MS Quiz #6

Question 1

What fluid becomes more viscous from pressure? It also transports nutrients and waste.

Answer 1

synovial fluid

Question 2

What is the motto for any acute mono arthritis?

Answer 2

Any acute mono arthritis is an infection until proven otherwise.

Question 3

What is it called when 2-4 joints are involved?

Answer 3

pauciarticular

Question 4

What are the joints of the hand that are more proximal than the PIPs?

Answer 4

MCP metacarpalphalangeal

Question 5

What do you call a swollen digit?

Answer 5

dactalitis

Question 6

What are some questions you can ask to get specifics about pain?

Answer 6

• Morning stiffness lasting how long?
• characteristics of pain? (stiffness)
• Pain at rest?
• Diurnal pattern of pain?
• activities of daily living impacted?
• other associated systems?

Question 7

List 5 important PEs for joint pain

Answer 7

• Temp
• eyes for inflammation
• skin for rashes/vasculitis
• check shins for nodules
• nail changes
• lymph system

Question 8

What are some categories of abnormality in joints?

Answer 8

• deformity
• swelling (hard/soft)
• color change
• muscle atrophy
• canges in ROM and gait

Question 9

Labs for joint pain

Answer 9

ESR - systemic inflammation
CRP - measures dz progression
Serum Uric acid - gout
Rheumatoid Factor - RA
ANA - SLE (scleroderma, RA, Sjorgens)
Vit D
CBC
Urinalysis (SLE)

Question 10

What do you do when there is any suspicion of septic arthritis (mono arthritis)

Answer 10

immediately aspirate synovial fluid

Question 11

List 5 causes of polyarthritis

Answer 11

• Viral infxn (parvo, entero, adeno, EBV)
• Direct bacterial (gonoc, staph, strep)
• Reactive to bacterial infxn (chlamydia, salmonella, shigella)
• Systemic hematological disease (RA, SLE)
• cyrstal arthropathy (gout)

Question 12

RA (diffuse CT dz) hand symptoms

Answer 12

• soft synovial swelling
• MCP synovitis and volar
• subluxation
  synovitis of wrists and PIP (swan neck)

Question 13

broad differentials

Answer 13

cancer
autoimmune
infection
exposure
metabolic
trauma

Question 14

examples of amphiarthroses

Answer 14

pubic symphsis, SI joint, intervertebral discs

Question 15

which type of joints have synovial fluid?

Answer 15

diarthrosis

Question 16

stenosing

Answer 16

swelling of a tendon sheath causing triggering

Question 17

Osteoarthritis hand sx

Answer 17

• hard boney enlargements
• Heberden’s nodes at DIPs
• Bouchard’s nodes at PIPs
• squared first CMC joint

Question 18

swan neck deformity vs boutonniere deformity

Answer 18

Swan neck: PIP extension
DIP flexion
Boutonnierre: opposite

Question 19

psoriatic arthritis sx

Answer 19

• sausage fingers
• inflammation of DIPs
• nail changes
• psoriatic patches
• arthritis may start before skin

Question 20

SLE sx

Answer 20

interarticular dermatitis

periungal erythema

Question 21

RA general sx

Answer 21

• variable, unrelenting onset of hand and foot swelling
• pain, stiffness, swelling joints
• symmetric MCPs, PIPs, wrists, MTP, elbows, knees, midfoot
• > 1 hr morning stiffness
• 1/3 have systemic myalgia, fatigue, fever, weight loss

Question 22

labs for RA

Answer 22

CBC - anemia
CRP and ESR elevated
anti CCP 95%
synovial fluid clowdy

Question 23

Juvenile Idiopathic Arthritis

Answer 23

• uveitis is most common bad sx
• dx of exclusion
• involves 1 or more joints for at least 6 weeks
• systemic onset: high fever, rashes, LA

Question 24

complications of juvenile idiopathic arthritis

Answer 24

cardiac tamponade, vasculitis, marcrophage activation syndrome

Question 25

Sjogren’s syndrome

Answer 25

chronic inflammatory disorder characterized by diminished lacrimal and salivary gland function leading to dry eyes, dry mouth.

Question 26

sx of sjogrens

Answer 26

• dry eyes (keratoconjunctivitis sicca)
• dry mouth (xerostomia)
• burning, itching, corneal ulcers
• conjunctival injection
• vasculitis
• vaginitis
• pancreatitis

Question 27

Names of Eye tests for sjogrens

Answer 27

• Schirmer’s Test
• Rose Bengal test
• Slit lamp Exam of cornea

Question 28

What are some questions you could ask a pt to assess how dry their eyes are?

Answer 28

• daily persistent dry eyes for more than a month?
• do you have recurrent sensation of sand or gravel in eyes?
• do you use tear substitutes more than 3 times a day?

Question 29

What joints does RA not like?

Answer 29

DIPs and SI joints

Question 30

Early sx of RA in hand

Answer 30

soft, squishy swelling

Question 31

what are some extraarticular involvement of RA?

Answer 31

anemia
fatigue
subcutaneous rhematoid nodules
neuropathy
scleritis
vasculitis

Question 32

What hand joints does polyarthritis JIA affect?

Answer 32

PIPs

Question 33

micrognathia

Answer 33

changes in jaw bone growth

Question 34

what is the most serious complication of oligoarthritis JIA?

Answer 34

uveitis

Question 35

What exam is recommended if ocular involvement in oligo poly or psoriatic JIA?

Answer 35

slit lamp exams quarterly

Question 36

What are questions you can ask to see how severe xerostomia is?

Answer 36

• have you had a daily feeling of dry mouth for more than 3 months?
• have you had recurrently or persistently swollen salivary glands as am adult?
• do you frequently drink liquids to aid in swallowing dry food?

Question 37

what type of joint is the pubic symphysis?

Answer 37

amphiarthroses