Pathology Mesodermal

Front 1

Osteoarthritis what occurs in osteoarthritis?

Back 1

mechanical wear and tear of the joints, leads to destruction of the articular cartilage, subchondral bone formation, sclerosis, osteophytes, eburnation, Herberden's nodes (DIP), and Bouchard's nodes (PIP)

Front 2

Osteoarthritis classical presentation of osteoarthritis?

Back 2

pain in weight bearing joints after use (worse at the end of the day0 improves w/ rest. No systemic symptoms

Front 3

Rheumatoid Arthritis : what happens in in RA?

Back 3

autoimmune inflammatory proccess which affects synovial joints, w/ pannus formation in joints (MCP, PIP), S-Q rheumatoid nodules, ulnar deviation,subluxation

Front 4

Rheumatoid Arthritis : classical presentation of RA?

Back 4

female, 80% pts Rf positive (anti-IgG Ab) morning stiffness improving w/ use, symmetrical joint involvement, and systemic symptoms (fever, fatigue, pleurtis, pericarditis)

Front 5

What is the classic triad of Sjogren’s syndrome?

Back 5

dry eyes (conjunctivitis, xeropthalmia), dry mouth (dysphagia, xerostomia), arthritis

Front 6

What is SICCA syndrome?

Back 6

dry eyes, dry mouth, nasal and vaginal dryness, chronic bronchitis, reflux esophagitis

Front 7

T/F Sjogren’s syndrome predominantly affects males between 40 and 60 years of age.

Back 7

False. Females between 40 and 60 y.o are predominantly affected in Sjogren’s syndrome.

Front 8

T/F Gout is the precipitation of monosodium urate crystals into joints due to hyperuricemia.

Back 8

TRUE

Front 9

What is the favored manifestation of gout?

Back 9

Podagra. (painful MTP joint)

Front 10

The crystals of gout are:

Back 10

needle shaped and negatively bifringent

Front 11

T/F Pseudogout is the precipitation of calcium pyrophosphate crystals within the joint space.

Back 11

TRUE

Front 12

The crystals of psuedogout are:

Back 12

basophilic, weakly positively birefringent, rhomboid crystals

Front 13

Psudogout usually affects:

Back 13

Large joints (classically the knee)

Front 14

T/F Both gout and psuedogout predominantly affect men.

Back 14

False. Gout is more common in men. Pseudogout affects both sexes equally, most pts are >50 years old.

Front 15

T/F The treatment for both pseudogout and gout is allopurinol, probenecid, colchicines, and NSAIDS.

Back 15

False. That is the tx for gout. However, there is no tx for pseudogout.

Front 16

Celiac sprue is the autoimmune-mediated intolerance of what substance, leading to steatorrhea?

Back 16

gliadin (wheat)

Front 17

T/F Findings in Celiac sprue include blunting of villi, neutrophils in the lamina propria, and abnormal D-xylose test.

Back 17

False. lymphocytes, not neutrophils are found in the lamina propria.

Front 18

What drugs can produce a SLE-like syndrome that is commonly reversible?

Back 18

HIPP: Hydralazine, INH, Phenytoin, Procainamide

Front 19

SLE causes LSE. What is LSE?

Back 19

Libman Sacks Endocarditis. Valvular vegetations found on both sides of valve (Mitral Valve Stenosis) and do not embolize.

Front 20

T/F 90% Systemic lupus erythematousus pts are female between ages 14 and 45. SLE is most common and severe in black females.

Back 20

Both statements are true

Front 21

What are 4 lab tests in SLE? Which test, when positive is predictive of a poor prognosis?

Back 21

1. ANA (antinuclear antibodies)- sensitive, not specific for SLE 2. anti-ds DNA (antibodies to double stranded DNA)- very specific, poor prognosis 3. Anti-Smith antibodies (anti-Sm)- very specific, but not prognostic 4. Antihistone antibodies- drug induced lupus

Front 22

In what organ are wire loop lesions found in SLE?

Back 22

kidney (with immune complex deposition and nephrotic syndrome)

Front 23

What causes death commonly in SLE?

Back 23

Renal failures and infections

Front 24

What are symptoms of SLE?

Back 24

fever, fatigue, wt loss, joint pain, malar rash, photosensitivity. Also: pleuritis, pericarditis, nonbacterial verrucous endocarditis, Raynaud’s phenomenon

Front 25

What disease is characterized by gamaglobulinemia, rheumatoid arthritis, ace increase, interstitial fibrosis, and noncaseating granulomas?

Back 25

Sarcoidosis

Front 26

Name 2 seronegative spondyloarthropathies.

Back 26

ankylosing spondylitis, reiters’ syndrome

Front 27

What is a seronegative spondyloarthropathy?

Back 27

Arthritis without rheumatoid factor (no anti-IgG Ab). Strong association with HLA-B27 (gene that codes for HLA MHC1)

Front 28

T/F seronegative spondyloarthropahties occur more often in males

Back 28

TRUE

Front 29

What is the classic triad for Reiter’s syndrome?

Back 29

Urethritis, conjunctivitis and anterior uveitis, arthritis. “Can’t see, can’t pee, can’t climb a tree”

Front 30

T/F reiter’s syndrome occurs commonly post respiratory or chlamydia infections.

Back 30

False. Post-GI or chlamydia infections

Front 31

Describe ankylosing spondylitis

Back 31

Chronic inflammatory disease of spine and sacroiliac joints. Ankylosis (stiff spine), uveitis and aortic regurg.

Front 32

T/F Crest syndrome is wider-spread than diffuse scleroderma.

Back 32

False. Diffuse scleroderma has widespread skin involvement, rapid progression, early visceral involvement. CREST syndrome has limited skin involvement, often confined to fingers and face. More benign clinical course.

Front 33

what does CREST stand for?

Back 33

False. CREST= calcinosis, raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia.

Front 34

What antibodies are associated with scleroderma (progressive systemic sclerosis- PSS)?

Back 34

"diffuse scleroderma- anti-Scl-70 antibody; CREST--anticentromere

Front 35

T/F Pemphigus vulgaris is described as an autoimmune disorder with IgG antibody against epidural basement membrane (linear immunofluorescence). Affects skin but spares oral mucosa.

Back 35

False. That description is for Bullous pemphigoid (less severe disease than Pemphigus vulgaris). Pemphigus vulgaris is a potentially fatal autoimmune skin disorder. Intradermal bullae involve the oral mucosa and skin. Findings include acantholysis, IgG ab against epidermal cell surface.

Front 36

T/F Dermatitis is a group of inflammatory pruritic skin disorders. The etiology is allergy (usually type IV hypersensitivity), chemical injury, or infection.

Back 36

TRUE

Front 37

What HLA groups are associated with psoriasis?

Back 37

HLA-B27, HLA-13, HLA-17

Front 38

What is psoriasis? Where is it most commonly found?

Back 38

Psoriasis is nonpruritic chronic inflammation of the skin, particularly on the knees and elbows.

Front 39

T/F Goodpasture’s syndrome affects the lungs and liver.

Back 39

False. Lungs and Kidneys. (Pulmonary hemorrhagesà hemoptysis, renal lesionsà hematuria, anemia, crescentic glomerulonephritis)

Front 40

What type of Abs are associated with Goodpastures?

Back 40

anti-glomerular basement membrane abs produce linear staining on immunofluorescence.

Front 41

Who commonly gets Goodpastures?

Back 41

Men between 20-40 years.