Intro To Rheum P1

Question 1

What is rheumatology?

Answer 1

Medical specialty dealing with diseases of the musculoskeletal system

Question 2

What is a joint?

Answer 2

Where two bones meet

Question 3

What are tendons?

Answer 3

Cords of strong fibrous Collagen tissue attaches muscle to bone

Question 4

What are ligaments?

Answer 4

Flexible fibrous connective tissue which connects two bones

Question 5

When looking at joints what four things should you look for?

Answer 5

Pain, swelling, stiffness, restricted range of movement

Question 6

At what time of the day is stiffness of the joints more likely?

Answer 6

Morning

Question 7

What is the term for when only one joint is involved?

Answer 7

Monoarthritis

Question 8

What is the term for when 2-4 joints are involved?

Answer 8

Oligoarthritis

Question 9

What is the term for when over five joints are involved?

Answer 9

Polyarthritis

Question 10

What are some systemic features you should look for when dealing with patients with rheumatological problems

Answer 10

Fever, weight loss, malaise

Question 11

What is malaise?

Answer 11

General feeling of discomfort

Question 12

What is arthritis?

Answer 12

Disease of the joints

Question 13

What are the two major divisions of arthritis?

Answer 13

Degenerative joint disease (osteoarthritis)
Inflammatory joint disease

Question 14

Why is arthritis categorised into two major divisions?

Answer 14

As the treatment of these two are completely different

Question 15

What are the five cardinal features of inflammation

Answer 15

Red, pain, hot, swelling, loss of function

Question 16

What is inflammation?

Answer 16

Physiological response to deal with injury or infection

Question 17

What are the physiological cellular and molecular changes associated with inflammation?

Answer 17

Increase blood flow,
migration of leucocytes into tissue
, activation of leucocytes,
cytokines production

Question 18

Which cytokines are produced an inflammation?

Answer 18

TNF alpha, IL-1, IL-6, IL17

Question 19

What are the three main causes of joint inflammation?

Answer 19

Infection, crystal arthritis, immune mediated (autoimmune)

Question 20

What are the two main infections that can cause joint inflammation?

Answer 20

Septic arthritis and tuberculosis

Question 21

What can cause Crystal arthritis?

Answer 21

Gout and pseudogout

Question 22

What can cause immune mediated joint inflammation?

Answer 22

Mainly rheumatoid arthritis

Question 23

What Is an example cause of sterile joint inflammation?

Answer 23

Crystal arthritis and immune mediated

Question 24

What can cause septic arthritis?

Answer 24

Bacterial infection of a joint typically staphylococcus aureus

Question 25

How might a patient with septic arthritis present in a clinic?

Answer 25

Acute red spots painful swollen joint Monoarthritis Fever

Question 26

How can you diagnose septic arthritis?

Answer 26

Do a joint aspiration and send a sample for urgent gram staining

Question 27

How do you treat septic arthritis?

Answer 27

Surgical lavash which is essentially washing out the joint

Question 28

What form of septic arthritis affects multiple joints?

Answer 28

Gonococcal septic arthritis

Question 29

 what are the two main types of crystal arthritis

Answer 29

Gout and pseudogout

Question 30

What causes gout?

Answer 30

Deposition of monosodium urate (Uric acid) around joints

Question 31

What is a risk factor for gout?

Answer 31

Hyperuricaemia (high uric acid levels)

Question 32

What causes pseudogout?

Answer 32

Caused by deposition of calcium pyrophosphate dehydrate (cppd) crystals in joints

Question 33

What does cppd stand for

Answer 33

Calcium pyrophosphate dihydrate

Question 34

What is tophi? 

Answer 34

Aggregated deposits of monosodium urate crystals in tissue and develop on hands feet elbows and ears

Question 35

In which condition is tophi seen in

Answer 35

 gout

Question 36

Which joint is particularly affected by gout?

Answer 36

Metatarsophalangeal joint (big toe)

Question 37

What is the term for when uric acid crystals deposit in the big toe joint?

Answer 37

Podagra

Question 38

What blood markers would you look at for gout?

Answer 38

Raised c reactive protein (marker of inflammation) Raised uric aicd

Question 39

What would an x-ray of a patient with chronic gout look like?

Answer 39

Would have juxta-articular erosions (look like rat bites)

Question 40

How would you diagnose gout?

Answer 40

Joint aspiration & synovial fluid analysis

Question 41

What is rheumatoid arthritis?

Answer 41

Chronic autoimmune disease characterised by pain stiffness and symmetrical synovitis of Synovial joint

Question 42

Which joint is particularly affected by rheumatoid arthritis?

Answer 42

Proximal inter-phalangeal joint

Question 43

What joint is affected here?

Answer 43

Proximal inter-phalangeal joint

Question 44

What areas other than the synovial joints are affected by rheumatoid arthritis?

Answer 44

Tenosynovium Bursa

Question 45

What condition is this picture showing and in which disease do you see this in?

Answer 45

Extensor tenosynovitis seen in RA

Question 46

What condition is the image showing and which disease causes this?

Answer 46

Olecranon (elbow) bursitis from RA

Question 47

Describe the pattern in RA?

Answer 47

Symmetrical, Poly arthritis, Affects mainly small joints but affects big joints too

Question 48

What causes osteoarthritis?

Answer 48

Wearing away of articular cartilage

Question 49

What are some of the symptoms of osteo arthritis?

Answer 49

Joint point (worser with activity) Joint crepitus (creaking) Joint enlargement Limited range of motion

Question 50

What are some signs of osteoarthritis

Answer 50

Heberdens nodes and Bouchard nodes

Question 51

What is the term for this sign and which joint is affected in this image?

Answer 51

Heberdens nodes & distal interphalangeal joints

Question 52

What is the term for this sign and which joint is affected?

Answer 52

Bouchard nodes & proximal interphalangeal joints

Question 53

What are some radiograph in features seen in osteoarthritis?

Answer 53

Joint space narrowing Subchondral bony sclerosis (increased whiteness) Osetophytes

Question 54

What is the speed of onset of rheumatoid arthritis?

Answer 54

Rapid