Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Rheumatology > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

How to diagnose a rheumatological disease?

A

H&P

Labs/radiographic findings- confirmatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Sensitivity

A

Proportion of patients with positive test who have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Specificity

A

Proportion of patients with negative test who do not have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

H&P in Rheumatologic Diseases

A

Increase “pretest probability” with history

Look for clues on physical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When to Order Serologic Tests

A

Assist in confirming a specific diagnosis
Formulate appropriate management
Evaluate/monitor disease activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define Acute Phase Reactants

A

Proteins synthesized by the liver and induced by inflammation and tissue injury/necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define Erythrocyte Sedimentation Rate (ESR)

A

Distance at which erythrocytes have settled in a vertical column of anticoagulated blood in an hour (mm/hr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ESR Measurement

A

Indirect measurement of serum acute phase reactant concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ESR Influenced by

A

Size
Shape
Number of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ESR Increased by

A 
Acute phase reactants
Paraproteins
Anemia (fewer, less repellent forces)
Age
Gender
Pregnancy
DM
Renal failure
Malignancy
Tissue damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ESR in Polymyalgia Rheumatica

A

ESR >40 mm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ESR in Giant Cell Arteritis

A

ESR >90 mm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define C-Reactive Protein (CRP)

A

Acute phase protein produced by the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is CRP produced in response to and enhance?

A

Produced in response to inflammation

Enhances complement binding & phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does CRP measure?

A

Direct measure of acute phase reactants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pros & Cons of CRP

A

Pro: responds more quickly
Cons: more expensive, don’t always know how to interpret

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define Rheumatoid Factor

A

Auto antibody directed against Fc portion of IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Conditions Causing Positive Rheumatoid Factor

A 
SLE
Scleroderma
Sjogren syndrome
Cryoglobulinemia
Infections: hepatitis, TB, SBE, syphillis, parasitic disease, viral
Pulmonary diseases
Malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define Post Test Probability

A

Probability that the patient has the disease given a positive test result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is rheumatoid factor measured?

A

Less than 1:80 is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anti-CCP (citrulline antibody)

A

Antibody directed against “citrullinated” peptide residues present within inflammatory sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Anti-CCP vs. RF

A

Sensitivity equal

Specificity: anti-CCP > RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anti-Nuclear Antibodies (ANA)

A

Autoantibodies directed at nuclear antigens or content of the cell nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a serologic hallmark of systemic autoimmune disease?

A

ANAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Uses of ANA
Help establish diagnosis when suggestive of an autoimmune or connective tissue disorder Exclude such disorders with uncertain clinical findings Subclassify a patient with an established diagnosis of an autoimmune or connective tissue disease Monitor disease activity
26
When is a positive ANA seen?
Systemic autoimmune disease Organ-specific immune diseases Variety of infections Normal individuals
27
Non-Rheumatic Conditions Causing Positive ANA
``` Normal individuals Hepatic diseases Pulmonary diseases Chronic infections Malignancies Hematologic disorders Drug-induced Misc: autoimmune thyroiditis, DM1 ```
28
Criteria for Classification of SLE (Need 4+)
``` Malar rash Discoid rash Photosensitivity Oral ulcers Arthritis Serositis Neurologic disorder Renal disorder: proteinuria or casts Hematologic disorder: leukopenia, lymphocytopenia, or thrombocytopenia Immunologic disorders: antiphopholipid antibody, abnormal titer of anti-nDNA, anti-Sm, confirmed false + STS Positive antinuclear antibody ```
29
When to Order an ANA
Moderate pre-test probability: 3/11 lupus criteria
30
ANA Specific Autoantibody Tests
``` Anti-dsDNA Anti-Sm Anti-centromere antibody (ACA) Anti-topoisomerase I (Scl-70) Anti-Ro (SS-A) and Anti-La (SS-B) Anti-U1 snRNP Anti-Jo-1 (anti-histidyl-tRNA synthestase) ```
31
Anti-dsDNA
Specific for SLE | May fluctuate with disease activity
32
Anti-Sm (Smith antigen)
Highly specific for SLE
33
Anti-Centromere Antibody (ACA)
Associated with CREST & scleroderma
34
Anti-Topoisomerase I (Scl-70)
Associated with diffuse scleroderma
35
Anti-RO (SS-A) & Anti- La (SS-B)
Associated with Sjogren's Can be seen in SLE Maybe associated with neonatal heart block in babies of mothers with antibody
36
Anti-U1 snRNP
Part of criteria for Mixed Connective Tissue Disease (MCTD) | May be seen in other rheumatic diseases
37
Anti-Jo-1 (anti-histidyl-tRNA synthestase)
Specific for myositis associated with interstitial lung disease Raynaud's
38
Use of Serum Complements
Monitoring disease activity in SLE
39
Low C3, C4 Levels
Reflect consumption of complement | Active SLE
40
Antineutrophil Cytoplasmic Antibodies
Group of autoantibodies mainly of the IgG type directed against antigens in the cytoplasm of neutrophil granulocytes & monocytes P-ANCA: perinuclear C-ANCA: cytoplasmic
41
ANCA Association
Vasculitis
42
Most Common Rheumatologic Disorder with a Positive C-ANCA
Wegener's granulomatosis | Microscopic polyangiitis
43
Most Common Rheumatologic Disorder with a Positive P-ANCA
Churg-Strauss vasculitis
44
Human Leukocyte Antigen (HLA-B27)
Ankylosing spondylitis Reactive arthritis Enteropathic spondylitis Psoriatic spondylitis
45
Diagnosing Ankylosing Spondylitis
Inflammatory back pain of insidious onset, worse in the morning, better with exercise & NSAIDs Radiographic evidence HLA-B27 positive
46
Relative Contraindications of Arthrocentesis
Overlying skin infection | Bleeding diathesis
47
Complications of Arthrocentesis
Infection Bleeding Cartilage injury Vasovagal episode
48
Define Uric Acid
By-product of purine (adenine, guanine) catabolism
49
2 Mechanisms of Hyperuricemia
Increased production | Decreased excretion
50
Reasons for Increased Production of Uric Acid
``` Dietary purines (meat, yeast/beer, beans) Endogenous purine synthesis (CA) Tissue nucleic acid breakdown (chemo, hemolysis) ```
51
Reasons for Decreased Excretion of Uric Acid
Renal failure Inhibition of tubular rate secretion (ketoacidosis) Enhanced tubular rate reabsorption (diuretics, insulin resistance, dehydration)
52
Uric Acid Increased by What Medications
Low-dose ASA ETOH Caffeine Vitamin C
53
Uric Acid Decreased by What Medications
High-dose ASA Estrogens Corticosteroids
54
Clinical Significance of Elevated Uric Acid
``` Gout Asymptomatic hyperuricemia Renal impairment Toxemia of pregnancy Conditions associated with increased production ```
55
Define Gout
Joint pain with swelling & erythema | Deposition of sodium urate crystals in joints & tissues
56
Parts of CREST Syndrome
``` Calcinosis Raynaud's Esophageal dysmotility Sclerodactyly Telangectasias ```
57
Systemic Sclerosis Characterized by
Functional & structural abnormalities of small blood vessels, fibrosis of skin & organs, & autoantibodies
58
Sjogren's Syndrome Characterized by
Diminished lacrimal & salivary gland secretion (sicca syndrome)
59
Define Mixed Connective Tissue Disorder (MCTD)
Syndrome of overlapping disease manifestations with features of RA, SLE, scleroderma, & polymyositis
60
Define Dermatomyositis
Inflammatory myopathy with cutaneous lesions & muscle pain & weakness
61
Polymyositis Characterized by
Progressive muscle pain & weakness

Rheumatology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions