Block 2 Clinical Systems 4.0 Rheumatology

Front 1

Symmetric
Inflammatory
Polyarthritis

Back 1

What is the classis triad for rheumatoid arthritis?

Front 2

IL-1 and TNF-a activate synovial cells to produce what substances?

Back 2

Prostaglandins and Matrix Metalloproteinases both degrade bone and cartilage. What substances activate them?

Front 3

Name the osteoclast activating factors.

Back 3

TNF-a, IL-1, and lymphotoxin are all ________.

Front 4

Examination of joint fluid in a patient with rheumatoid arthritis would reveal what findings?

Back 4

Presence of WBCs (mostly PMNs), Rheumatoid factor (+), and Anti-CCP Antibody in joint fluid are strong indicators of what disease?

Front 5

What are the diagnostic criteria for Rheumatoid Arthritis?

Back 5

*Morning Stiffness > 1 hr
*Swelling in 3+ Joints
*Swelling in hands
*Symmetric Joint Swelling
*Present for > 6 wks
Rheumatoid nodules/factor
Hand X-ray erosions/ostopenia
4 of these diagnostic features must be met for what disease?

Front 6

What is pannus?

Back 6

Hypertrophic synovium is also known as what?

Front 7

What joint is spared in rheumatoid arthritis?

Back 7

DIP joint is spared in what condition?

Front 8

Testing of rheumatoid nodules will show what 100% of the time?

Back 8

(+) Rheumatoid Factor occurs in tests of what anatomic abnormality 100% of the time?

Front 9

What are the inflammatory eye diseases associated with RA?

Back 9

Scleritis
Scleromalacia
Scleromalacia Perforans

These diseases are often associated with what condition?

Front 10

Sjogren's syndrome is characterized by what?

Back 10

Dry eyes
Dry mouth
Vaginal Dryness
Tracheo-Bronchial Dryness
(+) SS-A (Ro) Ab
(+) SS-B (La) Ab

Are symptoms of what condition associated with RA?

Front 11

Which cytokines are anti-inflammatory?

Back 11

IL-1Ra
sIL-1R1

These cytokines are _______.

Front 12

Describe the epidemiology of rheumatoid arthritis in monozygotic twins.

Back 12

There is a discordance among monozygotic twins in what disease?

Front 13

Monoarthritis is what until proven otherwise?

Back 13

Septic Arthritis often appears in how many joints?

Front 14

The most likely organism involved in adults with septic arthritis is what?

Back 14

N. gonorrhea is the most common organism involved in _____ with septic arthritis.

Front 15

The most likely organism in children with septic arthritis is what?

Back 15

S. aureus is the most common organism involved in ______ with septic arthritis.

Front 16

Septic arthritis is generally caused by what type of organisms?

Back 16

Gram negative bacteria are often the culprit in what condition?

Front 17

How does septic discitis differ from spinal neoplasia?

Back 17

Crossing the disc space is a major indication that you are dealing with ______ and not ______.

Front 18

Patient presents oligoarthritis, fever, rash (pustules on erythematous base), and tenosynovitis. He is young. Blood and synovial cultures are negative (pos is rare). What is the most likely diagnosis?

Back 18

Disseminated Gonococcal Arthritis commonly presents how?

Front 19

Patient presents with intermittent oligoarthritis with large effusions. He has an expanding rash near the knees. What is the most likely diagnosis?

Back 19

Borrelia Borgderferi (Lyme Disease) commonly presents how?

Front 20

Describe the synovial fluid of someone with rheumatoid arthritis?

Back 20

Opaque
Low viscosity
WBC 5-75000
50% PMNs

This is the synovial fluid analysis of which arthritis?

Front 21

Describe the synovial fluid of someone with septic arthritis?

Back 21

Opaque
Low viscosity
WBC > 50000
PMNs > 75%

This is the synovial fluid analysis of a patient with which type of arthritis?

Front 22

Describe the synovial fluid of someone with osteoarthritis?

Back 22

Clear
High viscosity
WBC 200-10000
PMNs < 50%

This is the synovial fluid analysis of a patient with which type of arthritis

Front 23

T.B. (Pott's disease) is associated with what presentation?

Back 23

T10-L2 region has a paraspinal cold abscess. What is the most likely diagnosis?

Front 24

What are the two most common organisms involved in infected joint prostheses?

Back 24

S. aureus and S. epidermidis are the two most common culprits involved in what arthritis?

Front 25

Describe the Hepatitis associated musculoskeletal syndromes.

Back 25

A- transient arthralgias
B- abrubt, systemmic, severe
C- mixed type II, rare

These are the syndromes associated with what organism?

Front 26

What tests rule out the possibility of false (+) with ELISA and confirm the diagnosis of Lyme Arthritis?

Back 26

Western Blot test is used to confirm which type of septic arthritis?

Front 27

Rheumatic Fever can cause arthritis if Jones criteria are met, especially recent infection by what organism?

Back 27

Strep infection is causative of what type of septic arthritis?

Front 28

What is the Classic presentation of Psoriatic Arthritis?

Back 28

DIP arthritis with nail change is _____ presentation for what disease?

Front 29

What is the Common presentation of Psoriatic Arthritis?

Back 29

Assymmetric Oligo/Pauciarthritis is the ______ presentation for what disease?

Front 30

What is the classic triad for Reiter's syndrome (reactive arthritis)?

Back 30

Urethritis
Anterior Uveitis
Conjunctivitis

Are the main symptoms of what arthritis?

Front 31

Seronegative Spondyloarthropathis have a strong association with what factor?

Back 31

HLA-B27 is strongly associated with what group of arthritis?

Front 32

Schober's test is used to diagnose what type of arthritis?

85% of patients have elevated ESR.

Back 32

Ankylosing Spondylitis is often diagnosed based on what positive test?

What blood test is indicative of this condition?

Front 33

What disease usually starts in the vertebrae and SI, chronic progressively limiting back motion/chest expansion, in young adults especially in the morning?

Back 33

Ankylosing Spondylitis usually starts where?

Front 34

Management of psoriatic arthritis includes what?

Back 34

Topical PUVA
Methotrexate etc

Used for what type of arthritis?

Front 35

Psoriatic arthritis often presents with what?

Back 35

Sausage digits are most commonly seen in what type of arthritis?

Front 36

Keratoderma Blenorrhagica is most closely associated with which arthritis?

Back 36

Reactive Arthritis is commonly associated with what skin condition of the feet/hands?

Front 37

Circinate Balanitis is most closely associated with which arthritis?

Back 37

Reactive Arthritis is commonly associated with what skin condition of the penis (STD)?

Front 38

Oral Ulcers are most closely associated with which arthritis?

Back 38

Reactive Arthritis is commonly associated with what skin condition of the mouth?

Front 39

Cool joints are associated with which type of arthritis?

Back 39

Osteoarthritis has what joint presentation?

Front 40

Exacerbation with weather change is a common feature of what type of arthritis?

Back 40

Osteoarthritis is often exacerbated with changes in ______.

Front 41

Which type of arthritis causes difficulty swallowing?

Back 41

Diffuse Idiopathic Skeletal Hyperostosis (DISH) can present with what seemingly unrelated symptom?

Front 42

What is the basic initiating pathology behind osteoarthritis?

Still followed by metalloproteinase degradation.

Back 42

Type II collagen defect fails under normal weight bearing

or

Trauma followed by inadequate repair response and release of degradative enzymes.

Which arthritis?

Front 43

Marginal spurs or osteophytes are commonly seen in which type of arthritis?

Back 43

Osteoarthritis commonly presents with what boney deformity?

Front 44

What are the joints involved in osteoarthritis?

Back 44

*Knee*
Hip
Cervical and Lumbar Spine
1st CMC, PIP, *DIP*
1st MTP