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Clin Med- P > Intro to Rheum > Flashcards

Intro to Rheum Flashcards

1
Q

many rheum diseases involve what two processes?

A

autoimmunity and inflammation (also some with non immune and non inflammatory processes)

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2
Q

intra-articular and inflammatory diseases (8)

A 
RA
Systemic lupus erythematosus
Septic arthritis
Gout
Pseudogout
spondyloarthropathy
Polymyalgia rheumatica
psoriatic arthritis
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3
Q

extra articular and inflammatory diseases (4)

A

tendinitis
bursitis
myositis
vasculitis

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4
Q

non inflammatory and intraarticular disease

A

osteoarthritis

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5
Q

extra-articular and noninflammatory disease

A

fibromyalgia

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6
Q

RA is a __________ disease, with an ________ in baseline over time. Its pattern is ______

A

progressive; increase; wavy

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7
Q

Gout is characterized by acute ______ over time; how is the pain severity over time?

A

acute attacks (periods of symptoms); pain severity decreases over time (first is the worst)

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8
Q

Fibromyalgia process pattern

A

increases in pain severity until a plateau is hit (plateau is hit early on)

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9
Q

osteoarthritis process pattern

A

slow incline in pain severity over time and then sharp increase

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10
Q

Traumatic arthritis process pattern

A

present over time but no pain until a traumatic event triggers pain/flare

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11
Q

autoimmunity: problem with what? not _____, usually ______, just

A

problem with the immune system failing to recognize self; not weak (immunosuppressed), usually strong, just misdirected

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12
Q

what is the goal of drugs used to treat rheum diseases?

A

goal is to suppress cell division so that there is less release of cytokines

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13
Q

adiponectin is beneficial in fighting what? its decreased in what?

A

fighting inflammation; decreased in obesity

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14
Q

activation of the immune system leads to ______ ______ through _________

A

tissue damage through inflammation

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15
Q

inflammation occurs when?

A

there is tissue death and inflammatory cells called (macrophages, white cells, complement, and enzymes)

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16
Q

immunity usually leads to _________

A

inflammation

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17
Q

can have inflammation without ______ ________ being active

A

immune system

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18
Q

what two types of effects can you have with inflammation?

A

local and systemic (fever, fatigue)

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19
Q

Hadley says this test is pretty good at detecting systemic inflammation

A

sed rate

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20
Q

factors that increase ESR (6)

A

1) . advancing age
2) . female sex
3) . pregnancy
4) . hypercholesterolemia
5) . B cell neoplasm
6) . Renal failure

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21
Q

factors that decrease ESR (8)

A

1) . congestive heart failure
2) . sickle cell
3) . altered erythrocyte shape
4) . polycythemia
5) . extreme leukocytosis
6) . cachexia
7) . hypofibrinogenemia
8) . hyper viscosity attributable to paraproteinemia

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22
Q

what are the two types of inflammation?

A

acute and chronic

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23
Q

Local effects of inflammation (5)

A

redness, swelling, heat and pain, loss of function

24
Q

local effects of inflammation: ______ blood flow and migration of ______

A

increased; WBCs

25
Q

what two chemicals have a role in local inflammation?

A

histamine and prostaglandins

26
Q

what response occurs during systemic inflammation?

A

acute-phase

27
Q

what are some acute phase reactants? (4)

A

CRP, ESR, and WBCs

labs that go up with any severe illness or trauma (very non specific)

28
Q

4 symptoms with systemic inflammation

A

fever, lethargy, malaise, weight loss

29
Q

acute inflammation: _________ response with release of ________ and ________ to bring in blood and cells

A

vascular response; histamines and vasodilation

30
Q

chronic inflammation: releases ______ that cause _____ formation (more _______)

A

cytokines; scar; damage

31
Q

sometimes inflammation causes _________ damage

A

permanent

32
Q

____________ is the most commonly involved process with rheum illnesses

A

autoimmunity

33
Q

autoimmunity: can occur in almost any ______ or any _____; causes damage by activation of the _______ system and then __________ system

A

tissue or cell; immune or inflammatory

34
Q

is autoimmunity simple or complex?

A

complex, usually a series of things go wrong to lose tolerance and recognize self as foreign antigen

35
Q

what gene causes an increased risk of RA?

A

HLA-DR4

36
Q

increased autoimmunity in what gender?

A

female

37
Q

Woman get a preponderance of rheumatologic illness with exception of ______ and ______________

A

gout; spondyloarthropathy

38
Q

what are the three major drug groups used to tx autoimmunity?

A

1) . steroids- suppress cell division but can cause skin atrophy
2) . immunosuppressants
3) . biologic txs

39
Q 
what do WBC levels tell you?
<200
<3000
3000-50000
>50000
A

<200- normal
<3000 non inflammatory
3000-5000: inflammatory (could be infected)
>50,000- assume infected

40
Q

what does pauciarticular mean?

A

2-4 joints

41
Q

examples of peripheral, girdle and axial joints

A

peripheral- shoulder
girdle- hip
axial- spine

42
Q

acute is less than ____ weeks; three examples of acute inflammation

A

6 weeks: gout, infection, fracture

43
Q

chronic is more than ____ weeks; two examples of chronic inflammation

A

6 weeks: RA and osteoarthritis

44
Q

two pauciarticular conditions

A

psoriatic arthritis, juvenile idiopathic arthritis

45
Q

example of polyarticular condition

A

RA (more than 5 joints)

46
Q

what three conditions involve the DIP joints?

A

Gout, PSA, OA

47
Q

what condition more often involves the PIP and MCP joints?

A

RA

48
Q

what are three asymmetric diseases?

A

SNA, Lyme arthritis, crystal arthritis

49
Q

inflammatory conditions involve the _____ _____ (have what consistency?) VS non inflammatory have ______ ______

A

inflammatory- soft tissue (gooey or gummy)

non inflammatory- bone spurs (osteophytes)

50
Q

extra-articular manifestations are always suggestive of __________ disease

A

systemic

51
Q

female to male ratio: SLE, RA, OA, AS

A

SLE 9:1
RA 3:1
OA 1:1
AS 1:5

52
Q

the F:M ratio disappears for SLE and RA after age ___

A

50

53
Q

gout is very ___ in women before menopause

A

rare

54
Q

what two conditions occur mainly in Caucasians?

A

PMR, Wegner’s

55
Q

what two conditions occur mainly in African americans?

A

SLE, sarcoidosis

56
Q

acute conditions usually affect how many joints? chronic?

A

acute- more common for monoarticular

chronic- more common for polyarticular

Clin Med- P (124 decks)

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