Musculoskeletal: 4. Leech : Diseases Of The Joints

Front 1

Osteoarthritis vs. Rheumatoid Arthritis

Wear and tear

Back 1

OA

Front 2

Osteoarthritis vs. Rheumatoid Arthritis

Systemic autoimmune disease

Back 2

RA

Front 3

Osteoarthritis vs. Rheumatoid Arthritis

Degeneration of articular cartilage

Back 3

OA

Front 4

Osteoarthritis vs. Rheumatoid Arthritis

Synovial proliferation

Back 4

RA

Front 5

Osteoarthritis vs. Rheumatoid Arthritis

Weight-bearing joints
Knees, hips, spine

Back 5

OA

Front 6

Osteoarthritis vs. Rheumatoid Arthritis

Small joints
Hands and feet

Back 6

RA

Front 7

Osteoarthritis vs. Rheumatoid Arthritis

Symmetry?

Back 7

OA: Asymmetrical

RA:Symmetrical and migratory

Front 8

what is the most common from of arthritis?

Back 8

Osteoarthritis

Front 9

What is crepitus?

Back 9

creaking of old joints

Front 10

Insidious onset of joint stiffness
Deep, aching joint pain, which worsens with repetitive motion
Decreased range of motion
Crepitus
Joint effusions and swelling
Osteophytes may cause nerve compression

are all seen in?

Back 10

Osteoarthritis

Front 11

describe chondroctye injury in Osteoarthritis

Back 11

if you injure the condrocyte, it will never come back, the cartilage is gone

Front 12

what are some of the leading predisposing factors for Osteoarthritis

Back 12

obesity, previous joint injury, ochronosis, diabetes, trauma, and hemarthrosis

Front 13

in Osteoarthritis are you going to see both the left and the right hip experiencing problems?

Back 13

not normally, it is usually asymmetrical

Front 14

what is Eburnation

Back 14

wearing away of the bone

Front 15

what are Heberden nodes? what are they seen in?

Back 15

osteophytes at the distal interphalangeal (DIP) joints

Osteoarthritis

Front 16

what are Bouchard nodes? what are they seen in?

Back 16

osteophytes at the proximal interphalangeal (PIP) joints

Osteoarthritis

Front 17

what population is going to be more greatly affected by autoimmune diseases such as RA?

Back 17

WOMEN

Front 18

what is the genetic predisposition seen in RA?

Back 18

HLA-DR4 and DR1

Front 19

Morning stiffness that improves with activity is associated wtih what?

Back 19

RA

Front 20

if a 35 year old female comes in with symmetrical pain in the hands and wrists came in, what would you think maybe?

Back 20

RA

Front 21

Fusiform swelling, redness, and warmth of the proximal interphalangeal (PIP) joint is characteristic of?

Back 21

RA

Front 22

Diffuse proliferative synovitis is seen in what?

Back 22

RA

Front 23

what is Pannus formation and what is it seen in?

Back 23

proliferation of the synovium and granulation tissue over the articular cartilage of the joint

seen in RA

Front 24

an IgM autoantibody against the Fc fragment of IgG would be an example of what?

Back 24

Rheumatoid factor (RF)

Front 25

how are RF titer and the degree of the disease related

Back 25

the worse the disease the more severe the arthritis

Front 26

Back 26

COOKASS

Front 27

man comes in with problems in the SI joint and spine. He also has signs of inflammatory bowel disease. He is HLAB27 positive.. what does he have?

Back 27

Ankylosing spondylitis

Front 28

again...what is the triad of Reiter's syndrome... what HLA would be positive?

Back 28

Classic triad: conjunctivitis, urethritis, arthritis

Associated with HLA-B27 (90%)

Front 29

this disease Occurs in 10-20% of patients with ulcerative colitis
May develop peripheral arthritis or spondylitis
May respond with treatment of the ulcerative colitis
Associated with HLA-B27

what is it?

Back 29

Enteropathic arthritis

Front 30

what is Suppurative arthritis

Back 30

purulent invasion of a joint by an infectious agent which produces arthritis

Front 31

if you aspirated fluid from the joint of a suppurative arthritis, what would you expect to see? 3

Back 31

Cloudy synovial fluid that clots readily

High neutrophil count

Positive Gram’s stain and culture in 50-70% of cases

Front 32

given the following peak age of incidence and the gram stain appearance, what does the pt have?

Children
Gram negative coccobacilli

Back 32

Hemophilus influenzae

Front 33

Young Adults
Gram negative diplococci

Back 33

Neisseria gonorrheae

Front 34

given the following peak age of incidence and the gram stain appearance, what does the pt have?

Children & young adults with sickle cell anemia

Gram negative rods

Back 34

Salmonella

Front 35

given the following peak age of incidence and the gram stain appearance, what does the pt have?

Adults
Gram positive cocci in clusters

Back 35

Staphylococcus aureus

Front 36

given the following peak age of incidence and the gram stain appearance, what does the pt have? 2

Adults
Gram negative rods

Back 36

Escherichia coli

or
Pseudomonas

Front 37

what causes lyme disease? (not tics, but the actual cause)

Back 37

Spirochete: Borrelia burgdorferi

Front 38

what is gout?

Back 38

hyperuricemia and deposition of monosodium urate crystals in joints, resulting in recurrent bouts of acute arthritis

Front 39

what causes gout?

Back 39

Overproduction or underexcretion of uric acid

Front 40

a patient has an inflammed big toe and says it is exquisitely painful

what is this?

Back 40

gout

Front 41

you have fluid you aspirated, but can't remember what it was from. You look and see neutrophils and needle-shaped uric acid crystals. What did this patient have?

Back 41

gout

Front 42

What does this patient have?

Back 42

GOUT

Front 43

if your patient has deposition of calcium pyrophosphate crystals what do they have?

Back 43

Pseudogout (chondrocalcinosis)

Front 44

Positively birefringent (weak), rhomboid-shaped crystals

are characteristics associated with?

Back 44

Pseudogout (chondrocalcinosis)

Front 45

what joint is most commonly involved in Pseudogout (chondrocalcinosis)

Back 45

Knee joint most commonly involved

Front 46

what type of tumor presents with

Up to 1.5 cm
Joint capsule or tendon sheath
No communication with joint space

Back 46

Ganglion

Front 47

you will see this secondary to
Herniation of synovium through a joint capsule
Massive enlargement of a bursa

Back 47

Synovial cyst

Front 48

this tumor is described as
True neoplasm – not reactive lesion
Monoarticular – knee in 80%
Pain, locking, swelling, decrease ROM

what is it?

Back 48

Pigmented Villonodular Synovitis (PVNS)

Front 49

describe a Giant cell tumor of tendon sheath

Back 49

Slow growing & painless
Solitary lesion of wrist or finger

Front 50

where do Synovial Sarcomas occur?

Back 50

60 - 70% lower extremities


Origin unclear

< 10% are really in the joint

20 - 40 year old