Joint and Soft Tissue Pathology I Flashcards Preview

MSK Exam 1 Spring 2015 > Joint and Soft Tissue Pathology I > Flashcards

Flashcards in Joint and Soft Tissue Pathology I Deck (46):
1

osteoarthritis

defective repair

2

osteoarthritis clinical

sx in 50yo

3

younger person with osteoarthritis

look for underlying cause**

4

heberden nodes

osteophytes at distal interphalangeal joint - common in women

5

DIP

osteoarthritis

6

PIP

rheumatoid arthritis

7

scope knee - see granulation tissue, red/ragged, bloody

osteoarthritis

8

ulnar deviation and PIP joint swelling

rheumatoid arthritis - autoimmun

9

rheumatoid arthritis

CD4 T cells autoimmune response

10

tx of RA

TNF antagonist

11

fibrous ankylosis

RA over time - cartilage destroyed and pannus bridges to opposing bone
can fusion - bony ankylosis if ossifies**

tell patient to stretch to avoid this

12

pannus

mass of edematous synovium in RA

13

rheumatoid subQ nodules

common cutaneous lesion with RA
resemble necrotizing granulomas

14

Rh factor

with RA
-increased risk for vasculitis

15

if see granuloma

need to acid fast stain
-to rule out TB

16

diagnosis of RA

Xray findings
sterile cloudy synovial fluid that is liquidy
Rh factor and anti-CCP Ab

17

anti-CCP Ab

screening test for RA

18

juvenile idiopathic arthritis

unknown cause

arthritis before age 16 for 6 weeks

more in large joints

often ANA seropositive

19

ANA test

positive in juvenile idiopathic arthritis

20

seronegative spondyloarthropathies

pathologic change of ligament attachments

with HLA-B27

21

HLA B27

ankylosing spondylitis

22

ankylosing spondylitis

can lead to SI and vertebral fusion

23

30-40yo with lower back pain and spinal immobility

ankylosing spondylitis

24

reactive arthritis

reiter syndrome

association with HLA-B27 and ankylosing spondylitis

25

can't see, can't pee, can't climb a tree

reiter syndrome - reactive arthritis

triad of arthritis, urethritis, conjunctivitis

26

enteritis associated arthritis

associated with GI infection
-yersinia, salmonella, shigella, campylobacter

knees and ankles
wrists fingers toes

underlying disease- crohns

27

pencil in cup on Xray

psoriatic arthritis

involves DIPs in asymmetric distribution

28

infectious arthritis

heme spread

sudden development of acute painful swollen joint that has restricted ROM

fever, leukocytosis, elevated sed rate

commonly knee

29

diagnosis of infectious arthritis

joint aspiration

ID of causative agent

30

gram negative diplococci bacterial arthritis

sailor returns home

neisseria gonorrhea

31

lyme arthritis

borrelia burgdorferi - deer tick - ixodes ricinus

late stage - develop arthritis

32

diagnosis of lyme arthritis

serologic test for anti-borrelia Abs

33

gout

crystals of monosodium urate

34

pseudogout

crystals of basic calcium phosphate

35

majority of gour

90% primary - idiopathic

36

HGPRT deficiency

can cause gout
-involved in DNA salvage pathway

37

hyperuricemia

above 7-8mg/dL
-precipitate out of solution

38

gout clinical

usually appear 20-30yo

genetic predisposition - X-linked issue with GHPRT

39

URAT1 and GLUT9

gout

40

lifestyle promoting gout

alcohol
obesity
drugs
lead toxicity

41

stages of gout

acute arhritis

chronic tophaceous gout

42

chronic tophaceous gout

after 12 years
-juxtarticular bone erosion - loss of joint space - severe crippling disease can occur

43

pseudogout clinical

calcium pyrophosphate crystals

age 50yo

85yo - 30-60%

44

coffin lids

calcium pyrophosphate - pseudogout

45

YIPA

yellow in parallel
-axis is parallel gives yellow
-axis not parallel gives blue

for gout**

46

BIPA

blue in parallel
-axis in parallel gives blue
-axis not parallel gives yellow

for pseudogout