Joint and Soft Tissue Pathology I

Question 1

osteoarthritis

Answer 1

defective repair

Question 2

osteoarthritis clinical

Answer 2

sx in 50yo

Question 3

younger person with osteoarthritis

Answer 3

look for underlying cause**

Question 4

heberden nodes

Answer 4

osteophytes at distal interphalangeal joint - common in women

Question 5

DIP

Answer 5

osteoarthritis

Question 6

PIP

Answer 6

rheumatoid arthritis

Question 7

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

Answer 7

osteoarthritis

Question 8

ulnar deviation and PIP joint swelling

Answer 8

rheumatoid arthritis - autoimmun

Question 9

rheumatoid arthritis

Answer 9

CD4 T cells autoimmune response

Question 10

tx of RA

Answer 10

TNF antagonist

Question 11

fibrous ankylosis

Answer 11

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

tell patient to stretch to avoid this

Question 12

pannus

Answer 12

mass of edematous synovium in RA

Question 13

rheumatoid subQ nodules

Answer 13

common cutaneous lesion with RA

resemble necrotizing granulomas

Question 14

Rh factor

Answer 14

with RA

-increased risk for vasculitis

Question 15

if see granuloma

Answer 15

need to acid fast stain

-to rule out TB

Question 16

diagnosis of RA

Answer 16

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

Question 17

anti-CCP Ab

Answer 17

screening test for RA

Question 18

juvenile idiopathic arthritis

Answer 18

unknown cause

arthritis before age 16 for 6 weeks

more in large joints

often ANA seropositive

Question 19

ANA test

Answer 19

positive in juvenile idiopathic arthritis

Question 20

seronegative spondyloarthropathies

Answer 20

pathologic change of ligament attachments

with HLA-B27

Question 21

HLA B27

Answer 21

ankylosing spondylitis

Question 22

ankylosing spondylitis

Answer 22

can lead to SI and vertebral fusion

Question 23

30-40yo with lower back pain and spinal immobility

Answer 23

ankylosing spondylitis

Question 24

reactive arthritis

Answer 24

reiter syndrome

association with HLA-B27 and ankylosing spondylitis

Question 25

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

Answer 25

reiter syndrome - reactive arthritis triad of arthritis, urethritis, conjunctivitis

Question 26

enteritis associated arthritis

Answer 26

associated with GI infection -yersinia, salmonella, shigella, campylobacter knees and ankles wrists fingers toes underlying disease- crohns

Question 27

pencil in cup on Xray

Answer 27

psoriatic arthritis involves DIPs in asymmetric distribution

Question 28

infectious arthritis

Answer 28

heme spread sudden development of acute painful swollen joint that has restricted ROM fever, leukocytosis, elevated sed rate commonly knee

Question 29

diagnosis of infectious arthritis

Answer 29

joint aspiration ID of causative agent

Question 30

gram negative diplococci bacterial arthritis

Answer 30

sailor returns home neisseria gonorrhea

Question 31

lyme arthritis

Answer 31

borrelia burgdorferi - deer tick - ixodes ricinus late stage - develop arthritis

Question 32

diagnosis of lyme arthritis

Answer 32

serologic test for anti-borrelia Abs

Question 33

gout

Answer 33

crystals of monosodium urate

Question 34

pseudogout

Answer 34

crystals of basic calcium phosphate

Question 35

majority of gour

Answer 35

90% primary - idiopathic

Question 36

HGPRT deficiency

Answer 36

can cause gout | -involved in DNA salvage pathway

Question 37

hyperuricemia

Answer 37

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

Question 38

gout clinical

Answer 38

usually appear 20-30yo genetic predisposition - X-linked issue with GHPRT

Question 39

URAT1 and GLUT9

Answer 39

gout

Question 40

lifestyle promoting gout

Answer 40

alcohol obesity drugs lead toxicity

Question 41

stages of gout

Answer 41

acute arhritis chronic tophaceous gout

Question 42

chronic tophaceous gout

Answer 42

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

Question 43

pseudogout clinical

Answer 43

calcium pyrophosphate crystals age 50yo 85yo - 30-60%

Question 44

coffin lids

Answer 44

calcium pyrophosphate - pseudogout

Question 45

YIPA

Answer 45

yellow in parallel - axis is parallel gives yellow - axis not parallel gives blue for gout**

Question 46

BIPA

Answer 46

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