Introduction to Rheumatology :)

Question 1

define rheumatology

Answer 1

medical specialty dealing with diseases of the musculoskeletal system

Question 2

define joint

Answer 2

where 2 bones meet

Question 3

define tendon

Answer 3

tissue that attaches muscle to bone

Question 4

what are tendons made of?

Answer 4

cords of strong fibrous collagen tissue

Question 5

what are the role of ligaments

Answer 5

connects 2 bones

Question 6

what are ligament tissues made of?

Answer 6

flexible fibrous connective tissue

Question 7

define acute

Answer 7

develop suddenly and last a short time

Question 8

define sub-acute

Answer 8

state between acute and chronic

Question 9

define chronic

Answer 9

long-lasting condition, that develops over time

Question 10

how many joints are involved in monoarthiritis

Answer 10

1 joint involved

Question 11

how many joints are involved in oligoarthritis

Answer 11

2-4

Question 12

how many joints are involved in polyarthritis

Answer 12

5+

Question 13

define systemic features

Answer 13

entire body effects

Question 14

what is arthritis

Answer 14

disease of the joints

Question 15

what is sterile inflammation?

Answer 15

inflammation occurring in the absence of micro-organisms

Question 16

what is defined as prolonged inactivity/morning stiffness

Answer 16

stiffness that lasts >30 mins

Question 17

define non-sterile inflammation

Answer 17

inflammation occurring due to micro-organisms

Question 18

define lavage

Answer 18

surgical wash out

Question 19

define rheumatoid arthritis

Answer 19

chronic autoimmune disease characterized by pain, stiffness and synovitis

Question 20

what is synovitis

Answer 20

inflammation of synovial membrane

Question 21

define osteophytes

Answer 21

bony lumps that grow on bones in spine or around joint

Question 22

define osteopenia

Answer 22

when mineral content of bone is reduced, but less so than osteoporosis

Question 23

how can you detect osteopenia on a X-ray

Answer 23

bone appears darker and less bright

Question 24

define birefringence

Answer 24

refraction of light in a transparent material

Question 25

define tophi

Answer 25

aggregated deposits of MSU in tissue

Question 26

state the 2 divisions of arthritis

Answer 26

1. degenerative joint disease (osteoarthritis) 2. inflammatory joint disease

Question 27

state the difference in onset between inflammatory joint disease and osteoarthritis

Answer 27

inflammatory = rapid onset osteoarthritis = slow onset

Question 28

state the difference in joint pattern between inflammatory joint disease and osteoarthritis

Answer 28

inflammatory joint disease = symmetrical joint pattern osteoarthritis = asymmetrical joint pattern

Question 29

state the difference in the age range of patients impacted between inflammatory joint disease and osteoarthritis

Answer 29

inflammatory = younger age groups osteoarthritis = older age groups

Question 30

is osteoarthritis autoimmune?

Answer 30

no

Question 31

in which arthritis division is osteopenia common?

Answer 31

inflammatory joint disease

Question 32

in which arthritis division is osteophytes common?

Answer 32

osteoarthritis

Question 33

what is the cause of septic arthritis

Answer 33

bacteria

Question 34

what is the clinical presentation of septic arthritis

Answer 34

inflammation = rubor, tumor, calor and fever

Question 35

what type of arthritis is septic arthritis

Answer 35

monoarthritis

Question 36

when is septic arthritis not monoarthritis?

Answer 36

when gonoccoccal bacteria is involved => polyarthritis

Question 37

state the technique used to diagnose septic arthritis

Answer 37

joint aspiration

Question 38

what happens in joint aspiration

Answer 38

obtain a fluid sample from septic joint => analyse

Question 39

state the 2 treatments of septic arthritis

Answer 39

lavage and IV antibiotics

Question 40

state the bacterial causes of septic arthritis (3)

Answer 40

streptococci, staphylococcus aureus and gonococcus

Question 41

does rheumatoid arthritis have a symmetrical or asymmetrical joint pattern?

Answer 41

symmetrical

Question 42

how many joints are impacted in rheumatoid arthritis

Answer 42

5+ (polyarthritis)

Question 43

what joints does rheumatoid arthritis impact

Answer 43

small and larger joints

Question 44

what is the cause of rheumatoid arthritis

Answer 44

auto-immune

Question 45

what is the clinical presentation of an individual with rheumatoid arthritis?

Answer 45

early morning stiffness in and around joints => long term joint damage

Question 46

what is used to diagnose rheumatoid arthritis?

Answer 46

autoantibody against IgG (rheumatoid antibody) => found in blood test

Question 47

state 3 areas commonly impacted by rheumatoid arthritis

Answer 47

1. hands 2. wrists 3. feet

Question 48

state 2 types of crystal arthritis

Answer 48

1. gout 2. pseudogout

Question 49

state the cause of crystal gout

Answer 49

deposition of monosodium urate (MSU) crystals

Question 50

what is a risk factor of gout

Answer 50

high uric acid levels

Question 51

state the 3 causes of gout

Answer 51

1. genetic tendency 2. increased intake of purine rich foods 3. kidney failure

Question 52

where is gout common?

Answer 52

big toe

Question 53

what is the name of the joint in the big toe which is impacted by gout

Answer 53

metatarsophalangeal joint

Question 54

state the onset of gout

Answer 54

abrupt

Question 55

what is a characteristic of gout on X-Rays?

Answer 55

‘juxta-articular erosions’ aka rat bite erosions

Question 56

state 2 diagnostic tests for gout

Answer 56

1. joint aspiration and synovial fluid analysis 2. bloods => C-reactive proteins and serum urate

Question 57

positive result of joint aspiration and synovial fluid analysis test for gout - 2

Answer 57

needle shaped crystals and negative bifringence

Question 58

how is the joint aspiration and synovial fluid analysis done?

Answer 58

Needle inserted => fluid aspirated => sent to lab for microbiology OR polarising light microscopy to detect crystals

Question 59

what are the positive blood tests for gout? - 2

Answer 59

increased C-reactive proteins increased serum urate

Question 60

problem of using blood tests to diagnose gout

Answer 60

non-specific and only shows inflammation

Question 61

what is the acute treatment of gout?

Answer 61

reduces inflammation (steroids and anti-inflammatory drugs)

Question 62

what is the chronic treatment for gout?

Answer 62

reduces long term uric acid levels (lifestyle diet changes and xanthine oxidase inhibitors)

Question 63

state the cause of pseudogout

Answer 63

deposition of calcium pyrophosphate dihydrate (CPPD) crystals

Question 64

state the 2 risk factors of pseudogout

Answer 64

1. elderly 2. background of OA

Question 65

State the diagnostic test for pseudogout

Answer 65

synovial fluid analysis and joint aspiration

Question 66

state the positive result of joint aspiration and synovial fluid analysis for pseudogout

Answer 66

1. brick shaped crystals 2. +ve birefringence

Question 67

is osteoarthritis inflammatory?

Answer 67

no

Question 68

what is the speed of onset of osteoarthritis

Answer 68

gradual

Question 69

when is osteoarthritis prevalent

Answer 69

as age increases and if there is previous joint trauma

Question 70

state the 4 common joints impacted by osteoarthritis

Answer 70

1. spine 2. hand joints 3. knees 4. hips

Question 71

state 3 signs of osteoarthritis

Answer 71

1. joint pain when moving 2. joint crepitus 3. joint enlargement

Question 72

what is joint crepitus

Answer 72

cracking sound when moving joint

Question 73

what are the names of the enlarged joints

Answer 73

Heberden's nodes

Question 74

state the 3 X-Ray features of osteoarthritis

Answer 74

1. joint space narrowing 2. sub-chondral bony sclerosis 3. osteophytes

Question 75

what is sub-chondral bony sclerosis

Answer 75

whiteness on X-Rays

Question 76

what is sub-chondral bony sclerosis

Answer 76

whiteness on X-Rays

Question 77

what clinical features are analysed in rheumatology?

Answer 77

1. speed of onset 2. pattern of joint movement 3. size 4. symmetrical or asymmetrical