Osteoarthritis vs RA

Question 1

osteoarthritis: pathogenesis?

Answer 1

mechanical: wear and tear destroys cartilage

Question 2

osteoarthritis: which cells are involved in pathogenesis? what do these cells mediate?

Answer 2

chondrocytes mediate degradation and inadequate repair

Question 3

which one (osteoarthritis or RA) is a degenerative joint disorder?

Answer 3

osteoarthritis

Question 4

Osteoarthritis: predisposing factors?

Answer 4

age
female
obesity
joint trauma

Question 5

age, female, obesity and joint trauma. predisposing for what?

Answer 5

osteoarthritis

Question 6

in which disease do chondrocytes mediate degradation and inadequate repair?

Answer 6

osteoarthritis

Question 7

osteoarthritis: presentation?

Answer 7

pain in weight-bearing joints after use (end of the day), improves with rest

assymetric

no systemic symptoms

Question 8

which disease causes pain in weight-bearing joint at the end of the day, and improves with rest

Answer 8

osteoarthritis

Question 9

osteoarthritis: knee cartilage loss begins medially or laterally?

Answer 9

medially (bow-legged/genu varum/’O’)

Question 10

does osteoarthritis cause systemic symptoms?

Answer 10

no

Question 11

osteoarthritis: joint involvement symmetric or asymmetric?

Answer 11

asymmetric

Question 12

osteoarthritis: joint findings x-ray

(4 total)

Answer 12

osteophytes (bone spurs)
joint space narrowing (asymmetric)
subchondral sclerosis
cysts

Question 13

x-ray findings: osteophytes, joint space narrowing, subchondral sclerosis and cysts. suggestive of?

Answer 13

osteoarthritis

Question 14

osteoarthritis: synovial fluid findings?

Answer 14

non-inflammatory
WBC < 2000/mm3

Question 15

osteoarthritis: findings hands?

Answer 15

Heberden nodes at DIP
Bouchard nodes at PIP
Nodes at 1st cmc (thumb)

Question 16

osteoarthritis: which fingers joints are involved?

Answer 16

DIP, PIP, CMC (thumb base)

DIP: heberden
PIP: bouchard

Question 17

Heberden nodes: where?

Answer 17

DIP (in osteoarthritis)

Question 18

Bouchard nodes: where?

Answer 18

PIP (in osteoarthritis)

Question 19

What are nodes at DIP called in osteoarthritis?

Answer 19

Heberden nodes

Question 20

What are nodes at PIP called in osteoarthritis?

Answer 20

Bouchard

Question 21

Are MCP involved in osteoarthritis?

Answer 21

no

Question 22

which fingers joints are NOT involved in osteoarthritis?

Answer 22

MCP

Question 23

osteoarthritis: treatment?

Answer 23

activity modification
NSAID, acetaminophen
intra-articular glucocorticosteroids

Question 24

RA: pathogenesis?

Answer 24

Autoimmune and inflammation causes formation of pannus which erodes articular cartilage and joints

(pannus: proliferative granulation tissue)

Question 25

what is pannus?

Answer 25

proliferative granulation tissue

Question 26

formation of pannus which erodes articular cartilage. which disease?

Answer 26

RA

Question 27

RA: predisposing factors?

Answer 27

Female HLA-DR4 tobacco smoking

Question 28

which disease is associated with HLA-DR4?

Answer 28

RA

Question 29

RA is associated with which HLA type?

Answer 29

HLA-DR4

Question 30

female, HL-DR4, tobacco smoking. predisposing factors for what?

Answer 30

RA

Question 31

Which antibodies are associated with RA?

Answer 31

Rheumatic factor anti-cyclic citrullinated peptide

Question 32

which is more specific for RA: RF or anti-cyclic citrullinated peptide?

Answer 32

anti-cyclic citrullinated peptide

Question 33

which antibody is most specific for RA?

Answer 33

anti-cyclic citrullinated peptide

Question 34

which percentage of RA cases is positive for RF?

Answer 34

80%

Question 35

what kind of antibody is RF?

Answer 35

IgM targets IgG Fc region

Question 36

RA: presentation?

Answer 36

pain, swelling and morning stiffness lasting >1hr, improving with use systemic symptoms extraarticular manifestations

Question 37

how long does the morning stiffness in RA last?

Answer 37

>1 hr

Question 38

how do RA symptoms improve in the morning?

Answer 38

with use

Question 39

pain, swelling and morning stiffness lasting >1hr, improving with use. suggestive of?

Answer 39

RA

Question 40

does RA have systemic symptoms?

Answer 40

yes

Question 41

what are the systemic symptoms in RA

Answer 41

fever, fatigue, weight loss

Question 42

RA: joint findings on x-ray

Answer 42

erosions osteopenia (juxta-articular) joint space narrowing (symmetric) cysts

Question 43

x-ray findings: erosions osteopenia (juxta-articular) joint space narrowing (symmetric) cysts suggestive of what?

Answer 43

RA

Question 44

RA: which part of the body can be subluxated?

Answer 44

cervical spine

Question 45

cervical subluxation. suggestive of what?

Answer 45

RA

Question 46

RA: deformities?

Answer 46

cervical subluxation ulnar finger deviation swan neck (DIP flexed) boutonniere (PIP flexed)

Question 47

ulnar finger deviation. suggestive of what?

Answer 47

RA

Question 48

swan neck deformities. suggestive of what?

Answer 48

RA

Question 49

boutonniere deformities. suggestive of what?

Answer 49

RA

Question 50

which joint is flexed in a swan neck deformity?

Answer 50

DIP

Question 51

which joint is flexed in a boutonniere deformity?

Answer 51

PIP

Question 52

which finger joint are involved in RA?

Answer 52

MCP, PIP

Question 53

which finger joints are NOT involed in RA?

Answer 53

DIP, CMC (thumb base)

Question 54

treatment RA?

Answer 54

NSAIDs glucocorticosteroids disease modifying agents: methotrexate, sulfasalazine biological agents: TNF-a inhibitors

Question 55

biological agent used for RA?

Answer 55

TNF-a inhibitor

Question 56

disease modifying agents used for RA?

Answer 56

methotrexate (chemo/immuno-surpressive) sulfasalazine (anti-inflammatoru)

Question 57

extra-articular manifestations RA? (10 total)

Answer 57

rheumatoid nodules (skin and lung) Interstitial lung disease pleuritis pericarditis anemia neutropenia + splenomegaly amyloidosis sjogren scleritis CTS