or optic
atrophy leading to blindness in as many as 60% of patients

A

GCA (giant cell arteritis)

57
Q

This is a standard procedure of choice and the standard for the diagnosis of GCA?

A

Biopsy of Temporal Artery

58
Q

True or False: you would expect to see: Erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP) increased in GCA (giant cell arteritis)?

59
Q

Angiography and Magnetic resonance angiography (MRA) are used to diagnose this zero positive vasculitis disease?

A

GCA (giant cell arteritis)

60
Q

True or False Corticosteroids can treat GCA (giant cell arteritis)?

61
Q

Hydroxychloroquine (Plaquenil) is used to treat which disease?

a) GCA (giant cell arteritis)
b) Lupus
c) Sjögren’s Syndrome,
d) Rheumatoid Arthritis

62
Q

Antimalarials - hydroxychloroquine (Plaquenil) is used to treat which disease?

63
Q

COX-2 inhibitors can treat which diseases?

A

Lupus & Rheumatoid Arthritis

64
Q

This is known as the Silent Disease?

A

Osteoporosis

65
Q

Alendronate (Fosamax) is a drug used to treat which disease?

A

Osteoporosis: It can cause difficulty swallowing (dysphasia)

66
Q

True or False: Osteoarthritis is a Rheumatic Disease?

A

True: it’s a Degenerative Arthritis

67
Q

True or False: Osteoarthritis is a systemic disease?

A

False: Localized

68
Q

HLA DR4 is a marker for what inflammatory disease?

69
Q

HLA-B27, a genetic marker for what inflammatory disease?

A
  • Spondylitis is a type of psoriatic arthritis

- Ankylosing Spondylitis

70
Q

Tophi & Kidney Stones are indicative of what inflammatory disease?

71
Q

Monoarticular arthritis is the initial presentation of what disease?

72
Q

Indomethacin & Allopurinol treat what inflammatory disease?

73
Q

Ankylosing spondylitis (AS) Psoriatic arthritis are zero negative or seropositive?

A

Seronegative

74
Q

True or false: DMARDs: Methotrexate / Cyclosporine / Sulfasalazine can all treat psoriatic arthritis?

75
Q

Methotrexate - MTX for what diseases?

A

RA / Psoriatic Arthritis

Rheumatology Musculoskeletal (2 decks)

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