Term
| Why do autoimmune diseases often lead to cardio and cerebrovascular events? |
|
Definition
| because of the uncontrolled inflammation |
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Term
| What types of hematological derangements are seen in lupus? |
|
Definition
| leukopenia, anemia, and thrombocytopenia |
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Term
| T/F Lupus can cause pericarditis. |
|
Definition
|
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Term
| Names some signs/symptoms of dermatomyositis? |
|
Definition
| proximal muscle weakness, shawl sign, heliotrope rash, calcinosis, interstitial lung disease; increased creatine kinase and aldolase |
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|
Term
| What is the pathogenesis of scleroderma? |
|
Definition
| endothelial dysfunction and vascular insult, unbridled inflammation and the laying down of reparative collagen causes disruption of vascular architecture and subsequently architecture of adjacent tissues. |
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Term
| Why is scleroderma associated with GI bleeds? |
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Definition
| vascualar injury causes dilated capillary loops on the skin and along the GI tract that can abrade and cause a slow bleed as in watermelon stop or a large bleeding ectasia |
|
|
Term
| What are the clinical manifestations of scleroderma? |
|
Definition
| pulmonary hypertension, pulmonary fibrosis which can cause heart failure |
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|
Term
| What should you suspect if a patient with scleroderma experiences an abrupt blood pressure elevation? |
|
Definition
|
|
Term
| What are the 2 leading causes of death in scleroderma? |
|
Definition
| 1) pulmonary fibrosis 2) pulmonary hypertension |
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|
Term
| Besides synovitis, nodules and erosions on xray, what are some symptoms of RA? |
|
Definition
| pulonary fibrosis, vasculitis, constrictive pericarditis, inflammatory eye disease |
|
|
Term
| T/F Symmetrical polyarticular hand joint pain that produces joint deformity can be diagnosed as RA. |
|
Definition
| false! gout can also present this way |
|
|
Term
| What's the difference between osteoarthritis and rheumatoid arthritis of the fingers? |
|
Definition
| osteo= bony enlargment of PIP and DIP joints without much inflammation; RA= spongy swelling of PIP joints |
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|
Term
| T/F Fibromyalgia is an inflammatory disase. |
|
Definition
|
|
Term
| What are the laboratory derangements associated with fibromyalgia? |
|
Definition
|
|
Term
| What causes fibromyalgia? |
|
Definition
| muscle tension prompted by stress and continued stress; muscles get tighter and tighter as we try to hold 'it' together |
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|
Term
| Name the spondarthropathies. |
|
Definition
| inflammatory back disease, ankylosing spondylitis, psoriasis, inflammatory bowel disease, uveitis |
|
|
Term
| The spondarthropathies is related to which HLA type? |
|
Definition
|
|
Term
| What are the laboratory markers associated with teh spondarthropathies? |
|
Definition
| elevated acute phase reactants such as ESR or CRP |
|
|
Term
| What is a contraindication for joint aspiration? |
|
Definition
| putting the needle through cellulitic or psoriatic skin to get to the joint |
|
|
Term
| What is the normal appearance of synovial fluid? |
|
Definition
| clear, pale yellow, viscid, and does not clot |
|
|
Term
| What is the glucose level of synovial fluid? |
|
Definition
|
|
Term
| Why is the viscosity of synovial fluid high? |
|
Definition
| because of homogenously diffuse hyaluron |
|
|
Term
| What is a normal protein content and cell number of synovial fluid? |
|
Definition
| protein count < 500 mg/dL and cell number < 1000/cc |
|
|
Term
| What causes a low viscosity of synovial fluid? |
|
Definition
| when components that contribute to viscosity clump in response to inflammation; also enzymes concurrent with inflammation degrade hyaluron, making the synovial fluid less viscous |
|
|
Term
| What is the glucose level of a septic joint? |
|
Definition
|
|
Term
| What is the protein content and cell number in inflammed synovial fluid? |
|
Definition
| >1 gram and cell number is >10,000 to >200,000 |
|
|
Term
| What does "birefringence" mean? |
|
Definition
| means that the substance breaks up a light ray into two rays; depending on the direction of the new rays it can be called negative or positive birefringence |
|
|
Term
| Describe the appearance of monosodium urate cyrstals? |
|
Definition
| needle-shaped, strongly negative birefringent crystals |
|
|
Term
| Describe the appearance of calcium pyrophosphate crystals. |
|
Definition
| rhomboid-shaped weakly positive birefringent crystal |
|
|
Term
| What are the positive acute phase reactants? |
|
Definition
| sed rate, c-reactive protein, thrombocytosis, fibrinogen |
|
|
Term
| What are the negative acute phase reactants? |
|
Definition
|
|
Term
| What are the units of erythrocyte sedimentation rate? |
|
Definition
|
|
Term
| How does inflammation cause an increased sed rate? |
|
Definition
| inflamation changes the charge of RBCs and they no longer repel each other |
|
|
Term
| T/F ESR is elevated in multiple myeloma. |
|
Definition
|
|
Term
| T/F ESR can be elevated due to renal disease. |
|
Definition
|
|
Term
| What is C-reactive protein? |
|
Definition
| a protein produced by the liver when stressed by inflammation |
|
|
Term
| What inflammatory marker is elevated in heart disease? |
|
Definition
|
|
Term
| Foaming urine is a sign of... |
|
Definition
| 150 grams of protein lost in the urine/day |
|
|
Term
| What percent of RA patients are RF+? |
|
Definition
|
|
Term
| What is the significance of high titers of RF in patients with RA? |
|
Definition
| more severe disease and extra-articular disease |
|
|
Term
| What percent of RF+ patients have a disease other than RA? |
|
Definition
|
|
Term
| What diseases besides RA cause patients to be RF positive? |
|
Definition
| hepatitis C, chronic infection, other rheumatologic disease (SLE, Sjorgren's), normal process of aging, pulmonary fibrosis |
|
|
Term
| Is rheumatoid factor titer useful in following the course of rheumatoid arthritis? |
|
Definition
|
|
Term
| What ist he sensitivity and specificity of anti-CCP? |
|
Definition
| senstivity= 70-80%; specificity= 88-96% |
|
|
Term
| What other marker is used for RA and may actually appear earlier than RF? |
|
Definition
|
|
Term
| Patients with anti-CCP are more likely to have... |
|
Definition
| poorer prognosis and extra-articular disease |
|
|
Term
| What are antinuclear antibodies? |
|
Definition
| antibodies specifically directed against various components of the nucleus (or cytoplasm) of tissue cells |
|
|
Term
| Peripheral or rim ANA is likely seen with what types of antibodies? |
|
Definition
|
|
Term
| Peripheral or rim ANA is likely seen with which disease? |
|
Definition
|
|
Term
| Homogenous (diffuse) ANA is seen with what kinds of antibodies? |
|
Definition
| anti-DNA, anti-histone, anti-DNP (nucleosomes) |
|
|
Term
| Homogenous (diffuse) antibodies are seen in what disorders? |
|
Definition
| RA and SLE; miscellaneous disorders |
|
|
Term
| What kinds of antibodies are associated with speckled ANA? |
|
Definition
| anti-SM and RNP, anti-Ro and La, anti0Jo-1 and Mi-2, anti-Scl-70 |
|
|
Term
| What diseases are associated with speckled ANA? |
|
Definition
| SLE and SS, PM/DM, PSS (Systemic) |
|
|
Term
| What disease is associated with anti-centromere antibodies? |
|
Definition
|
|
Term
| Which dieseases are associated with anti-nucleolar antibodies? |
|
Definition
|
|
Term
| At what uric acid level do crystals precipitate? |
|
Definition
|
|
Term
| At what serum uric acid level do tophi desolve? |
|
Definition
|
|
Term
| What finding is the gold standard for diagnosing gout? |
|
Definition
| crystals in synovial fluid |
|
|
Term
| What percent of caucasians have HLA-B27? |
|
Definition
|
|
Term
| What percent of spondarthropathies are positive for HLA-B27? |
|
Definition
|
|
Term
| What is another term for c-ANCA? |
|
Definition
|
|
Term
| What is the antibody associated with Wegerner's granulomatosis? |
|
Definition
|
|
Term
| What is another name for p-ANCA? |
|
Definition
|
|
Term
| What diseases are associated with p-ANCA? |
|
Definition
| churg strauss, systemic vasculitides, microscopic polyangitis |
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