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32 Cards in this Set
- Front
- Back
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primary and secondary osteoarthritis.
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Primary variants of OA occur as localized or generalized syndromes
versus Secondary OA has a known underlying cause |
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major etiologies of osteoarthritis
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Obesity
Repetitive motion Occupation Sports Trauma Genetic factors |
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physiology of normal cartilage
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Functions include:
Movement across joint Distribution of weight across the joint Stabilization of the joint Easily compressed |
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pathologic changes associated with osteoarthritis.
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Increased production and activity of proteases
Matrix metalloproteinases (MMPs) Chondrocytes undergo apoptosis |
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clinical presentation of osteoarthritis.
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Typically affects knees, hips, hands
-Pain with motion Due to activation of nociceptive nerve endings within the joint Joint stiffness Crepitus Limited ROM |
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key features of RA and osteoarthritis
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Age of Onset
Joints Involved Symptoms Systemic symptoms |
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signs and symptoms of RA
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Joint involvement tends to be symmetrical
-Joint pain and stiffness Tends to be worse in AM; usually lasts >1 hr after getting up in AM Joint swelling/warmth/tenderness -proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints |
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extra-articular manifestations of RA
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Rheumatoid nodules
-Vasculitis |
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Role of CD4+ Helper T Cells in RA pathophysiology versus Role of B Lymphocytes
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Promote cytokine release
TNF-alpha, IL-1, IL-6 Produce receptor activator of nuclear factor κβ ligand (RANKL) B lympocytes on the other hand Form antibodies called rheumatoid factors (RF) |
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Laboratory Findings of RA
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CBC
Anemia (normocytic, normochromic) Thrombocytosis Neutropenia -the presence of ≥4 |
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Uric Acid overproducers versus underexcretors
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Overproduction of Uric Acid:
-Deficiency of HGPRT ~10-20% of patients Underexcretion of Uric Acid : -~80-90% of patients -Organic acids compete with urate for excretion Decreased kidney function Diuretics -24 hour urine sample to distinguish b/n the two |
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clinical manifestations of acute gouty arthritis
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Predisposition to great toe (Low temperature and poor solvent )
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Epidemiology of gout
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Increasing age
SCr, BUN Male gender Postmenopausal women Blood pressure Body weight (obesity) Alcohol intake Meat/fish intake |
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Tophaceous gout
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Deposits of urate in soft tissues
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risk factors for SLE
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Genetics
Hormonal and immunologic Environmental |
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T/F.SLE is a chronic inflammatory disease
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True
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T/f.Most patients with ANAs do not have SLE; but most people with SLE do have ANAs
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True
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T/F. SLE Onset can be acute OR insidious
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True
-Disease course characterized by exacerbations and remissions. |
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Signs and symptoms of SLE includes arthritis, arthralgia, myositis
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True
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three methods of bacterial spread to the bone
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Hematogenous Osteomyelitis
Contiguous Spread Osteomyelitis Vascular Insufficiency |
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most common organisms involved in the development of osteomyelitis
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Staphylococcus aureus:Long bones, vertebrae
S. aureus:Femur, tibia, cranium, mandible S. aureus:Feet |
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Likely Pathogen of osteomyelitis in IVDA or hemodialysis
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S. aureus, Pseudomonas aeruginosa
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Risk of AOM greatest in young children (< 3 years)
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ET is shorter, less rigid, and more horizontal
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Key elements in the diagnosis of AOM
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Acute (abrupt) onset of signs and symptoms
Middle ear inflammation and erythema of the tympanic Presence of middle ear effusionmembrane |
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Most Prevalence pathogen of Acute Otitis
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Streptococcus pneumoniae
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A Certain diagnosis of AOM
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Certain diagnosis = rapid onset + middle ear effusion + middle ear inflammation
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4 primary factors involved in the pathogenesis of acne
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Increased sebum production
Sloughing of keratinocytes Bacterial growth & colonization Inflammation |
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5 different acne lesions
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Acne Vulgaris( No inflammation present)
Papules( inflammation present) Pustules (inflammation present) Nodules (cysts) |
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Open Comedones versus Closed Comedones
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Blackheads”
Plugs of material open to skin surface in a dilated hair follicle versus “Whiteheads” Plugs of material open to skin surface in a closed hair follicle |
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Etiology of Acne
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Factors that DO affect acne
Genetics Climate Stress Physical activity Factors that DO NOT affect acne Diets high in fat Poor hygiene |
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Psoriasis etiologies
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Immunologic Mechanisms
-Activation of T-cells |
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4 different types of psoriasis.
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Psoriasis vulgaris (plaque-type)-(Auspitz sign)
Guttate(Teardrop shaped ,mostly in children ) Pustular Erythrodermic(Affects all body surfaces (i.e., hands, nails, trunk, extremities) ) |
