Bone, Joint, Collagen

Question 1

what are the clinical features of RA

Answer 1

slow onset 
chronic 
polyarticular - hands/feet 
small joints 
low grade fever 
myalgia 
malaise 
fatigue 
systemic - heart and lungs

Question 2

what are the lab features of RA

Answer 2

anemia present
WBC normal or increase
RF/RA factor
Anti CCP

Question 3

what percent of people with RA have anemia

Answer 3

40% of men

60% of women

Question 4

in 3% of RA cases, what other problems occur

Answer 4

leukopenia
splenomegaly
RA

= Feltys Syndrome

Question 5

how sensitive is RA/RF factor for rheumatoid arthritis

Answer 5

85%

Question 6

how sensitive is anti CCP for rheumatoid arthritis

Answer 6

95%

Question 7

what are the seronegative spondyloarthropathies also called

Answer 7

rheumatoid variants

Question 8

what are the clinical features of AS

Answer 8

spine and SI joints
extremities - 30%
males common

Question 9

what are the lab features of AS

Answer 9

ESR increase 90%

HLA-B27 - not diagnostic

Question 10

what are the clinical features of psoriatic arthritis

Answer 10

DIP joints

spine 20%

Question 11

what percent of psoriatics develop arthritis

Answer 11

10%

Question 12

what are the clinical features of reiters syndrome

Answer 12

arthritis 
urethritis - non GC 
conjuctivitis 
iritis 
mucocutaneous oral ulcers

Question 13

what are the clinical features of arthritis associated with IBD

Answer 13

20% of IBD develop migratory, lower extremity, peripheral joint disease

sacroilitis 15%

iritis is common

spondylitis 5%

Question 14

iritis is common in what 2 arthritidies

Answer 14

reiters syndrome
and
enteropathic/IBD

Question 15

enteropathic/IBD arthritis commonly affects what joints

Answer 15

knee and ankle

Question 16

acute rheumatic fever is caused by what

Answer 16

group a beta hemolytic strep

hypersensitivity reaction after infection of GABHS

Question 17

what are the aggregations of histiocytes called in acute rheumatic fever

Answer 17

aschoff bodies

Question 18

what are the clinical features of acute rheumatic fever

Answer 18

fever
migratory arthritis
cardiac damage
renal damage

Question 19

what is the ASO titer used for

what are the values that may indicate or that are diagnostic of the disease

Answer 19

GABHS

> 200 = indicative of recent strep infection

> 500 = diagnostic for disease

Question 20

what are the lab values of acute rheumatic fever

Answer 20

ASO titer
>200 - indicates strep
>500 - diagnostic

ESR elevated

Question 21

what is a extremely painful and immobilizing form of arthritis

Answer 21

gout

Question 22

what are the clinical features of gout

Answer 22

painful
monoarticular
affects big toe

Question 23

what part of the body does gout rarely affect

Answer 23

spine

Question 24

what causes gout

Answer 24

uric acid accumulation from purine synthesis

increased intake of purines - doesnt cause gout - may worsen tho

decreased excretion of uric acid

increased production of uric acid

Question 25

decreased secretion of uric acid can be caused by what

Answer 25

``` renal insufficiency thiazide diuretics ketoacidosis alcoholism hypothyroidism ```

Question 26

increased production of uric acid can be caused by what

Answer 26

``` hypermetabolic syndromes myeloproliferative syndrome leukemia polycythemia vera malignancy chemo or radiation hemolytic anemia diabetes sarcoidosis ```

Question 27

what are a defined group of diseases exhibiting necrosis of collageneous tissue and inflammatory arterial disease

Answer 27

collagen vascular disease

Question 28

what are the clinical features of collagen vascular diseases

Answer 28

myalgia fatigue headache stiffness

Question 29

what are examples of diseases in the group of collagen vascular diseases

Answer 29

``` progressive systemic sclerosis (PSS) mixed connective tissues disease (MCTD) sjorgens syndrome temporal arteritis SLE ```

Question 30

what does ANA indicate

Answer 30

any autoimmune disorders SLE, MTCD, PSS, RA, scleroderma, sjorgens

Question 31

ANA is 95% sensitive for what autoimmune condition

Answer 31

SLE

Question 32

anti DNA is found in what conditions

Answer 32

SLE 60-80% (anti DNA ds) rare in all other autoimmune disorders

Question 33

what are the two subtypes of anti DNA

Answer 33

double strand ds | single strand ss

Question 34

which subtype of anti DNA is found in SLE

Answer 34

double strand anti DNA ds

Question 35

anti ENA is found in what conditions

Answer 35

SLE and MCTD not found in any other autoimmune conditions

Question 36

what does anti ENA stand for

Answer 36

anti extractable nuclear antigen

Question 37

anti scleroderma 70 is DIAGNOSTIC for what condition

Answer 37

PSS