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15 Cards in this Set
- Front
- Back
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What is the threshold cellularity before synovial fluid is considered inflammatory?
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greater than 2000 cells/mL
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Up to how many cells can normal synovial fluid contain?
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180 cells/mL
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What joint is most commonly effected in pts with gout?
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1st metatarsophalangeal joint (hallux)
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What are normal uric acid levels in men and women? At what level do you risk acute gout?
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men: 3-7
women: 2-6 You risk acute gout attacks at >10 |
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What is the effect of urate crystals precipitating in the joints?
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Stimulates complement activation which is chemotactic. PMNs show up to phage the crystals, they lyse when they try to phage, releasing lysosomal enzymes, LTB4, prostaglandins, and free radicals that damage the surrounding tissue.
Macrophages release interleukins that stimulate the same processes and also stimulated the release of proteases from the synovium, causing more tissue damage. |
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How is monosodium urate identified in the lab?
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Under special polarized light it will appear as a yellow needle like crystal when parallel to the slow ray. This is negatively birefringent.
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How is calcium pyrophosphate identified in the lab?
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Under special polarized light it will appear as a blue rhomboid-like crystal when parallel to the slow ray. This is positively birefringent.
These crystals are coffin shaped (rhomboid). |
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The presence of rhomboid, coffin-shaped, crystals in the synovial fluid indicates ________ .
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pseudogout
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Pt with pain in both knees, tired, with right inguinal adenopathy. Has had a tick bite that left a red spot that lasted a long time. What does he have? What causes it?
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Lyme disease caused by Borrelia burgdorferi.
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What is stage one of lyme disease?
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erythema migrans.
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What is this? What causes it? When will it fade?
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Lyme disease erythema migrans
Caused by Borrelia burgdorferi Will fade in 3-4 weeks Look for bull's eye appearance. |
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What are the characteristic clinical features of stage 2 lyme disease? How long can this last?
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Meningitis
Facial palsy Arthritis of large joints (knees) Appearance of IgM, followed by IgG Will last weeks to months. |
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When is it most likely to get a false negative screen for a pt with lyme disease?
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Early
Within the first weeks |
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What can cause false positive screens for lyme disease?
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Syphilis
Rocky mountain spotted fever Autoimmune conditions Neuro disorders |
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What is the major risk factor associated with infection with Borellia?
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Duration of deer-tick attachment
72 hours is the critical time. Ticks attached for 72hrs have a 20x higher transmission rate. |
