Shared Flashcard Set

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Med Surg: Rheumatology Test 1
Winter Semester - 2011
44
Medical
Graduate
01/30/2011

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Cards

Term
What is the hallmark of anklyosing spondylitis?
Definition
Sacroilitis
Term
What are extra-articular symptoms of ankylosing spondylitis?
Definition
Uveitis
Skin Rash
Bowel disease
Aortitis
Apical Pulmonary Scarring
Term
What are some additional S&S to help diagnose ankylosing spondylitis?
Definition
Elevated ESR or CRP
+HLA B-27
Diminished chest excursion
Limited spinal ROM + Schober’s test
Term
What is seen on oblique x-ray with AS?
Definition
Sclerosis on SI joints
Syndesmophytes
Bamboo spine
Term
What is the best treatment for AS?
Definition
NSAIDs – Indocin
Term
What comes first: the skin diseases or joint disease in psoriatic arthritis?
Definition
Skin disease in 85%
Term
How will psoriatic arthritis present?
Definition
One or more of: fatigue, tenderness, pain and swelling over tendons; swollen fingers and toes; stiffness, pain, throbbing, swelling and tenderness in one or more joints; reduced ROM, morning stiffness and tiredness, nail changes, redness and pain of the eye
Term
What are the subtypes of psoriatic arthritis?
Definition
Asymmetric olioarthritis with dactylitis
RA-like polyarthritis
Distal interphalangeal
Spondylitis
Arthritis Multilans
HIV related
Term
How can psoriatic arthritis mimic RA?
Definition
Polyarticular
Term
What deformity can be seen on x-ray with psoriatic arthritis?
Definition
Pencil in cup – bone erosions at the distanl phalanx
Term
What test should you get in a male with new onset psoriatic arthritis?
Definition
HIV test
Term
What meds are used to treat psoriatic arthritis?
Definition
NSAIDs (can make skin worse)
DMARDs – MTX
Biologics – TNF inhibitors
Term
What is the triad of sx for Reiter’s syndrome?
Definition
Oligoarthritis
Urethritis
Conjunctivitis
Term
In general, how does reiter’s syndrome present?
Definition
Lesions of the skin and mucous membranes
Term
What tests do you do for Reiter’s syndrome?
Definition
Joint and SI x-ray
U/A
Urethral/cervical swab for Chlamydia
Stool culture
HLA-B27
HIV
Term
What are the characteristics of Parvovirus B19?
Definition
Transient generalized rash
Small joint swelling – usually symmetrical
Resolves in 2-4 weeks
IgM parvovirus titers positive
Non-erosive
Term
What can Enteropathic arthropathies be linked to?
Definition
Inflammatory bowel disease (IBD)
Bacteria
Parasites
Other GI pathologies
Term
What is the treatment of IBD?
Definition
Surgery – alleviates the pain of peripheral arthritis
Term
What may be helpful in enteropathic arthropathies to treat peripheral sx?
Definition
Corticosteroids
Term
What is another group of medicine that is FDA approved for IBD and arthritis?
Definition
TNF antagonists
Term
Which type of cartilage lines joints?
Definition
Hyaline
Term
Which type of cartilage forms syndesmoses like the pubic synthesis?
Definition
Fibrin
Term
Which type of cartilage is found in the ligamentum nuchae of the C-spine?
Definition
Elastin
Term
When do alk phos levels rise?
Definition
With bone disease
Term
What is the chief structural component of bone?
Definition
Hydroxyapetite
Term
Where does osteoarthritis "attack"?
Definition
attacks the cartilage than works its way out
Term
Where does avascular necrosis "attack"?
Definition
cartilage
Term
What is the function of the synovial membrane?
Definition
synovial membrane
Term
Where does RA attack?
Definition
targets the synovium and works its way into the joint space
Term
What is an enthesis?
Definition
where the tendon attaches to the bone
Term
What disease attacks the enthesis?
Definition
Ankylosing Spondylitis
Term
Which type of joint has no movement? What are some examples?
Definition
Fibrous (Synarthroidial)
Examples - Cranium, Distal Tib/Fib
Term
Which type of joint has minimal movement? What are some examples?
Definition
Cartilignous (amphiarthroidial)
Costochondral joints, pubic synthesis, spine
Term
Which type of joint is freely movable?
Definition
Synovial (diarthroidial)
Term
What are the type of crystals found in gout?
Definition
Monosodium urate, needle-like negatively (yellow) birefringent
Term
What type of crystals are found in pseudogout?
Definition
Calcium pyrophosphate (short, rhomboid positively blue birefringent)
Term
Which fluid type appears yellow, clear, and has a cell count of 200 - 2,000?
Definition
Non-Inflammatory Type I
Term
Which type of joint fluid is yellow, cloudy, and has a cell count of 2,000 - 75,000?
Definition
Inflammatory Type II
Term
What type of joint aspirate is described as purulent, opaque, has a cell count of greater than 60,000 and has greater than 80% of PMN?
Definition
Septic Type III
Term
What type of diseases can cause Non-Inflammatory Type I joint aspirate?
Definition
Osteoarthritis
Trauma
Osteonecrosis
SLE
Term
What type of diseases can cause Inflammatory Type II joint aspirate?
Definition
RA
Reiter's Syndrome
Crystal Arthritis
SLE
Viral Arthritis
Fungal Arthritis
TB Arthritis
Term
What type of diseases can cause Septic Type III joint aspirate?
Definition
Bacterial Arthritis
Crystal Arthritis
Term
What are some causes of Hemorrhagic Type IV joint aspirate?
Definition
Trauma
Fracture
Ligament Tear
Hemophilia
Charcot Arthritis
PVNS
Term
What is Anti-CCP a predictor of?
Definition
Excellent predictor of RA
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