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Flashcards in MSK path IX Deck (50)
1

what is OA

degeneration of cartilage causing structural and functional failure of synovial joints
failure/disordered repair

2

what occurs in early OA

chondrocytes proliferate and the collagent II fibers cleaved causes fissures and clefts

3

what are joint mice

parts of cartilage that slough into joint in OA

4

what cap the osteophytes in OA

fibrocartilage and hyaline

5

what is eburnated articular surface in OA

friction on bone causing smoothign surface

6

Sx OA

deep achy pain that worsens with use
morning stiffness, crepitus
limited ROM
impingement on spinal foramina by osteophytes

7

what occurs with radiculopathy from OA

muscle spasms, radicular pain, muscle atrophy and neurologic deficits

8

joints commonly involved in OA

hips knees, lower lumbar and cervical vertebrae, PIPs DIPs, first CMC and first TMT

9

heberden nodes

prominent osteophyes at DIP joints
common in women

10

Dx OA

radiographically because can see osteophytes

11

red ragged bloody clots in joint capsule

RA

12

RA

chronic inflammatory disorder of autoimmune origin
may affect many tissues and organs principally attacks joints producing nonsuppurative proliferatice and inflammatory synovitis

13

what do hands look like in RA

ulnar deviation

14

What is common genetically in RA

HLA susceptibility

15

what cells are involved in RA

T ell B cell and Macrophages

16

What cells initiate immune response in RA

CD4 T cells
reacti with arthritogenic agent

17

what specified Tx is helpful in RA and why

TNF antagonists because TNF somehow involved in RA

18

What is in the synovium of RA

germinal centers with secondary follicles and many plasma cells (autoAb)

19

synovium in RA

thick edema
hyperplastic
synovial cell hyperplasia, dense inflammatory infiltrates
increased vasculaity
fibrinopurulent exudate
osteoclastic activity in underlying bone

20

what is pannus

mass of edematous synovium, inflammatory cells, granulation tissue and fibroblasts that grows over articular cartilage and causes its erosion

21

what is it called when pannus bridges opposing bones

fibrous anklyosis leads to boney ankylosis when it fuses

22

blue cells with hoff bodies

plasma cells

23

are plasma cells normal in synovium

no

24

what are RA subcutaneous nodules

parts of skin subject to pressure
firm nontender and round to oval
in subcutaneous tissue

25

what do RA subcutaneous nodules look like microscopically

necrotizing granulomas with central zone fibrinoid necrosis with rim of macrophages, lymphocytes and plasma cells

26

increased RF in RA patient

higher risk for vasculitis

27

acute necrotizing vasculitis with RA involves what and can lead to what

small and large aa
neuropathies, ulcers and gangrene

28

leukocytoclastic vasculitis can cause what

purpura, cutaneous ulcers, nail bed infarction
ocular changes like uveitis and keratoconjunctivitis

29

palisade necrozing granuloma need to test for?

TB
can be rheumatoid nodule in lung

30

Sx RA

slow malaise, fatigue, generalized MSK pain

31

what mediates pain in RA

IL1 and TNF

32

joint progression in RA

small joints first
symmetrically

33

what part of skeleton is usually spared in RA

lumbosacral and hips

34

Dx RA

characteristic radiographic finding
sterile turbid synovial fluid with poor mucin clot
combination of RF and anti CCP Ab

35

ehy does the synovial fluid of RA joint have poor mucin clot

all the inflammatory products break it downw

36

what are the inclusion breaing neutrophils in RA synovial fluid

tart cells

37

anti CCP Ab is best used for what

RA screening!!

38

What is Juvenile idiopathi arthritis

unknown cause arthritis before age 16 and persist for >6 weeks

39

differences of RA and JIA

JIA:
oligoarthritis
unilateral
systemic disease more frequent
large joints affected more
RF and nodules usually absent
ANA sero +

40

ANA + means what

autoimmune

41

seronegative spondylarthropathies have what

assoc with HLA B27
no RF
involve SI joints

42

anklyosing spondylitis

destruction of cartilage and bony anklyosis of SI and apophyseal joints

43

what are apophyseal joints

between tuberosities and processes

44

when does anklyosing spondylitis become Sx

20-30 years because of low back pain and spinal immobility

45

what peripheral joints are involved in anklyosing spondylitis sometimes

hips, knees, shoulders

46

HLA with anklyosing spondylitis

B27

47

What is reactive arthritis

reiter syndrome
arthritis, nongonococcal urethritis or cervicitis
conjunctivitis

48

HLA assoc with reactive arthritis

HLA B27 and HIV individuals

49

age of reactive arthritis

20s 30s

50

prior infection that can trigger reactive arthritis

chlamydia, shigella, salmonella, yersinia, campylobacter