Diagnostic Testing in Rheumatology Lecture Powerpoint Flashcards Preview

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Flashcards in Diagnostic Testing in Rheumatology Lecture Powerpoint Deck (20)
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1
Q

Rheumatoid factor

A

An antibody directed against the Fc portion of IgG found in 80% of RA patients, correlates with being a more severe disease and having extra-articular disease with seronegative RA having better prognosis, titers do not change or correlate with disease activity

2
Q

What other conditions can rheumatoid factor be found in? (5)

A
  • bacterial infection
  • viral infeection
  • sarcoidosis
  • SLE
  • pulmonary fibrosis
3
Q

Anti-citrullinated peptide antibody CCP antibody test

A

Antibody that may be present prior to appearance of RA symptoms, may be as sensitive as rheumatoid factor for diagnosing RA but much more specific**, rarely present in arthropathies associated with hep C

4
Q

Antinuclear antibody test

A

Positive in 99% of patients with SLE, negative ANA rules out diagnosis of SLE, but can also be found in other connective tissue diseases or drug induced so not diagnostic*** not useful to monitor disease activity

5
Q

Anti DNA antibody test

A

Very specific for lupus with very few false positive results, but not very sensitive depending on disease progression

6
Q

Anti SSA/SSB antibodies test

A

Associated 70% with sjogren’s syndrome and ANA negative lupus (rare), if seen in pregnancy can indicate neonatal lupus syndrome and congenital heart block

7
Q

Anticardiolipin antibody test

A

Seen in recurrent venous or arterial thrombosis (in young unexpected cases with antiphospholipid antibody syndrome) or recurrent fetal loss

8
Q

Antineutrophil cytoplasmic antibody (ANCA) test (c-ANCA, p-ANCA)

A

Found in patients with vasculitis associated with wegener’s granulomatosus and some rapidly progressing glomerulonephritis

9
Q

Sed rate

A

Nonspecific test for inflammation, useful in diagnosis and monitoring of polymyalgia rheumatica and giant cell arteritis, sometimes useful in diagnosis and monitoring RA, vasculitis, SLE, etc

10
Q

Lyme testing

A

Should only be done in suspected clinical setting, not useful for screening

11
Q

Synovial fluid analysis

A

Can be analyzed for gross exam, leukocyte count, wet prep, gram stain, and cultures

12
Q

Synovial fluid group 1

A

Present in noninflammatory conditions such as osteoarthrtiis, trauma, is pale yellow, transluscent, high viscosity

13
Q

Synovial fluid group II

A

Present in inflammatory conditions such as RA, spondyloarthropathies, and microcrystalline disease, deeper yellow color and opaque

14
Q

Synovial fluid group III

A

Present in septic fluid, purulent and opaque with WBC often very high, opaque, associated with positive gram stains and cultures

15
Q

Synovial fluid group IV

A

Present in hemorrhagic fluid, has bloody appearance, due to trauma, bleeding disorders, tumors, etc.

16
Q

Rheumatoid arthiritis sees __ of bone, osteoarthrtiis sees __ of bone

A

loss, increase

17
Q

C1-C2 sublaxation can indicate what rheumatological condition?

A

Rheumatoid arthritis (compression of the spinal cord might manifest as tingling in the extremities

18
Q

Pencil in cup erosions and what disease are they often seen in?

A
  • Radiological finding often asymmetrical where there is dramatic joint space loss giving the proximal phalanx the appearance of a pencil sitting inside the cup of the expanded distal phalanx
  • Psoriatic arthritis
19
Q

Enthesitis

A

Inflammation where tendons or ligaments attach on bone

20
Q

Radiographic findings of gout (remember we don’t diagnose gout radiographically)

A
  • Tophi
  • joint space preservation
  • punched out erosions with sclerotic borders
  • overhanging edges of cortex

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