16. Bone and Joint

Question 1

40% of men and 60% of women with RA also have

Answer 1

anemia

Question 2

3% of cases: leukopenia, splenomegaly, and RA

Answer 2

Felty’s syndrome

Question 3

85% sensitive for RA

Answer 3

RA factor (RF) which involves immunoglobins

Question 4

can be ordered along with RF to assess RA severity and prognosis

Answer 4

cyclic citrullinated peptide (CCP)

Question 5

95% of those with a positive _______ will meet RA criteria in future

Answer 5

CCP antibody

Question 6

Spine and SI (peripheral j 30%) and ESR elevated in 90%

Answer 6

AS

Question 7

is HLA-B27 diagnostic of AS?

Answer 7

NO

Question 8

Psoriatic arthritis invovles

Answer 8

DIP and Spine (20%)

Question 9

what percent of psoriatics develop Psoriatic arthritis?

Answer 9

10%

Question 10

50% with chronic Reiter’s also have _____ involvement

Answer 10

spine

Question 11

hypersensitivity reaction after beta-hemolytic group A strep infection which causes aggregations of histiocytes called Aschoff bodies

Answer 11

Acute Rheumatic Fever (ARF)

Question 12

Aschoff bodies

Answer 12

Acute Rheumatic Fever (ARF)

Question 13

ASO titer over 200 indicates

Answer 13

recent strep infection

Question 14

ASO titer over 500 indicates

Answer 14

Acute Rheumatic Fever (ARF)

Question 15

is elevated ESR specific for ARF?

Answer 15

NO

Question 16

how common does gout hit the spine?

Answer 16

RARELY

Question 17

examples of improper purine metabolism causing gout

Answer 17

increased uptake, decreased excretion, or increased production

Question 18

most important cause of gout to rule out?

Answer 18

increased production

Question 19

hyper-metabolic syndromes that cause uric acid to rise?

Answer 19

• Myloprolifertive syndromes
• leukemia
• polycythemia vera
• malignancies
• chemo/radiation
• hemolytic anemia
• diabetes
• sarcoidosis

Question 20

myalgia/fatigue, headache, stifness

Answer 20

collagen-vascular diseases

Question 21

important marker for collagen-vascular diseases

Answer 21

Anti Nuclear Antibody (ANA)

Question 22

list of collagen-vascular diseases

Answer 22

• progressive systemic sclerosis (PSS)
• mixed connective tissue disease (MCTD)
• Sjorgens syndrome
• temporal arteritis

Question 23

ANA indicates

Answer 23

autoimmune disease

Question 24

ANA is present 95% in

Answer 24

SLE

and others

Question 25

found in 60-80% of active SLE and rarely in others

Answer 25

Anti DNA

Question 26

anti-ds DNA, but not anti-ss DNA, is seen in

Answer 26

SLE

Question 27

used to rule in SLE and MCTD and rule out others

Answer 27

Anti-extractable nuclear antigen (Anti-ENA)

Question 28

Anti-scleroderma-70 is diagnostic for

Answer 28

progressive systemic sclerosis (PSS)