pathology - arthritis

Question 1

etiology of osteoarthritis

Answer 1

mechanial joint wear and tear that destroys articular cartilage type II

Question 2

etiology of rheumatoid arhtirits

Answer 2

autoimmune 0 inflammatory destruction of synovila joints

Question 3

type of hypersensitivity of RA

Answer 3

type III and type IV

Question 4

OA or RA? subchondral cysts

Answer 4

OA

Question 5

OA or RA? pannus

Answer 5

RA

Question 6

OA or RA? sclerosis

Answer 6

OA

Question 7

OA or RA? osteophytes

Answer 7

OA

Question 8

OA or RA? MCP and PIP

Answer 8

RA

Question 9

OA or RA? no MCP, DIP and PIP

Answer 9

OA

Question 10

OA or RA? eburnation

Answer 10

OA

Question 11

OA or RA? synovitis

Answer 11

OA

Question 12

OA or RA? subcutaneous nodules

Answer 12

RA

Question 13

OA or RA? ulnar deviation of fingers

Answer 13

RA

Question 14

OA or RA? heberden nodes

Answer 14

OA

Question 15

OA or RA? bouchard nodes

Answer 15

OA

Question 16

OA or RA? swan neck deformiton (extended at mcp and pip and flexed at dip)

Answer 16

RA

Question 17

OA or RA? boutonniere deformint (extended at MCP and dip, flexed at pip)

Answer 17

RA

Question 18

predisposing factors for OA

Answer 18

age
obesity
joint trauma

Question 19

labs in RA

Answer 19

positive for rheumatoid factor = IgM anti IgG that froms complexes with IgG and deposits = Type III = screening
positive for anti-citrullinated peptide ab - more specfic

Question 20

HLA of RA

Answer 20

HLA-DR4

Question 21

describe classical presentation of OA

Answer 21

pain in weight beirng joints after use
pain improves with rest
knee cartilage lose medially - bowlegged
noninflammatory
non systemic symptoms

Question 22

pain in weight bearing joints after use
pain improves with rest
bowlegged

Answer 22

OA
non inflammatory
knee cartilage lsot medially first
no systemic symptoms

Question 23

cxpx fo ra

Answer 23

females more than males
mornign stiffness lasting more than 30 minutes
stiffness improves with use
symmetric joint invovlement
systemic symptoms - fever, fatigue, weight loss, pleuritis, pericardtis

Question 24

mornign stiffness that lasts more than 30 mins
stiffness improves with use
symmetrical joints

Answer 24

ra

systemic symptoms - fever, fatigue, weight loss, pleuritis and pericarditis

Question 25

where does pannus form

Answer 25

granulation tissue in the MCP and PIP

Question 26

how to treat OA

Answer 26

acetaminophen nsaids intraarticular glucocorticoids

Question 27

how to treat RA

Answer 27

nsaids glucocorticoids disease modifires - methotrexate and sulfasalzine biologics - tnfa inhibitors

Question 28

what is sjogren syndrome

Answer 28

autoimmune disorder characterized by destruction fo exocrine glands - lacrimal and salivary especially by lymphocytic infiltrates

Question 29

typically pat with sjogrens

Answer 29

female | 40-60 years odl

Question 30

cxpx of sjogrens

Answer 30

inflammatory joint pain xerophthalmia - decrease tear production and subsequent corneal damage xerostomia - decrease saliva - dental caries bilateral parotid enlargement

Question 31

labs in sjogrens

Answer 31

anti nuclear abs: SS-a/anti Ro and/or SS-B/anti La

Question 32

joint pain dry eyes dental caries dry mouth

Answer 32

sjogrens

Question 33

what are the complications fo sjuogrens

Answer 33

dental caries | increased MALT - may present as parotid enlargement

Question 34

dental caries | increased MALT

Answer 34

sjogrens

Question 35

what autoimmune disease is associated with sjogrens

Answer 35

RA

Question 36

acute inflammatory monoarthtiris in males with acute onset

Answer 36

goutt

Question 37

pathogenesis of gout

Answer 37

hyperuricemia lead to ppt of monosodium urate crystals in joints that cause inflammation

Question 38

what can cause hyperuricemia

Answer 38

underexretion of uric acid = thiazides | overproduction (10% only) = lesch nyhan, PRPP xcess, increased cell tumovoer in tumor lysis and vongirke disease

Question 39

diseases that you can suspect gout in

Answer 39

lesch nyhan thiazides - chf etc von gierke tumot cell lysis

Question 40

joitn aspirate in gout

Answer 40

negative birefringence = yellow in parallel and blue in perpendicular

Question 41

swllen, red, painful, asymmetric joint distribution

Answer 41

gout

Question 42

most common joint in gout

Answer 42

first metatarsal

Question 43

what is podagra

Answer 43

painful mtp joint gout

Question 44

common locations of tophi?

Answer 44

external ear olecranon bursa achilles tendon

Question 45

when do acute attacks of gout happen?

Answer 45

large meal or Oh consupmtoin - bc OH metabolites compete for same excretion sites in kidney as uric acid - decreased secretion and buildup in blood

Question 46

treat acute gout!

Answer 46

nsaids/indomethacin glucocorticoids colchicine

Question 47

treat/prevent chronic gout!

Answer 47

xanthing oxidase inhibtiors/allopurinol and febuxostate

Question 48

what is febuxostat

Answer 48

inhibts xanthine oxidase whatce out with thiopurines.

Question 49

what causes pseudogout

Answer 49

calcium pyrophosphate crystals deposited in joint

Question 50

what is the differnece between chondrocalcinosis and pseudogout?

Answer 50

chondrocalcinosis - linear depostiion fo calcium pyrophosphate in articular cartilage pseudogout - acute pain with redness, swellign and pimited motion

Question 51

describe synovial fluid in pseudogout

Answer 51

calcium pyrophosphate forms basophilic rhomboid crystals that are weakly birefringent under polarized light.

Question 52

what joint typical in pseudogotu

Answer 52

usually large and KNEE

Question 53

typical patient in pseudogout

Answer 53

>50 years odl male = female

Question 54

list the diseases associated with pseudogout and why please

Answer 54

hymochromatosis and hemosiderosis - pyrophase levels are increased primary hyperparhtyroidism - icnrease calcium osteoartihritis - i dont know

Question 55

disease associated with OA and disease associated with RA please

Answer 55

``` pseudogout = OA sjogrens = RA ```

Question 56

treat acute pseudogout

Answer 56

nsaids

Question 57

prevent pseudogout

Answer 57

dont have hemochromatosis, osteoartirhis, primary hyperparathyroidsim ;) and give glucocorticoids and colchicine

Question 58

difference betwen gout and pseudogout crystals

Answer 58

@ paralelle light pseudo gout - blue and gout - yellow @ perpendicular light gout = blue hurah calcium = blue

Question 59

bugs involved in infectious arthritis pelase

Answer 59

s aureus, strepto, n gonorrhoesa

Question 60

synovitis of one joint that is swollen, red, painful tenosynovitis at hands/wrist dermatitis = pustules on wrist and ankles

Answer 60

dissemiated gonoccoal arthritis | STD

Question 61

how does gonoccocal arthritis present?

Answer 61

migratory arthrutios with asymmetric pattern

Question 62

i say migratory arthritis with asymmetric pattern, you think?

Answer 62

gonococcal arthritis

Question 63

what are seronegative spondyloarthropaties

Answer 63

family of overlapping syndromes that are lines wtih disease manifestations and genetics

Question 64

HLA fo seroneg spondylos

Answer 64

HLA B27

Question 65

list the seronegative spondylos

Answer 65

psoriatic arthritis anylosing spondylitis inflammatory bowel disease reactive arthirtiis/reiter syndrome

Question 66

asymmetric and patchy involvement dactylitiis pencilin cup on xray erosive nails

Answer 66

psoriatir arhticitis

Question 67

ankylosis uveitis aortic regugitation

Answer 67

ankylosing spondylitis

Question 68

cxpx of ankylosing spondylitis

Answer 68

ankylosis uveitis aortic regurgitation

Question 69

bamboo spine

Answer 69

ankylosing spondylitis

Question 70

what type of arthritis associated with uc and chrons

Answer 70

ankylosing spondyltiis - aortic regurg, uveitis, ankylosis

Question 71

what is anklylosis

Answer 71

stiff spin due to fusion of joints

Question 72

conjunctivitis and anterior uveitis urehtitis arthritis circinate balantitis

Answer 72

reactive arthritis/reiter syndrome

Question 73

bugs involved in reiter syndrome

Answer 73

post gi - shigella, salmonella, camplyobacteria, yersina | post uti - chlamydia

Question 74

compare and contrast presentation of chlamydia vrs gonorrhea when disseminated

Answer 74

chlamydia: conjunctivitis, anterior uveities, urethritis, arhtritis gonorrhoea: septic arthitits - migratory arhtirits with asymmteri patther, tenosynovities, dermatitis

Question 75

asymmetric patchy invovlement

Answer 75

psoriatic athrtitis

Question 76

migratory arhtirits with asymmeter patterh

Answer 76

infetious arthritis