Pbd Quiz/exam: Arthritis And Gout

Front 1

True/False
Synarthrodial joints are the type of joint that are most frequently affected by rheumatoid diseases.

Back 1

False. Synovial joints

Front 2

True/False
Genetic defects in purine metabolism are the most common causes of primary Gout in man.

Back 2

True

Front 3

True/False
Heat exchange occurring as air flow over the nasal mucosa can be in either direction (into or out of) depending on the direction of flow (inhalation vs exhalation).

Back 3

True

Front 5

The degradation and formation of the articulating cartilage (turnover) is maintained by ___________(cell type).

Back 5

Chondrocytes

Front 6

Which of the following statements on osteoarthritis is FALSE?
a. Women are more severely affected then men.
b. The morning stiffness is usually of short duration (less than 30 minutes).
c. Aging is the most important associated factor in the primary form of the disease.
d. In osteoarthritis there is a change in composition and mechanical properties of the articulating cartilage so that there is less water and more proteoglycans.
e. Osteophytes can grow out of margins of the joint.

Back 6

d. In osteoarthritis there is a change in composition and mechanical properties of the articulating cartilage so that there is less water and more proteoglycans.

Front 7

Chronic gout is characterized by the formation of ___________, which are chronic granulomas.

Back 7

tophi

Front 8

____________ is made in cells of the synovial membrane and is responsible for the viscosity of the synovial fluid.

Back 8

hyaluronic acid

Front 9

In rheumatoid arthritis the synovial membrane becomes infiltrated with monocytes and eventually transforms to a granulation tissue called a ________ which covers the articulating cartilage.

Back 9

pannus

Front 10

The mucin clot test is formed by the addition of acetic acid to the synovial fluid. This forms a clot with ______________.

Back 10

hyaluronic acid

Front 11

Bone spurs, known as __________, form in osteoarthritis.

Back 11

osteophytes

Front 12

Of the 4 modes of injury described for hypersensitivity of the immune system, which mode of injury would best characterize that observed in Rheumatoid Arthritis: _______

Back 12

Type 3

Front 13

The loss of _______ from the articulating cartilage is the hallmark of the osteoarthritic process.

Back 13

proteoglycans

Front 14

True/False
The synovium is characterized as having a good blood and autonomic nerve supply and completely covers the articulating cartilage.

Back 14

True

Front 15

True/False
Hyaluronic acid is a component of the synovial fluid that is responsible for increasing the viscosity of the synovial fluid.

Back 15

True

Front 16

True/False
In the majority of arthritic conditions an exudative inflammation predominates the
condition and this is followed by degeneration processes that eventually can limit movement of the specified joint.

Back 16

True

Front 17

True/False
The loss of proteoglycans from articulating cartilage is a hallmark of the osteoarthritic process.

Back 17

True

Front 18

True/False
One of the most striking articular manifestations in Rheumatoid arthritis is the development of a Pannus that covers the articulating cartilage.

Back 18

True

Front 19

True/False
The loss of mobility of a joint in the early stages of Rheumatoid Arthritis could be attributed to pain, while in the later stages of the disease it more likely is due to fibrosis.

Back 19

True

Front 20

True/False
In Osteoarthritis, patients normally present with other systemic manifestations other than just the joint pain.

Back 20

False. Rheumatoid Arthritis.

Front 21

Rheumatoid Arthritis can be matched to the following type of hypersensitivity (mode of tissue injury):
a. Type 1
b. Type 2
c. Type 3
d. Type 4

Back 21

c. Type 3

Front 22

Which of the following statement(s) islare TRUE about the synovial fluid?
a. The Mucin clot test is the addition of acetic acid to the synovial fluid and the resulting precipitate that is formed with hyaluronic acid.
b. The color of the synovial fluid becomes cloudier as the inflammation of the joint increases.
c. The Mucin clot test would demonstrate poorer clot formation with increased inflammation since lysosomal action reduces hyaluronic acid levels.
d. All of the above are true
e. Only b and c are correct.

Back 22

d. All of the above are true

Front 23

Which of the following statement(s) describe(s) the possible way(s) that connective tissue damage is produced in Osteoarthritis?
a. Heparin released from mast cells may play a role in bone resorption.
b. Monocytes/macrophages and fibroblasts release chemotactic factors to resorb bone.
c. Cytokines, such as IL-I , can stimulate the production and/or release of proteases (enzymes) that are destructive
d. Hypoxia from diminished blood flow causes acidosis, which stimulates release of hydrolytic enzymes.
e. All the above are true

Back 23

c. Cytokines, such as IL-I , can stimulate the production and/or release of proteases (enzymes) that are destructive

Front 24

Which of the following statement(s) islare FALSE with regard to Rheumatoid Arthritis?
a. The inflammatory response observed in the synovial membrane of a patient with Rheumatoid Arthritis is characterized by a striking angiogenesis initiated by the infiltration of mononuclear cells.
b. Immune complexes that contain the Rheumatoid Factors play a major role in the amplification of the immune response.
c. The synovial fluid phase of rheumatoid arthritis is predominately composed of PMN's.
d. The presence of Rheumatoid Factors in the serum of an individual is the absolute test used for the diagnosis of rheumatoid arthritis
e. Extra-articular manifestations of Rheumatoid Arthritis are correlated with high titers of Rheumatoid Factors and the development of granulomas.

Back 24

d. The presence of Rheumatoid Factors in the serum of an individual is the absolute test used for the diagnosis of rheumatoid arthritis

Front 25

Which of the following statements are TRUE about Gouty Arthritis (Gout)?
a. Secondary gout can develop as a consequence of associated renal disorders or even as a consequence of the use of some drugs.
b. Uric acid is free filtered by the kidney, and secreted in the proximal tubules
c. Increases in uric acid clearance most probably contribute to the hyperuria observed in the majority of patients with gout.
d. Due to the phagocytic actions of PMN in the synovial fluid, the pH is increased, which leads to an increase in the precipitation of urate crystals.
e. All of the above are True

Back 25

a. Secondary gout can develop as a consequence of associated renal disorders or even as a consequence of the use of some drugs.

Front 26

Which of the following is a FALSE statement with regard to Gout ?
a. Patients with uric acid levels of 9-10 mg% would be correctly diagnosed as having gout.
b. Deposit of urate crystals surrounded by a granuloma (macrophages and giant cells) found in patients with Gout are called Tophi.
c. Uric acid nephropathy results from deposition of uric acid crystals (renal stones) in collecting tubules and can result in acute renal failure.
d. One commonly used diagnostic criterion for gout is the presence of monosodium urate crystals in leukocytes found in the synovial fluid obtained from the inflamed joint.
e. There is a strong correlation of alcohol use and the development of gout, since alcohol can decrease the renal excretion of uric acid.

Back 26

a. Patients with uric acid levels of 9-10 mg% would be correctly diagnosed as having gout.

Front 27

True/False
Intimal cells of the synovium secrete hyaluronate into the synovial fluid.

Back 27

True

Front 28

True/False
Arthritic diseases are characterized by 2 pathological responses: degeneration and inflammation.

Back 28

True

Front 29

True/False
Primary (idiopathic) osteoarthritis is characterized by a more generalized distribution of arthritis and is not associated with any known risk factors (other than aging itself).

Back 29

True

Front 30

True/False
In osteoarthritis the chondrocytes can release cytokines that can lead to the damage of the articulating cartilage.

Back 30

True

Front 31

True/False
Loss of proteoglycans from the articulating cartilage is the hallmark of the osteoarthritic process.

Back 31

True

Front 32

True/False
In rheumatoid arthritis the synovial membrane becomes primarily infiltrated with neutrophils and transforms into a granuloma tissue called a pannus.

Back 32

False. infiltrated with mononuclear cells

Front 33

True/False
Rheumatoid factors are transformed autoantibodies.

Back 33

True

Front 34

True/False
In rheumatoid arthritis damage to the articulating cartilage can occur due to hypoxia from diminished blood flow to the synovial membrane that causes acidosis. Acidosis can then stimulate release of hydrolytic enzymes.

Back 34

True

Front 35

Which of the following statements is FALSE with regards to rheumatoid arthritis.
a. Is defined as a chronic, systemic, autoimmune disease characterized by inflammation of connective tissue throughout the body.
b. The damage inflicted upon articulating cartilage is brought about by a type 3 mode of hypersensitivity injury.
c. Subcutaneous rheumatoid nodules, which are composed of high titers of RF (rheumatoid factors), are extra-articular manifestations.
d. Absolute diagnosis of rheumatoid arthritis can be determined by the presence of high titers of RF in the serum

Back 35

d. Absolute diagnosis of rheumatoid arthritis can be determined by the presence of high titers of RF in the serum

Front 36

Which statement is true of rheumatoid arthritis:
a. It affects men about 2 1/2 to 3 times more frequently than women.
b. Characterized by a fibrinoid necrosis of muscle.
c. Destruction of the joint is caused only by digestive destruction from hydrolytic enzymes.
d. Certain viral illnesses have been implicated in the development of the disorder.

Back 36

d. Certain viral illnesses have been implicated in the development of the disorder.

Front 37

True/False
Estrogens appear to offer some protection to women from developing gout. The mechanism of estrogen action is probably mediated by reducing the synthesis of uric acid.

Back 37

False. mediated by promoting secretion of uric acid.

Front 38

True/False
Urate nephropathy is a result of deposition of uric acid crystals in the collecting duct which can result in acute renal failure.

Back 38

False. Uric acid nephropathy.

Front 39

True/False
Synovial fluid is an example of transcellular fluid.

Back 39

True

Front 40

True/False
Extra-articular manifestations of Rheumatoid Arthritis are correlated with high titers of RF and the development of granulomas.

Back 40

True

Front 41

True/False
Uric acid is eliminated via the kidney and GI system. It is freely filtered, reabsorbed in the distal tubule and secreted at the proximal tubule.

Back 41

False. reabsorbed in the proximal tubule and secreted at the distal tubule.

Front 42

True/False
Primary Gout is mainly diagnosed in men and is usually an inherited defect in purine metabolism.

Back 42

True

Front 43

True/False
Deposits of urate crystals surrounded by a granuloma (macrophages and giant cells) are found in patients with Gout are called Tophi.

Back 43

True

Front 44

True/False
The loss of proteoglycans from the articulating cartilage is the hallmark of rheumatoid arthritis.

Back 44

False. osteoarthritic process.

Front 45

True/False
In the pathogenesis of Gout, uric acid crystals are deposited in the joint to activate complement, which, in turn, is chemotactic for macrophages, which amplify the tissue damage.

Back 45

False. ?

Front 46

True/False
Rheumatoid arthritis is an example of a type III mode of tissue injury.

Back 46

True

Front 47

True/False
The mucin clot test is one where acetic acid forms a precipitate with the hyaluronic acid of the synovial fluid.

Back 47

True

Front 48

True/False
The synovium is made up of two cell layers. The A cells of the subintimal layer secrete hyaluronic
acid.

Back 48

False. The B cells of the intimal layer.

Front 49

True/False
The synovial membrane covers the articulating cartilage and provides the nutrients for the non-vascularized collagen to survive.

Back 49

False. The synovial fluid.

Front 50

True/False
The major pathological responses observed in the pathogenesis of the rheumatoid disorders are inflammation and degeneration of the joint.

Back 50

True

Front 51

True/False
Rheumatoid factors are transformed autoantibodies.

Back 51

True

Front 52

Which of the following statement(s) describe(s) the major possible way(s) that connective tissue damage is produced in Rheumatoid Arthritis?
a. Heparin released from mast cells may play a role in bone resorption.
b. Monocytes/macrophages and fibroblasts release chemotactic factors and proteases to resorb bone.
c. Hypoxia from diminished blood flow causes acidosis, which stimulates release of hydrolytic enzymes.
d. Cytokines, such as IL-1 released from chondrocytes can stimulate the production and/or release of proteases (enzymes) that are destructive.
e. All the above are true
f. Only a and c are correct
g. Only b and d are correct
h. a, b, and c are correct

Back 52

h. a, b, and c are correct

Front 53

Which of the following statements is/are TRUE with regard to Rheumatoid Arthritis (RA)?
a. The inflammatory response observed in the synovial membrane of a patient with RA is characterized by a striking angiogenesis initiated by the infiltration of mononuclear cells,
b. Immune complexes that contain the RF play a major role in the amplification of the immune response.
c. The synovial fluid phase of rheumatoid arthritis is predominately composed of PMN's.
d. The presence of Rheumatoid Factors in the serum of an individual is the absolute test used for the diagnosis of rheumatoid arthritis.
e. All statements are true
f. Only a, b, and c are true,
g. Only a and b are true

Back 53

f. Only a, b, and c are true,

Front 54

Which of the following is a FALSE statement with regard to Gout:
a. Patients with uric acid levels of 9-10 mg% would be correctly diagnosed as having Gout,
b. Uric acid nephropathy results from deposition of uric acid crystals (renal stones) in collecting tubules and can result in acute renal failure.
c. One commonly used diagnostic criteria for Gout is the presence of monosodium urate crystals in leukocytes found in the synovial fluid obtained from the inflamed joint.
d. There is a strong correlation of alcohol use and the development of Gout, since alcohol can decrease the renal excretion of uric acid.

Back 54

a. Patients with uric acid levels of 9-10 mg% would be correctly diagnosed as having Gout,

Front 56

Which of the following are important pathological characteristics of osteoarthritis:
a. Formation of bone spurs (osteophyte).
b. Erosion of the glistening appearance of the articulating cartilage.
c. Sclerosis, or thickening, of the bone underneath the articulating cartilage.
d. Inflammation of the joint with eventual destruction of the articulating cartilage.
e. of the above are true.
f. Only a, b, and c are true.

Back 56

f. Only a, b, and c are true.

Front 57

Articulating cartilage is richly supplied with:
a. blood vessels
b. nerves
c. lymphatic vessels
d. none of the above
e. Only a and b

Back 57

d. none of the above

Front 58

Which of the following statement(s) is/are true with regards to Rheumatoid
Arthritis:
a. Is defined as a chronic, systemic, autoimmune disease characterized inflammation of connective tissue throughout the body.
b. It affects men about 2 1/2 to 3 times more frequently than women
c. The synovial membrane becomes infiltrated with a granulation tissue called a pannus that covers the articulating cartilage.
d. Absolute diagnosis of rheumatoid arthritis can be determined by the presence of high titers of RF (Rheumatoid factors) in the serum.
e. All are correct
f. Only a and c are correct

Back 58

f. Only a and c are correct