R/O - Arthropathies and septic arthritis

Question 1

what is the triad for gonococcal arthritis?

Answer 1

1. tenosynovitis
2. vesiculopustular skin lesions
3. polyarthralgia

Question 2

is gonococcal monoarthritis purulent or non-purulent?

Answer 2

purulent

Question 3

what is the treatment for gram positive cocci septic arthritis?

Answer 3

vancomycin

Question 4

what is the treatment for gram negative bacilli septic arthritis?

Answer 4

3rd gen ceph

Question 5

what medications can induce gouty monoarthritis?

Answer 5

• ASA (low dose)

- hydrochlorothiazide

Question 6

what is the diagnosis for gout?

Answer 6

• synovial fluid analysis
• intracellular monosodium urate
• crystals are NEGATIVELY birifringent
• WBC 10k - 100k

parallel and yellow - gout (negative)

Question 7

what does plain radiography show in gout?

Answer 7

• subcortical bone cysts

- bone erosions with overhanging edges

Question 8

what is the primary pathophysiology mechanism of gout?

Answer 8

impaired excretion

Question 9

what is the goal uric acid level for prevention of recurrent gout?

Answer 9

6 mg / dL (solubility level)

Question 10

where is febuxostat cleared?

Answer 10

liver

Question 11

what drugs are used for prophylaxis during initiation of antihyperuricemic therapy?

Answer 11

• colchicine

- NSAIDs

Question 12

acute attacks of calcium pyrophosphate crystal deposition disease (CPPD) occur in _____ (men / women), and osteoarthritis with chondrocalcinosis occurs in _________ (men / women)

Answer 12

• men

- women

Question 13

what are the clinical manifestations of CPPD?

Answer 13

• spine involvement

- crowded dens syndrome: recurrent fever, elevated CRP and ESR, neck and shoulder girdle pain and stiffness

Question 14

how is CPPD diagnosed?

Answer 14

• synovial fluid
• positively birifringent CPP crystals
• WBC 15k - 30k

Question 15

• rhomboid crystals

- pale blue when aligned with axis of compensator

Answer 15

CPPD

Question 16

what is the treatment of acute pseudogout?

Answer 16

• oligoarticular: steroids

- polyarticular: NSAIDs, colchicine, oral steroids, ACTH

Question 17

definition: spondyloarthropathies

Answer 17

inflammation of axial joints, asymmetrical oligoarthritis, dactylitis, and enthesitis

Question 18

spondyloarthropathies are often associated with manifestations in what other parts of the body?

Answer 18

• eye and bowel inflammation
• preceding infection
• positive familiy history
• HLA B27

Question 19

dactylitis - sausage finger is seen in what condition?

Answer 19

spondyloarthropathies

Question 20

what are the clinical manifestations of spondyloarthropathies?

Answer 20

• skeletal: low back pain (inflammatory), peripheral arthritis, enthesopathy, dactylitis
• non-skeletal: conjunctivitis, anterior uveitis, inflammatory bowel disease, psoriasis

Question 21

what is the lab eval for spondyloarthropathies?

Answer 21

• HLA B27
• ESR
• CRP

Question 22

what do radiographs show for spondyloarthropathies?

Answer 22

• SI joints
• hands
• feet

Question 23

what are the pharm treatments for spondyloarthropathies?

Answer 23

• NSAIDs
• analgesics
• DMARDs
• biologics