inflammatory extra

Question 1

what are blood test markers seen with SLE?

Answer 1

ESR elevated
+ ANA
+ RF

Question 2

steroids used with SLE may lead to what clinically significant signs?

Answer 2

osteoporosis
AVN
spinal fractures
gastric ulcerations

Question 3

what is the most frequent and serious complication of SLE?

Answer 3

kidney involvement leading to nephropathy and renal failure

Question 4

What conditions can you see increased ADI?

Answer 4

JRA- most likely
RA
SLE- 8.5%

Question 5

what conditions present with ulnar deviation?

Answer 5

SLE
Jaccouds
RA

Question 6

What is the SLE distribution in the hands?

Answer 6

MCP and PIP MC
reversible ligament laxity- ulnar deviation
swan neck and boutonniere deformity

Question 7

If a patient has ulnar deviation with minimal joint disease what is the most likely cause?

Answer 7

SLE

Question 8

which disorder follows rheumatic fever, streptococcal pharyngitis and other CT disorders?

Answer 8

Jaccoud’s arthropathy

Question 9

what presents with arthralgia, myalgia, weight loss, mitral valve disease?

Answer 9

Jaccoud’s arthropathy

Question 10

With Jaccoud’s arthropathy there is no synovial pathology only _____ or _______

Answer 10

capsular fibrosis or DJD

Question 11

scleroderma is the cutaneous manifestation of what disease?

Answer 11

progressive systemic sclerosis

Question 12

dysphagia and heartburn are seen in 90% of patients with?

Answer 12

scleroderma

Question 13

bowel sluggishness, distention, constipation and fibrosis in the lungs are seen with what condition?

Answer 13

scleroderma

Question 14

calcinosis and acro-osteolysis are seen with which condition?

Answer 14

scleroderma

Question 15

what is a chronic inflammatory disorder most commonly affecting young males primarily affecting the axial skeleton?

Answer 15

AS- chronic LBP in males

Question 16

what condition is characterized by sequela of articular ankylosis, ligamentous ossification and enthesopathic changes?

Answer 16

AS

Question 17

50% of AS patients will have peripheral disease especially affecting hips and shoulders, what is this called?

Answer 17

spondylitis rhizomelique

Question 18

what percent of AS patients are + HLA-B27?

Answer 18

90%

Question 19

how does AS typically affect the spine?

Answer 19

SI joint initially, then into the thoracolumbar jx, then lumbosacral and develops into ascending phenomenon

Question 20

reactive sclerosis seen with AS is known as what radiographically?

Answer 20

shiny corner sign

Question 21

corner erosions from reactive sclerosis seen in AS is known radiographically as?

Answer 21

romanus lesions

Question 22

what is dagger sign?

Answer 22

interspinous ligament calcification- AS

Question 23

what is trolley track sign?

Answer 23

z-joint capsular ossification- AS

Question 24

what are vertically oriented spurs that are ossification of outer annulus fibers and inner ALL fibers?

Answer 24

syndesmophytes

Question 25

vertebral body squaring is seen in?

Answer 25

AS

Question 26

who does psoriatic arthritis typically affect?

Answer 26

10-15% of those with psoriasis | 30-50 yrs old no gender bias

Question 27

axial skeleton involvement in what percent of psoriatic arthritis?

Answer 27

20-40%

Question 28

how does psoriatic arthritis usually present in hands?

Answer 28

asymmetrical small joint involvement, mostly DIP mouse ears pencil and cup sausage digit

Question 29

psoriatic mimics RA but is _____

Answer 29

less symmetric

Question 30

spinal changes with psoriatic mimic AS but have ______

Answer 30

bulkier syndesmophytes and non-marginal bilateral asymmetric

Question 31

Reiters is usually caused by what?

Answer 31

STI-chlamydia previous GI infection usually 1-3 weeks post infection

Question 32

what population is usually affected by Reiter's?

Answer 32

males 15-35

Question 33

what is the classic triad of Reactive arthritis?

Answer 33

conjunctivitis urethritis arthritis though few demonstrate all 3

Question 34

how does Reactive arthritis present in the SI joint?

Answer 34

asymmetric or unilateral

Question 35

how does reactive arthritis present in the spine?

Answer 35

thick, non marginal syndesmophytes

Question 36

what is lovers heel seen with reiters?

Answer 36

enthesopathy at plantar fascia and achille's insertions into calcaneus; MTP also involved

Question 37

sx before what age with CPPD are uncommon?

Answer 37

age 50

Question 38

what are the metabolic disease associations with CPPD?

Answer 38

``` hemochromatosis hyperparathyroidism gout diabetes mellitus DJD ```

Question 39

what are the 3 C's of chondrocalcinosis?

Answer 39

Cartilage degeneration- DJD Crystal deposition- gout CPPD Cation disease- wilsons, hemochromatosis, hyperparathyroidism

Question 40

when articular alterations occur secondary to cartilage degeneration what results?

Answer 40

pyrophosphate arthropathy

Question 41

what is the MC genetic disorder affecting 1 in 300 people?

Answer 41

hemochromatosis- males 20:1 40-60

Question 42

what is the triad seen in hemochromatosis

Answer 42

bronze skin cirrhosis diabetes

Question 43

hooked osteophytes and chondrocalcinosis usually at MCP is seen in?

Answer 43

hemochromatosis