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Random (Mostly Quizzes) Flashcards

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1
Q

septic arhtritis synovial fluid wbc

A

> 50,000 suggestive

> 100,000 septic until proven otherwise

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2
Q

low glucose in synovial fluid is most exaggerated in _____ and _____

A

rheumatoid arthritis and a septic joint

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3
Q

synovial membrane components

A

2 layers

1: myofibrils, proteoglycans, capillaries, lymphatics, nerve endings
2: synovial cells (macrophage-like, and fibroblast-like)

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4
Q

joint capsule components

A

Type I Collagen, Type III Collagen, mechanoreceptors, and free nerve terminals

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5
Q

articular cartilage

A

Type II Collagen, Proteoglycans, and Chondrocytes

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6
Q

path of nutrients –> articular cartilage

A

capillaries→ diffusion through FENESTRATED capillaries →synovial fluid → hyaline cartilage

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7
Q

healthy joint wbc

A

<2,000

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8
Q

RA joint protein levels

A

inc due to inc permeability of synovium

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9
Q

RA joint glucose level

A

dec due to impaired active transport into synovial fluid and inc consumption due to inflammation

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10
Q

bacterial arthritis protein levels

A

inc

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11
Q

bacterial arthritis glucose levels

A

dec

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12
Q

traumatic effusion joint wbc

A

non-inflammatory range (<2000)

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13
Q

penetrating path into knee joint

A

Muscle/tendon, joint capsule, synovial tissue (membrane), joint space and cartilage

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14
Q

joint capsule collagen

A

almost exclusively of densely packed type I collagen separated by thin sheets of fibrillar type III collagen.

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15
Q

RF

A

IgM Ab against the Fc portion of IgG

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16
Q

__ is more specific for RA than RF

A

CCP

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17
Q

major components of RA tx

A
  • NSAIDs
  • corticosteroids
  • disease-modifying anti-rheumatics (methotrexate)
  • biologics
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18
Q

Mycophenolate mofetil

A

SLE

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19
Q

HLA-DR4

A

RA

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20
Q

HLA-B27

A

spondyloarthropathies

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21
Q

ESR in RA

A

elevated

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22
Q

CRP in RA

A

elevated

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23
Q

A warm swollen knee or wrist are the most common presentations of

A

a pseudogout flare (calcium pyrophosphate crystal)

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24
Q

lyme wbc

A

tend to be in the typical inflammatory range of between 2,000 and 50,000

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25
mean onset of lyme arthritis
6 mo after the initial infective transmission
26
post-tx lyme arthritis is thought to be a result of
an ongoing immune response against retained B burgdorgeri fragments in immunegenetically susceptible host
27
HLA-DRB1-0401
Associated with greater likelihood of post-tx Lyme arthritis Great similarity to shared epitope of RA (but B burgdorfeti does NOT trigger RA)
28
Chondrocytes within the Hyaline Cartilage of an osteoarthritc joint become ________
hyperplastic
29
Chondrocytes ACTIVITY within the Hyaline Cartilage of an osteoarthritc joint
metabolically active in BOTH catabolic and anabolic functions
30
Normal cartilage chondrocytes
- terminally differentiated - maintain steady state - glucose main energy source - cartilage turnover is slow
31
Synovitis in Osteoarthritis is ___ distributed
focally
32
T/F The presence of synovitis in Osteoarthritic knee joints correlates with the degree of pain
T
33
synovial CK in OA
IL-1, IL-7, TNF-a
34
In OA, the extent of ___, measured histologically, correlates with the extent of cartilage damage, observed by arthroscopy
synovitis
35
____ is the most frequent reason for joint replacement.
Osteoarthritis
36
____ is the most common joint disease in the world
Osteoarthritis
37
OA innate or systemic response?
innate
38
Duloxetine
SNRI FDA indicated for fibromyalgia, generalized osteoarthritis and depression
39
Erosions are typical of ____ arthritis
inflammatory
40
T/F Asymptomatic hyperuricemia should not be treated with antihyperuricemic agents
T
41
Uricosuric agents such as probenicid should not be used in anyone who
has had a uric acid kidney stone
42
Allopurinol is an effective therapy for the treatment of an ___ attack of gout
acute
43
NSAIDs use in gout
acute attack
44
uric acid overproduction
HGPRT deficiency (lesch-nyhan)
45
uric acid underexcretion
renal fialure lead drugs (diuretics, SA, TB, cyclosporin) idiopathic
46
EtOH and gout
xs EtOH --> inc urate production --> dec urate excretion due to lactic acid
47
gout <30 y/o, suspect
enzyme defect in purine metab
48
Tophi
acid crystals that can be found in joints, bursae, tendons, and extensor surfaces of forearms, as well as in the pinna of the ear, and rarely other tissues such as cornea, sclera, and heart valves
49
all non-allergic pt w/ tophi should take an
XO inhibitor
50
pathogenesis of gout
phagocytosis of uric acid crystals by PMNs witin the synovial fluid --> initiates inflammatory cascade --> WBC recruitment and release of lysosomal enzymes, IL-1, and TNF
51
T/F high dose aspirin contributes to gout occurrence
F low dose aspirin = uric acid retaining in kidney
52
high dose aspirin ____ renal excretion of uric acid
promotes
53
lead and gout
lead poisoning --> decreased renal excretion of uric acid --> decrease the solubility of uric acid in the joint space, causing the precipitation of uric acid crystals
54
conditions w/ inc cell turnover leading to gout
leukemia lymphoma psoriasis polycythemia
55
chondrocalcinosis
linear calcifications in the cartilage seen in X-rays of affected joints with “pseudogout”
56
OA flare wbc
non-inflammatory <2000
57
low joint glucose
septic arthritis | RA
58
moonshine
lead --> gout --> renal underexcretion of uric acid
59
uric acid exposure induces...
``` lysosomal enzymes TNF IL-1 mast cell activation complement PMN oxidative burst ```
60
CPPD associated conditions
``` hypERparathyroidism hemochromatosis hypOMg hypOphosph familial hypOcalciuric hypERcalcemia ```
61
CPPD - acquired or inherited?
usually sporadic, can be inherited AD
62
gout closely linked to
``` hypERtriglyceridemia low HDL-CHL insulin resistance obesity HTN ```
63
Hyperparathyroidism and hemochromatosis lead to
CPPD
64
T/F TMJ is frequently experienced by patients with Fibromyalgia.
T
65
fibromyalgia abnormalities in central pain processing
dec NE dec serotonin inc substance P
66
MRI of Fibromylagia pts has shown increased BF to the __ and __, two pain-sensitive areas of the brain.
Amygdala and Anterior Insula
67
T/F NSAIDS are helpful in fibromyalgia
F
68
shown to improve overall fibromyalgia outcome
exercise and tricyclics
69
T/F The HLA-DR4 alleles are seen w inc freq in fibromyalgia
F
70
Polymorphisms seen with increased frequency in fibromyalgia
5HT COMT DA
71
An example of a chronic strain injury is
carpal tunnel syndrome
72
Chronic strain injuries are characterized by chronic degenerative changes in ____ structure reflecting failed healing resonses and scarring
cartilage
73
JIA has an onset before y/o
16 y/o
74
JIA peak onset
1-3 y/o
75
Overall, JIA is more common in M or F
F exceptions: systemic, enthesitis-related
76
most frequent rheumatic disease of children
JIA
77
ANA in systemic onset JIA
negative
78
clinical labs for MAS
dec ESR dec wbc dec PLT
79
T/F ibuprofen is a disease-modifying NSAID used in JIA
F only relieves pain/inflamm
80
dx criteria SLE
molar rash photo sensitivity arthritis cerebritis
81
The classification system for Lupus Nephritis is based upon...
histopathologic findings of renal glomeruli in SLE | NOT GFR
82
T/F anti-smith correlates well with level of lupus activity
F very specific but doesn't correlate w/ activity
83
hormonal fx in lupus pathogenesis
higher estrogen, greater risk of developing SLE *klinefelter's males at risk (XXY)
84
C3 C4 levels in SLE
low, indicate complement consumption from active lupus
85
anti-scl-70
found in pt w diffuse disease and assoc w scleroderma renal crisis
86
+ ANAs | anti-centromere abs
CREST syndrome
87
anti-mitochondrial Abs
pillory primary cirrhosis

Emma Rheumatology (8 decks)

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