Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
most serious cause of acute monoarthritis?
|
non-gonococcal bacterial infxn (staph and strep!!)
|
|
|
most common way of (non-gonoc) bacterial spread to joint?
|
hematogenous
|
|
|
classic triad of gonococcal infection
|
1) migratory tenosynovitis 2) vesiculopustular skin lesions, 3) oligoarthralgia
|
|
|
XR findings in chronic gout
|
oval/round peri/intra-articular bony erosions with sclerotic margin ("rat bite lesions"
|
|
|
what is chondrocalcinosis?
|
degenerative joint disease characterized by accumulation of calcium pyrophosphate crystals in/near articular tissues
|
|
|
3 kinds (?) of chondrocalcinosis
|
pseudogout (not as bad as gout); pseudo-osteoarthritis (usually knees, symmetric); pseudorheumatoid arthritis
|
|
|
lab findings of chondrocalcinosis
|
arc rod shaped often intracellular calcium pyrophosphate dihydrate (CPPD) crystals, positively birefringent (vs gout--neg)
|
|
|
pathogenesis of RA?
|
chronic autoimmune mediated primarly by T lymphocytes aginst synovium (similar to type IV)
|
|
|
7 Diagnostic criteria for RA
|
1. morning stiffness >1hr, 6wks+ 2. swelling 3+jnts simultaneously 3. swelling of wrist, MCP, PIP 4. symmetric swelling 5. hand XR changes (erosions/demineralization); 6. subQ nodules 7. anbl RF or anti-CCP
|
|
|
lab characteristic for RA (8)
|
inc'd ESR, anemia, thrombocytosis, WBC nl or slight inc'd, hypergammablogulinemia/hypocompletementemia, RF, aCCP, inc'd WBC in synovial fluid
|
|
|
RA in nervous system
|
myelopathy!!, mononeuritis multiplex, n. entrapment (carpal tunnel)
|
|
|
DDx of RA
|
other CT d/o (Sjogren's!), sarcoidosis, SBE, chronic polyarticular gout
|
|
|
urate level goal of gout treatment?
|
sr urate <5-6mg/dL
|
|
|
treatment of choice for acute gout
|
NSAIDs, esp. indomethacin (inhibit PG synthesis and urate crystal phagocytosis)
|
|
|
major adverse effect of colchicine?
|
diarrhea
|
|
|
MOA of colchicine
|
inhibits microtubules and somehow this leads to inhibition of leukocyte migration and phagocytosis ; also inhibits LTB4
|
|
|
indication for colchicine use in gout?
|
for those who can't take NSAIDs; good for prevention but can't give to people with renal/heart problems
|
|
|
what are uricosuric agents?
|
increase urinary excretion of uric acid. Ex: probenecid, sulfinpyrazone
|
|
|
major side effect of probenecid?
|
GI irritation. Also, allergic dermatitis. (rarely, aplastic anemia)
|
|
|
MOA of allopurinol?
|
inhibits xanthine oxidase
|
|
|
categories of RA treatment
|
NSAIDS, DMARDS--anti inflamm, immunosuppress, cytokine tx (TNFalpha inhib), corticosteroids
|
|
|
what is enthesitis?
|
inflammation of tendon/ligament insertion site
|
|
|
gene associated with seronegative spondyloarthropathies
|
HLA B-27
|
|
|
XR features of AS?
|
BILATERAL sacroiliitis, squaring of lumbar vert bodies, symmetic marginal syndesmophytes, bamboo spine, fusion of facet joints
|
|
|
triad of Reiter's syndrome/reactive arthritis
|
1.urethritis 2. conjunctivitis 3. arthritis
|
|
|
sausage digits possibly seen in which seronegatives?
|
Reiter's and psoriatic
|
|
|
how is Reiter's different from AS on XR?
|
Reiter's: ASYMMETRIC sacroiliitus, ASYMMETRIC syndesmophytes, involvement of upper spine is LESS common
|
|
|
possible mucocutaneous manifestations of Reiter's syndrome?
|
painless oral ulcers, psoriasis-like rash on feet (keratoderma blennorrhagicum), circinate balanitis
|
|
|
5 clinical pattersn of psoriatic arthritis
|
1. oligoarthritis (most common) 2. pseudorheumatoid polyarthritis 3. axial involvement (like Reiter's) 4. arthritis mutilans 5. DIP involvement with nail pitting/dystrophy
|
|
|
Which seronegatives show SYMMETRIC sacroiliitus?
|
AS and arthritis assoc'd with IBD (sxs do NOT parallel bowel dz activity unless it's the peripheral joint involvement)
|
|
|
Best treatment for axial involvemtn of seronegatives?
|
TNFalpha inhibitors
|
