Pathoma - Joint Disorders

Question 1

Osteoarthritis - what is it?

Answer 1

progressive degeneration of articular cartilage

Question 2

Osteoarthritis - cause

Answer 2

“wear and tear” (mechanical)

Question 3

Osteoarthritis- risk factors

Answer 3

Age, obesity, trauma

Question 4

Osteoarthritis - pathobiology

Answer 4

disruption of cartilage lining articular surface

Question 5

Osteoarthritis - joint findings

Answer 5

osteophyte formation
Herber/Bouchard nodes (DIP/PIP involvement)
eburnation
sclerosis
joint space narrowing

Question 6

Osteoarthritis - treatment

Answer 6

NSAIDS, corticosteroids

Question 7

Rheumatoid arthritis - cause

Answer 7

chronic autoimmune dz

Question 8

Rheumatoid arthritis - risk factors

Answer 8

HLA-DR4

Question 9

Osteoarthritis - Clinical presentation

Answer 9

pain that gets worse at end of day/with use

Question 10

Rheumatoid arthritis -joint findings

Answer 10

Pannus
increased synovial fluid
MCP/DIP joints involvement
joint deviation

Question 11

Rheumatoid arthritis- pathobiology

Answer 11

inflammatory destruction of synovial joints

Question 12

What type of hypersensitivity is RA?

Answer 12

Type III

Question 13

What is pannus?

Answer 13

inflamed granulation tissue

Question 14

Rheumatoid arthritis- clinical presentation

Answer 14

Morning stiffness
symmetric joint involvement
systemic symptoms (fever, malaise,etc)

Question 15

Rheumatoid arthritis- treatment

Answer 15

NSAIDS, corticosteroids, disease modifying agents (methotrexate, sulfasalazine, TNF-alpha inhibitors)

Question 16

Rheumatoid arthritis - associated

Answer 16

vasculitis
Baker’s cyst
pleural effusions

Question 17

Rheumatoid arthritis - labs

Answer 17

IgM autoantibody against Fc portion of IgG (RF)

Question 18

Seronegative spondyloarthropathies

Answer 18

arthritis with lack of rheumatoid factor

Question 19

SNSAs - location and risk factors

Answer 19

axial skeleton

HLA-B27

Question 20

SNSAs - diseases

Answer 20

PAIR:
Psoriatic arthritis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis (Reiter's syndrome)

Question 21

Ankylosing spondylitis - population

Answer 21

young adults, mostly male

Question 22

Ankylosing spondylitis - clinical presentation

Answer 22

low back pain, bamboo spine (joints fuse)

Question 23

Ankylosing spondylitis - associated

Answer 23

uveitis and aortitis

Question 24

Psoriatic arthritis - involved joints

Answer 24

DIP of hands/feet (asymmetric involvement)

Question 25

Psoriatic arthritis - clinical presentation

Answer 25

"sausage fingers/toes"

Question 26

Psoriatic arthritis - x-ray

Answer 26

"pencil in cup" deformity

Question 27

Reactive arthritis (Reiter's) - clinical presentation

Answer 27

arthritis, urethritis, conjunctivitis | ("can't see, can't pee, can"t climb a tree"

Question 28

Reactive arthritis (Reiter's) - associated

Answer 28

post GI or C. trachomatis (chlamydia) infection

Question 29

Infectious arthritis - common causes

Answer 29

N. gonorrheae (#1) | S. aureus

Question 30

Infectious arthritis - clinical presentation

Answer 30

single joint | fever, increase WBCs

Question 31

Gout - cause

Answer 31

hyperuricemia

Question 32

Gout - crystals

Answer 32

Monosodium urate (MSU)

Question 33

Causes of secondary hyperuricemia

Answer 33

leukemia, myeloproliferative disorders renal insufficiency Lesch-Nyhan syndrome

Question 34

Gout- clinical presentation (acute)

Answer 34

incredibly painful great toe | alcohol/meat consumption exacerbate

Question 35

Gout - clinical presentation (chronic)

Answer 35

tophi (white, chalky uric acid cystals) | renal failure

Question 36

Gout - labs

Answer 36

hyperuricemia | needle shaped crystals (negative birefringence) (yellow)

Question 37

Pseudogout - crystals

Answer 37

calcium pyrophosphate

Question 38

Pseudogout - labs

Answer 38

rhomboid shaped crystals (weakly + birefringence)

Question 39

Pseudogout - clinical presentation

Answer 39

large joints (knee)

Question 40

Gout - tx

Answer 40

acute- NSAIDs/corticosteroids | chronic xanathine oxidase inhibitors (allopurinol, febuxostat)