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32 Cards in this Set
- Front
- Back
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What are the #1 Cardinal sign of inflammation?
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1. Calor (heat)
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What are the 12 "S's" of RA?
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1. Synovitis 2. Swelling 3. Sex - F
4. Synovial effusions 5. Stiffness 6. Symmetry 7. Serology 8. SED rate 9. SubQ nodules 10. Systemic involve 11. Spinal involve 12. Six weeks |
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Psoriatic Synovitis
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-skin lesions consistent w/ psoriasis
-very crippling phenomenom 1. Erythema 2. Soft Tissue swelling 3. "Sausage" digits 4. Nail changes |
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Pustular synovitis
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-infx of the synovial space
-vesicles and pustules -gonococcal arthritis -in gonococcal dermititis arthritis synd you have bacteremia and septicemia |
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Septic olecranon bursitis
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-NO joint involvement
-will see low glucose b/c the "bug" (staph) is eating the glucose in the joint fluid -High SED rate indicates very severe inflammation process |
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Where are Bouchards nodes located?
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- At the PIP
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Where are Heberden's Nodes located?
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- At the DIP
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What are 3 sources of Rheumatic symptoms?
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1. Soft Tissue Disorders (outside of jt) (bursitis/tendonitis)
2. Arthritis (w/in the joint) 3. Bone disorders (trauma/metabolic) *these can co-exist! |
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What are 3 examples of inflammatory arthritis?
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-RA
-SLE -Psoriatic arthritis |
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What are characteristics of arthritis?
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1. Inflammation (varying degree)
2. All motion (passive/active) causes pain 3. Pain generalized around joint 4. Decreased ROM |
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What are the routine arthritis screening tests?
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1. Acute phase reactants
-SED rate increases w/ inflamm -CRP: elevated to indicate tissue dam and inflammation 2. Rheumatoid Factor (RF) (85%) 3. Antinuclear Abs (ANA) |
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Children w/ juvenile RA are negative w/ what screening test?
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RF
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ANA Patterns:
Homogenous |
Nuclear Ag: Histone/DNA
Clinical assoc: SLE, drug effect |
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ANA Patterns:
Speckled |
Nuclear Ag: Saline/Extractable NA
Clinical assoc: mixed CT disease (MCTD), SLE, Sjogen's disease poly/dermatomyositis |
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ANA Patterns:
Nucleolar |
Nuclear Ag: RNA assoc Ags
Clinical assoc: Schleroderma |
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ANA Patterns:
Peripheral (RIM) |
Nuclear Ag: DNA
Clinical assoc: SLE |
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ANA patterns:
Centromere |
Nuclear Ag: Centromere
Clinical assoc: CREST syndrome (limited scleroderma) |
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Special arthritis tests
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1. C levels (CH50 and C3/C4)
2. HLA test (B27; D locus alleles) 3. Antineutrophil cytoplasmic Ab (ANCA) 4. Cryoglobulins 5. Lyme titers |
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What could hemarthrois (blood in fluid of joint) indicate?
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-trauma, bleeding disorders
-villonodular ynovitis -pyrophosphate arthropathy -charcot joint -resolving infx -contamination during aspiration |
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Synovial Effusions: Classification
Normal Fluid |
-clear, colorless, viscous
-leukocytes/mm2: <200 (<25% PMNs) |
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Synovial Effusions: Classification
Noninflammatory |
-clear yellow, viscous
Leukocytes -200-2000 (<25% PMNs) |
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Synovial Effusions: Classification
Inflammatory |
Cloudy, yellow, watery, glucose may be low
Leukocytes 2000-100,000 (>50% PMNs) |
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Synovial Effusions: Classification
Septic**** |
-purulent, glucose very low
Leukocytes >80,000 (>75% PMNs) |
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Group 1: Noninflammatory Effusions
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-OA, early RA, trauma
-osteopchondritis dissecans -osteonecrosis -sickle cell -*chronic/subsiding crystal synovitis -lupus, vasculitis, scleorderma, amyloidosis, hypothyroidism |
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Group 2: Inflammatory Effusions
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-RA, Reiter's syndrome
-*Acute crystal synovitis -psoriatic arthritis, IBS arthritis -Ankylosing spondylitis -rheumatic fever, juvenile arthritis -Behcat's sydndrome |
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Group 3: Septic Synovial Fluid
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-Bacterial infx
-Fungal infx -Mycobacterial infx -Actue crystal synovitis *can destroy jt w/in 24hrs |
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Crystals found in synovial fluid:
Monsodium urate monohydrate |
-acute gout
-Tophaceous gout -asymptomatic |
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Crystals found in synovial fluid:
Calcium pyrophosphate dihydrate |
-acute pseudogout
-destructive arthropathy -asymptomatic |
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Crystals found in synovial fluid:
Basic calcium phosphate |
-acute calific periarthritis
-acute arthritis -Destructive athropathy |
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Crystals found in synovial fluid:
Calcium oxalate |
-acute/subacute arthritis
-asymptomatic *pts on dialysis |
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Urate crystals
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-Gout
-look like spears -negative birefringence |
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Calcium pyrophosphate crystals
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-psuedogout
-looks like rhomboids or little houses -positive birefringence |
