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93 Cards in this Set

  • Front
  • Back
Monosodium urate crystals (MSU):
yellow when parallel to slow ray of compensator
Calcium pyrophosphate crystals (pseudogout):
blue when parallel to slow ray of compensator
degeneration articular cartilage; subchondral cysts; eburnation; osteophytes at margins
Joints involved in OA
weight bearing (femoral head); DIP joint (Heberden's nodes), PIP joints (Bouchard nodes)
Neuropathic joint
2° to neurologic disease: DM, syringomyelia, tabes dorsalis
Rheumatoid arthritis (RA):
female dominant; HLA Dr4
RF for rheumatoid arthritis
IgM antibody against Fc portion IgG; causes inflammation of synovial tissue
inflamed hyperplastic synovial tissue destroys articular cartilage; joint fusion
Joints involved in RA
MCP and PIP joints
S/S of RA
morning stiffness; ulnar deviation of hands; carpal tunnel (entrapped median nerve)
Rx for RA
methotrexate often used as initial therapy, aspirin
Sjogren's syndrome
destruction lacrimal and minor salivary glands; RA; anti-SSA/SSB
S/S of Sjogren's syndrome
dry eyes and dry mouth
Caplan syndrome
pneumoconiosis + rheumatoid nodules in lungs
Felty's syndrome
RA + splenomegaly with hypersplenism
Gouty arthritis
underexcretion uric acid; big toe first affected; tophus in soft tissue sign chronic gout
Gout associations
alcohol, Pb poisoning
MSU (monosodium urate) crystals produce foreign body giant cell reaction next to joint
Uricosuric agents
probenecid and sulfinpyrazone
dec synthesis uric acid; xanthine oxidase inhibitor
involves knee; linear calcification in articular cartilage
Ankylosing spondylitis
HLA-B27 seronegative (RF negative) spondyloarthropathy; male dominant
S/S of Ankylosing spondylitis
sacroiliitis; bamboo spine causing kyphosis; aortitis; uveitis
Associations with Ankylosing spondylitis
C. trachomatis MC, psoriasis, ulcerative colitis, Shigella, Campylobacter, Yersinia
Reiter's syndrome
HLA-B27; Chlamydia urethritis; arthritis; conjunctivitis; Achilles tendon periostitis
Osteomyelitis in children
hematogenous spread of Staphylococcus aureus to metaphysic
Osteomyelitis in HbSS
Salmonella paratyphi
Pseudomonas aeruginosa osteomyelitis
puncture of foot when wearing rubber foot wear
Tuberculous osteomyelitis
usually involves vertebra (Pott's disease)
Disseminated gonococcemia
female dominant, C6-C9 deficiency
Disseminated gonococcemia
septic arthritis (knee); tendinitis/synovitis and skin pustules in feet/wrists
Lyme disease
bite from a Ixodes tick; Borrelia burgdorferi; reservoirs white footed mouse, white tailed deer
Early S/S of Lyme disease
: erythematous concentric rash (erythema chronicum migrans), Rx doxycycline
Late S/S of lyme disease
arthritis, Bell's palsy (often bilateral), myocarditis, Rx doxycycline
carried by Ixodes tick; Babesia are intraerythrocytic parasites; hemolytic anemia
Cat bite
potential for Pasteurella multocida septic arthritis
Osgood Schlatter's:
inflammation proximal tibial apophysis at patellar tendon insertion; knobby knee
Osteogenesis imperfecta
AD; dec synthesis type I collagen; pathologic fractures; blue sclera
Blue sclera
reflection of choroidal veins
AD; impaired enchondral calcification and premature closure of epiphyses
S/S of Achondroplasia
normal head/vertebral column, short extremities
AD/AR; osteoclast defect; too much bone; pathologic fractures
dec bone mass and density; pathologic fractures
Postmenopausal osteoporosis
estrogen deficiency- inc osteoclastic activity, dec osteoblastic activity
S/S of osteoporosis
vertebral compression fractures, Colles fracture
Colles fracture
fractured distal radius with dinner fork appearance
Prevention of osteoporosis
estrogen (under investigation), calcium, vitamin D, stress exercises (walking, weight lifting)
Aseptic necrosis femoral head
femoral head fracture, corticosteroids, sickle cell disease; MRI best test
Scaphoid bone fracture
aseptic necrosis in wrist bone
Volkmann's ischemic contracture
fracture of distal radius; damage to brachial artery and median nerve
Legg-Perthe's disease
aseptic necrosis of ossification center (femoral head) in children
Paget's disease
elderly males; lytic/blastic bone lesions produce thick, weak bone
S/S of Paget's disease
pathologic fractures; inc serum AP; inc risk for osteogenic sarcoma
Osteoid osteoma
radiolucent lesion in cortex proximal femur; nocturnal pain relieved by aspirin
Osteogenic sarcoma
adolescent male; RB suppressor gene association; distal femur; inc AP
Radiograph of Osteogenic sarcoma
"sunburst" appearance, Codman's triangle
Ewing's sarcoma
primitive neuroectodermal tumor; round cell tumor
Radiograph of Ewing's sarcoma
"onion skinning"
MC benign bone tumor; exophytic growth off metaphysis of distal femur
MC malignant cartilaginous tumor; pelvic bones, proximal femur
Giant cell tumor
epiphysis distal femur/proximal tibia; giant cells + neoplastic mononuclear cells
Muscle weakness
primary muscle disease, neurosynapse disease, neurogenic disease
Duchenne's muscular dystrophy
XR; deficiency dystrophin; inc serum CK at birth; waddling gait
attaches portions of cell membrane to sarcomere; important in contraction
Becker's dystrophy
XR, defective dystrophin
Myotonic dystrophy
AD; trinucleotide repeat disorder; cannot release grip
Myasthenia gravis
autoantibody against acetylcholine receptors (type II); thymic hyperplasia B cells
S/S of myasthenic gravis
diplopia at end of day first sign; dysphagia solids/liquids upper esophagus; thymoma
Dupuytren's contracture
fibromatosis palmar fascia
MC soft tissue tumor
MC adult sarcoma
MC childhood sarcoma
Embryonal rhabdomyosarcoma
Autoimmune disease
loss of self-tolerance
Serum ANA
greatest sensitivity for detecting SLE
type III reaction; confirm with anti-dsDNA, anti-Sm
S/S of SLE
malar rash, photophobia, joint pain, fibrinous pericarditis, nephritic GN
Drug-induced lupus
procainamide, hydralazine; anti-histone antibodies
Antiphospholipid antibodies
lupus anticoagulant, anti-cardiolipin antibodies; vessel thrombosis
excess collagen; anti-topoisomerase antibodies
S/S of PSS
dysphagia solids/liquids, Raynaud's, intersitial lung disease, renal failure
centromere ab/calcinosis; Raynaud; esophageal dysmotility; sclerodactyly, telangiectasia
inc serum CK; risk of malignancy
Mixed connective tissue disease
anti-ribonucleoprotein antibody
Antibody against acetylcholine receptor
myasthenia gravis
Antibody against basement membrane
Goodpasture's syndrome
Antibody against endomysium and gliadin
celiac disease
Antibody against insulin and islet cell
type I diabetes
Antibody against intrinsic factor and parietal cell
pernicious anemia
Antibody against microsome and thyroglobulin
Hashimoto's thyroiditis
Antibody against mitochondria
primary biliary cirrhosis
Antibody against proteinase 3 of neutrophil (cANCA):
Wegener's granulomatosis
Antibody against myeloperoxidase of neutrophil (pANCA):
microscopic polyangiitis
Antibody against TSH receptor
Graves disease