Quiz 6 - MS I Flashcards Preview

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Flashcards in Quiz 6 - MS I Deck (77)
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1

What parts of the body do MS disorders arise?

muscles, joints, tendons, ligaments and nerves

2

What are the three actions of synovial fluid?

reduction of friction via lubrication
shock absorption - becomes VISCOUS under pressure**
Nutrient and waste transportation - provides O2 and allows the movement of CO2 out

3

Any acute mono arthritis (involving one joint) is ______ until proven otherwise

INFECTIOUS

4

what does pauciarticular mean?

MS disease involving 2-4 joints

meaning polyarticular is 5+ joints.

5

what is the name for "swelling of a tendon sheath causing 'triggering'"

stenosing

6

when you have synovitis with a large effusion of non purulent fluid you have..

serous synovitis

7

what are the 8 carpal bones of the hand

Some Lovers Try Positions That They Can't Handle

Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

8

when discussing the onset and progression of disease with MS patients - what is important?

Speed of onset!
Location

9

What is one of the most important questions to ask specifically to MS patients?

Do you have morning stiffness and how long does it last?

This is important because it helps differentiate functional abnormalities vs pathology.
- AI inflammatory arthridities last >1 hr.

Does pain occur at rest?
Travel? Where and when?
What joints, where, swelling?
Toxic exposure

10

What patterns are seen on the hand that should help differentiate specific AIs?

OA - DIPS, PIPs, wrist (rarely MCP)
RA - PIPs, MCPs, writest (rarely DIPs)
PA - nails, asymm, sausage fingers (MCP, PIP and DIP - all affected)
Scleroderma - skin is thickened, flexion contractors, Raynaud's is common
Sarcoidosis - DIP, PID, MCP all affected

11

what does ESR assess?

indicates systemic inflammatory response.
NON-SPECIFIC

can increase in: cancer, pregnancy, infection

12

what does CRP assess?

acute phase reactant - more sensitive measure of disease activity and progression

*** BEST OBJECTIVE MEASURE of DISEASE ACTIVITY in RA, even though it's non-specific

13

what lab value increases for gout - but is associated with these other conditions

serum uric acid

also increases with low dose
ASA, Diuretics, other drugs and alcohol

14

what does Rheumatoid Factor tell us?

RF is antibodies directed agains the Fc portion of an IgG antibody.
May be representative of previous microbe interaction with antibodies
therefore indicated CHRONIC INFECTION (perhaps asx)

85% positive when disease is established.

NOT SPECIFIC FOR RA

15

what is anti-CCP and what is this lab value good for?

anti-cyclic citrullinated peptide antibody

> 90% SPECIFIC FOR RA!!!

as sensitve, but more specific than IgM RF.

May be present prior to RA symptoms.

Sjogren's and TB can also show positives in this one

can predict increased risk for erosive disease

16

HLA-B27 is associated with which 3 conditions?

sponyloarthropathies (AS)
reactive arthritis (RA)
psoriatic arthritis (PA)

17

Which vitamin is definitely associated with many MS disease?

Vitamin D deficiency

18

When there is any suspicion of septic arthritis (acute monoarthritis), immediate what must be carried out?

immediate aspiration of synovial fluid must be carried out

19

What is the broad differential to know for most any autoimmune disorder?

Cancer
AI disease
Infection
Exposure (pharmaceutical/environment)
Metabolic
Trauma

20

What are common etiologies of Rheumatoid Arthritis? What is the clinical picture? What joints are commonly affected? What labs would you order?

Etiologies
TLR

21

What are MMPs and why are they important?

Matrix metalloproeinases (MMPs)

implicated in many diseases of MS

22

what are the steps in the general approach to the MS patient?

first, listen. second, listen.
examine
gather data
provide a differential
make a plan

23

Recent GU/GI infection suggests which AI?

reactive arthritis

24

Bloody Diarrhea suggests?

Enteropathic arthropathy

25

When you have an individual present with Photosensitive rash, seizures, hallucinations, renal disease, what is suggested?

SLE

26

if patient presents with painful red eye, what does this suggest?

seronegative disease

27

Dry as a desert.. Dry eyes, mouth, vagina..

Sjogren's

28

Which condition present swift severe morning stiffness, amaurosis fugal and jaw claudation

Temporal Arteritis

29

Rash in the gluteal fold suggests which condition

Psoriatic Arthritis

30

Elderly lady on aspirin and diuretic suggest ..

Hand gout