Lab Testing in Rheumatic Diseases Flashcards Preview

MSK 2 Post Midterm > Lab Testing in Rheumatic Diseases > Flashcards

Flashcards in Lab Testing in Rheumatic Diseases Deck (44):
1

Polymyalgia rheumatica and Giant Cell Arteritis can both be monitored using __

ESR (acute phase reactant)

2

Where is CRP synthesized and what can increase it? Greater than __mg/l is considered inflammatory?

- synthesized in liver and can be increased by proinflammatory cytokines
- greater than 8mg/l is inflammatory

3

What Acute Phase Reactant increases with age and is higher in F>M

ESR

4

Does ESR or CRP rise/fall more rapidly?

CRP

5

What is produced by B cells in synovial joints in rheumatoid arthritis patients? This autoantibody targets ____.

Rheumatoid Factor. Tagets Fc portion of IgG

6

RF is present in ___% of RA pts.
RF is present in ___% of "nodular" RA pts.

70-80%

100%

7

Cutoff valve for positive RF in:
-ELISA
-latex fixation

-ELISA: RF > 45IU/ml
-latex fixation: RF > 1:80

8

What two tests have 99.5% specificity for RA?

Anti CCP and positive RF

9

homogenous pattern ANA - caused by?

drug induced lupus

10

postive ANA can occur in what four types of pts?

normal (20-30%), RA, CTD (connective tissue disease?), malignancy

11

Rim pattern ANA indicates...

anti DS DNA

12

Speckled anti SSA/B ANA indicates...

Sjögren syndrome

13

Anticentromere antibody indicates...

scleroderma

14

Criteria for SLE

SOAP MD BRAIN
-Serositis (inflammation in synovial fluid)
-Oral ulcers
-Arthritis
-Photosensitivity

-Malar rash, Discoid rash

-Blood - all low (anemia, thrombo/leukopenia)
-Renal
-ANA
-Immunologic (DS DNA)
-Neurologic

15

***Define hematologic manifestations of SLE

– Hemolytic anemia with reticulocytosis OR
- lymphopenia less than 1500
- leukopenia less than 4,000
- thrombocytopenia less than 100,000

16

Antistreptolysin O antibody (ASO titer) and anti DNAase B titers indicate evidence of preceding ___ infection.

evidence of preceding group A streptococcal infection
(Acute Rheumatic Fever; polyarticular)

17

strep often affects what parts of the body?

large joints (asymmetric)
Post-strep Reactive Arthritis effects SMALL joints SYMMETRICALLY

18

These tests indicate ___:
CBC indicating hemolytic anemia, leukopenia and false positive RPR (reactive plasma reagin - syphilis)

SLE

19

These tests indicate ___:
Positive anti‐CCP, elevated ESR and elevated rheumatoid factor level

Rheumatoid arthritis

20

alcohol promotes increased ___ production and decreased excretion

urate

21

attacks MTP, has tophi

gout

22

tx of acute gout (3)

NSAIDs, colchicene, steroids

23

tx of chronic gout (2)

XO inhibitors, Probencid (increased renal excretion)

24

What imaging study of rheumatic disease has:
– Poor visualization of soft tissue
– (RA) symmetrical involvement of MCP, periarticular
osteopenia, EROSIONS in late disease

radiography - digital radiographs have high spatial resolution

– Plane radiographs may not detect early arthritic disease

25

What imaging study of rheumatic disease:
– Aid in injecting/aspirating joint
– No radiation
– sensitive for SOFT TISSUE abnormalities (SYNOVITIS, TENDONITIS, BURSITIS) and erosions

Ultrasonography

26

What imaging study of rheumatic disease:
– is useful for soft tissue abnormalities; good for spine, SI, synovitis, tenosynovitis, erosions
– Gadolinium contrast taken up in inflamed synovium (thickened pannus) IV gadolinium can cause nephrogenic systemic fibrosis (NSF) in patient with kidney disease

MRI

**GADOLINIUM TOXICITY - use CT if you can

27

What imaging study of rheumatic disease is best forBONY ABNORMALITIES (trabecular, cortical bone), erosions, fractures, degenerative or inflammatory arthritis

CT

28

Number of Joints Involved
•Mono ‐
•Oligo ‐
•Pauci ‐
•Poly ‐

•Mono ‐ arthritis
•Oligo ‐ 3 or more
•Pauci ‐ 5 or more
•Poly ‐ more than 6

29

**What rheumatic disease affects MCPs and PIPs?

Rheumatoid arthritis

30

**What rheumatic disease affects knees, DIP, cervical and lumbar?

Osteoarthritis

31

Three types of swelling.

bony, effusion, soft tissue

32

define types of effusion swelling

synovial fluid (infl/non-inflam), pus, blood

33

swan neck:
looks like ___
indicates ___

hyperextension of PIP
advanced RA deformity

34

boutonniere:
looks like ___
indicates ___

hyperF of PIP
advanced RA deformity

35

name 5 arthritic syndromes

Syndromes
•Arthritis ‐ Dermatitis
•Arthritis ‐ Bowel
•Arthritis ‐ Pulmonary
•Arthritis ‐ Endocrine
•Arthritis ‐ Ophthalmologic

36

name causes of inflammatory bowel disease and Reactive arthritis that can cause arthritis

•Inflammatory Bowel Disease - Ulcerative Colitis, Crohn’s Diseasem Behcet’s
•Reactive Arthritis - Bowel Infection

37

**4 bowel infections that can cause reactive arthritis

Salmonella, shigella, campylobacter, Yersinia (N. gono/Chlamydia)

38

Name two endocrine disorders that can result in respective arthrtities

1. Thyroid - carpal/tarasal tunnel syndrome
2. Diabetes - charcot's and cheiroarthropathy (thiickened hand/skin that mimics scleroderma)

39

cytoid bodies and vasculitis result in...

retinopathy (arthritis-ophthalmologic)

40

dactylitis indicates

reactive arthritis

41

Sjogrens, SLE, and healthy, >60 years old - all can have false positive ___?

RF

42

Anti-CCP has greater specificity or sensitivity than RF?

specificity

43

Joint aspiration: 200-2,000 = ?; 2000-50,000 = ?; 50,000+ = ?

200-2,000 = noninflammatory
2000-50,000 = inflammatory (cloudy)
50,000+ = septic (cloudy, opaque)

44

causes of drug induced lupus

phenytoin, hydralazine