Term
| Which type of arthritis is caused by degenerative wear & tear? |
|
Definition
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|
Term
| An asymmetrically presenting arthritis is likely what? |
|
Definition
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|
Term
| Secondary factors that predispose someone to OA? (8) |
|
Definition
| Congenital/developmental disease, trauma, inflammatory joint disease, endocrinopathies, metabolic diseases, neuropathic disorders, avascular necrosis, Paget's disease |
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|
Term
| If arthritic pain worsens during day (or w use) it's likely what? |
|
Definition
|
|
Term
| What is seen radiologically in OA? (5) |
|
Definition
| Osteophytes (bony spur), joint space narrowing, subchondral cysts, bony sclerosis, malalignment |
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Term
| In which arthritis is crepitus a sign? |
|
Definition
|
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Term
| Important steps of OA pathogenesis? (7) |
|
Definition
| Swelling of articular cartilage--> loosening of collagen framework--> chondrocytes release degradative enzymes which break down proteoglycan--> thinning of articular cartilage--> thickening of subchondral bone--> bone outgrowth--> mild nonspecific inflammation |
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|
Term
| Which joints are normally spared in OA? |
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Definition
|
|
Term
| What is OA @ the DIP called? |
|
Definition
|
|
Term
| What is OA @ the PIP called? |
|
Definition
|
|
Term
| 4 joints commonly affected by OA? |
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Definition
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|
Term
| Name for increased bone density or thickening in the subchondral layer of bone due to increased blood flow? |
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Definition
|
|
Term
| Where is the subchondral layer of bone located? |
|
Definition
| Directly below the cartilage |
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|
Term
| What are villous hyperplasia of synovium & dense inflammatory infiltrate pathological features of? |
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Definition
|
|
Term
| How many joints need to have synovitis to meet criteria for RA? |
|
Definition
| at least 3 (polyarticular involvement) |
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|
Term
| Symmetrically presenting arthritis is likely which? Why is it symmetric? |
|
Definition
| RA, systemic inflammation |
|
|
Term
| Which 3 joints are commonly affected by RA? |
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Definition
| Wrist, MCP, PIP (proximal joints of hand) |
|
|
Term
| What are the four cardinal findings in RA? |
|
Definition
| Morning stiffness, polyarticular involvement, proximal joints of hand, symmetrical presentation |
|
|
Term
| How long do the cardinal findings of RA have to be present to be considered RA? |
|
Definition
|
|
Term
| At what age does RA onset typically occur? |
|
Definition
|
|
Term
| Characteristics of RA synovial fluid? |
|
Definition
| Turbid appearance, high WBC, mostly PMNs, normal glucose, no crystals, culture - |
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|
Term
| Which joint is always spared in RA? |
|
Definition
|
|
Term
| What does RA of the MCP joint lead to? |
|
Definition
| Ulnar deviation & subluxation |
|
|
Term
| What is a possible consequence of RA of the cervical spine? |
|
Definition
| Atlanto-axial subluxation --? increased risk of cervical cord transection w intubation (or whiplash) |
|
|
Term
| How does RA affect the lung? |
|
Definition
| Rheumatoid lung = interstitial pneumonitis |
|
|
Term
| What is a rheumatoid nodule & where are they commonly found? |
|
Definition
| Subcutaneous nodule composed of shell of fibrous tissue filled w fibroid necrosis @ pressure points in the vasculature, most commnoly olecranon bursa of elbow |
|
|
Term
| A cyst in the knee joint of a pt w RA is called what? What risk does it carry, how is it diagnosed & treated? |
|
Definition
| Baker's/Popliteal Cyst, can rupture into calf & mimic DVT, dx w Doppler imaging, treat w steroid injxn. |
|
|
Term
| What disorder presents w dry eyes, dry mouth, & RA? |
|
Definition
| Sicca/Sjogren Syndrome (autoimmune disorder) |
|
|
Term
| What disorder presents w splenomegaly, neutropenia, & RA? |
|
Definition
|
|
Term
| Approx how many RA pts test + for RF? |
|
Definition
|
|
Term
| Radiologic findings of RA? |
|
Definition
| Osteopenia, periarticular bone erosions, reduces joint space |
|
|
Term
|
Definition
| Control synovitis & pain, maintain joint fxn, prevent deformities |
|
|
Term
| What is the surgical option to treat RA? |
|
Definition
|
|
Term
| What are the 3 classes of remittive RA drugs? |
|
Definition
| DMARDS, TNF antagonists, chemotherapeutic agents |
|
|
Term
| What is the inflammatory synovial tissue that forms in joints affected by RA? |
|
Definition
|
|
Term
| What does pannus consist of? |
|
Definition
| Granulation tissue composed of mesenchyme & bone marrow derived cells. |
|
|
Term
| What does pannus secrete and what is the effect? |
|
Definition
| IL-1, prostaglandins, substance P; degrades surrounding bone & cartilage |
|
|
Term
| Histiological features of pannus? |
|
Definition
| Filled w inflammatory cells, hypereosinophilic staining due to cartilage cell death. |
|
|
Term
|
Definition
| Upregulated due to systemic inflammation. |
|
|
Term
|
Definition
| tumors, lymphoma, demyelination, etc |
|
|
Term
| What is periarticular osteopenia? |
|
Definition
| Thinning of bones around joints affected by RA due to degradation by cytokines & inflammatory mediators |
|
|
Term
| What type of anti-body is RA, who makes it, and where does it bind to? |
|
Definition
| IgM autoantibody made by B cells, binds to Fc portion of IgG antibodies |
|
|
Term
| Why is RF non-specific for RA? |
|
Definition
| Present in wide variety of chronic inflammatory conditions and is even more prevalent in Sjogren's Syndrome & Hep C. |
|
|
Term
| A polyarthritis involves how many joints? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What lab test is more specific, though less sensitive, for RA? |
|
Definition
|
|
Term
| What is anti-CCP an antibody against? |
|
Definition
|
|
Term
| If a pt tests neg for RF & anti-CCP, can they still be diagnosed w RA? |
|
Definition
|
|
Term
| Which gene predisposes someone to RA? |
|
Definition
|
|
Term
| How is the carpal tunnel compressed in RA? |
|
Definition
|
|
Term
| What is Boutonniere's Deformity? |
|
Definition
|
|
Term
| What is the Swan Neck Deformity? |
|
Definition
| Hyperflexed MCP & DIP, hyperextended PIP |
|
|
Term
| Which part of the skeleton is inflamed w seronegative spondyloarthropathies? |
|
Definition
|
|
Term
| Where does a "pencil in cup" deformity occur & why? |
|
Definition
| DIP synovitis in seronegative spondyloarthropathy |
|
|
Term
| Musculotaneous & opthalmic lesions are indicative of what? |
|
Definition
| Seronegative spondyloarthropathy |
|
|
Term
|
Definition
| A disorder of ligament or tendon attachment to bone (seronegative spondyloarthropathy) |
|
|
Term
| What is the HLA-B27 genotype assoc with? |
|
Definition
| Seronegative Spondyloarthropathy |
|
|
Term
| What is the role of bacterial infection in seronegative spondyloarthropathy? |
|
Definition
| Gram -/enteric bacteria may trigger because a)Klebsiella resembles HLA-B27 antigen-->cross reacting antibodies-->auto-immune disease, 2)Some gram - bacteria have antigenic peptide that may activate HLA-B27 autoreactive T cells |
|
|
Term
| What does "seronegative" indicate? |
|
Definition
|
|
Term
| What does radiologic finding of a heel spur point to? |
|
Definition
|
|
Term
| Which is the most common Seroneg Spondylo? |
|
Definition
|
|
Term
| Spondylitis, DIP synovitis, oligoarticular asymmetric arthritis, & polyarticular symmetric arthritis are all arthritic patterns possible in which disorder? |
|
Definition
|
|
Term
| Which is the most common Seroneg Spondylo to give peripheral deformity? |
|
Definition
|
|
Term
| What are the clinical manifestations of Psoriatic Arthritis that affect the hands? |
|
Definition
| Arthritis mutilans (complete bone resorption), Oncholysis (fungal nails), sausage digits, DIP "pencil in cup" deformity |
|
|
Term
| Which inflammatory disease causes fusion/rigidity of the spine? |
|
Definition
|
|
Term
| What is the mainstay of treatment for ankylosing spondylitis? |
|
Definition
|
|
Term
| What gender/age is most affected by ankylosing spondylitis? |
|
Definition
|
|
Term
| What are "chin on chest" deformity & kyphosis signs of? |
|
Definition
|
|
Term
| What joint does ankylosing spondylitis begin in? |
|
Definition
|
|
Term
| Process of ankylosing spondylitis pathogenesis? (3 steps) |
|
Definition
| Inflammation @ entheses, calcification, ossification |
|
|
Term
| What does the disc space look like on x-ray of ankylosing spondylitis? |
|
Definition
|
|
Term
| Radiological appearance of the pelvis in ankylosing spondylitis? |
|
Definition
| Erosion ("rosary bead") appearance @ SI joint, pubic symphysis enthesopathy |
|
|
Term
| Radiological appearance of spine in ankylosing spondylitis? |
|
Definition
| Bamboo appearance (flowing syndesmophytes along periphery, central osteopenia), Squaring of vertebrae due to bone resorption |
|
|
Term
| What is uveitis and what is it a symptom of? |
|
Definition
| Inflammation of the middle eye, Ankylosing Spondylitis |
|
|
Term
| What is Reiter's Syndrome also known as? |
|
Definition
|
|
Term
| What % of psoriatic arthritis pts are HLA-B27 pos? |
|
Definition
|
|
Term
| What % of ankylosing spondylitis pts are HLA-B27 pos? |
|
Definition
|
|
Term
| What % of Reiter's syndrome pts are HLA-B27 pos? |
|
Definition
|
|
Term
| Reiter's syndrom usually results from what types of infections? |
|
Definition
| Dysentary or Genitourinary |
|
|
Term
| Which 7 organisms/infxns are implicated in causing Reiter's syndrome? |
|
Definition
| Shigella, Salmonella, Campylobacter, Yersinia, C dif, Chlamydia, HIV |
|
|
Term
| Conjunctivitis, Urethritis, & Oligoarticular Arthritis make up the "Classic Triad" of what disorder? |
|
Definition
|
|
Term
| What disorder could asymmetris & patchy sacroilitis or spondylitis be indicative of? |
|
Definition
|
|
Term
| Calcaneal periostitis (inflamed periosteum of achilles tendon/heel) could be a sign of which disorder? |
|
Definition
|
|
Term
| Which disorder besides PSA causes nail changes/oncholysis? |
|
Definition
|
|
Term
| Oral ulcers/ Mucosal lesions on tongue are assoc w which disorder? |
|
Definition
|
|
Term
| How are the genitals affected in Reiter's Syndrome? |
|
Definition
| Circinate ballinitis (lesions) on penis or labia |
|
|
Term
| What are Keratodermia Blenorrhagicum & what disorder are they assoc with? |
|
Definition
| Plaque-like pustular lesions on palms & soles of feet; assoc w Reiter's syndrome. |
|
|
Term
| What are the treatment options for Reiter's syndrome? |
|
Definition
| Long-term abx, NSAIDs/steroids, DMARDs |
|
|
Term
| Which bowel diseases are assoc with arthropathy of IBD? |
|
Definition
| Ulcerative colitis or Crohn's colitis |
|
|
Term
| What is arthropathy of IBD an abnormal rxn to? |
|
Definition
| Enteric bacterial antigens in the large bowel. |
|
|
Term
| How does arthropathy of IBD present? |
|
Definition
| Asymmetric, non-deforming arthritis (more common in weight bearing joints) |
|
|
Term
| Treatment options for arthropathy of IBD? |
|
Definition
| Treat underlying bowel disease, PT for spondylitis |
|
|
Term
| What could sacroiliitis be a sign of? |
|
Definition
| Early ankylosing spondylitis or Reiter's syndrome |
|
|
Term
| What disorder is pubic symphysis enthesitis commonly seen in? |
|
Definition
|
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