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69 Cards in this Set
- Front
- Back
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Achondroplasia
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failure of endochondral ossification (longitudinal growth) = short limbs
normal membranous ossification = large head constitutive activation of FGFR3 = chondrocyte proliferation inhibition >85% are sporadic (advanced paternal age often) can be AD inheritance normal lifespan and fertility |
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type I osteoporosis
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postmenopausal
increase bone resorption due to decreased estrogen |
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type II osteoporosis
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senile
men and women >70 |
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osteoporosis definition
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reduced trabecular bone despite normal mineralization
also normal labs |
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common fractures in osteoporosis
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femoral neck
distal radius (colles') vertebral compression fx |
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symptoms of vertebral crush fx from osteoporosis
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pain
loss of height kyphosis |
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osteoporosis prophylaxis
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exercise
calcium before age 30 |
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treatment for osteoporosis
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estrogen
calcitonin bisphosphonates or pulsatile PTH for severe cases glucocorticoids are BAD |
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osteopetrosis
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failure of resorption = thickened dense bone
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labs in osteopetrosis
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normal AP
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complications of osteopetrosis
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cranial nerve impingement
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x ray of osteopetrosis
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erlenmeyer flask
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osteomalacia is
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defective mineralization of osteoid = soft bones
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pathogenesis of osteomalacia
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↓ vit D → ↓ calcium → ↑PTH → ↓ phosphate
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Paget's disease is...
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increase in osteoblastic and osteoclastic activity
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possible Paget's etiology
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viral
paramyxovirus |
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labs in Paget's disease
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normal calcium
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pathology of Paget's disease (bone)
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mosaic bone pattern
long bone chalk stick fx |
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complications of Paget's disease
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increased blood flow from arteriovenous shunts may cause high output heart failure
may lead to osteogenic sarcoma |
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polyostotic fibrous dysplasia
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bone is replaced by fibroblasts
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McCune Albright Syndrome
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type of polyostotic fibrous dysplasia
multiple unilateral bone lesions associated with endocrine abnormalities (precocious puberty) |
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pathology of osteoarthritis
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subchondral cysts
sclerosis osteophytes eburnation |
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hand manifestations of OA
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herberdens nodes
bouchards nodes (PIP) |
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OA predisposing factors
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age
obesity joint deformity |
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OA clinical presentation
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pain in weight bearing joints
after use (end of day) pain improves with rest no systemic symptoms |
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RA
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autoimmune
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pathology of RA
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pannus formation
SQ rheumatoid nodules (fibrinoid necrosis surrounded by palisading histiocytes) |
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gross pathology of RA
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Baker's cyst
behind knee SQ nodules ulnar deviation subluxation NO DIP INVOLVEMENT |
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gender preference of RA
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female>male
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hypersensitivity of RA?
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type III
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labs of RA
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Rh factor (80%)
anti CCP less sensitive but more specific |
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HLA association for RA
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HLA DR 4
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classic RA presentation
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morning stiffness
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sjogren's triad
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xerophthalmia
xerostomia arthritis |
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sjogren's population
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femals age 40
60 |
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Sicca syndrome
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dry eyes
dry mouth nasal and vaginal dryness chronic bronchitis reflux esophagitis no arthritis |
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causes of Gout
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Lesch
Nyhan syndrome PRPP excess decreased excretion of uric acid (thiazides) increased cell –urnover von Gierke's disease |
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gout crystals
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negatively birefringent
yellow under parallel |
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gender preference of gout
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men>women
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gout symptoms
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asymmetric joint distribution
red |
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common gout tophi locations
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external ear
achilles tendon olecranon bursa |
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gout attacks often occur after...
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alcohol consumptom (alcohol metabolites compete with uric acid for kidney excretion sites)
or after large meal |
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treatment of gout
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acute:
NSAIDs (indomethacin) colchicines chronic: allopurinol uricosurics |
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pseudogout crystals
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calcium pyrophosphate
basophilic rhomboid blue when parallel weakly positively birefringent |
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common bugs of infectious arthritis
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S. aureus
Streptococcus N. gonorrhea |
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gonococcal arthritis presentation
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monoarticular migratory arthritis
asymmetrical red |
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chronic infectious arthritis
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TB
Lyme |
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what is a seronegative spondyloarthropathy?
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arthritis without Rh
associated with HLA B27 more often in males |
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psoriatic arthritis
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joint pain and stiffness associated with psoriasis
asymmetric |
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ankylosing spondylitis
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chronic inflammatory disease of spine and SI joints leading to ankylosis
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reactive arthritis
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conjunctivitis and anterior uveitis
arthritis urethritis 'can't see |
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cause of reactive arthritis
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post GI or chlamydia
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SLE symptoms
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I'M DAMN SHARP
Immunoglobulins Malar rash Discoid rash ANA Mucositis (oral ulcers) Neurologic disorders Serositis (pleuritis |
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SLE kidney lesions
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immune complex deposition = wire loop lesions
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labs of SLE
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ANA
sensitive but not specific anti dsDNA sepcific |
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Sarcoidosis general...
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immune mediated
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sarcoidosis treatment
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steroids
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associated symptoms with sarcoid
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restrictive lung disease
hilar lymphadenopathy erythema nodosum Bell's paulsy epithelial granulomas uveopartitis hypercalcemia |
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polymyalgia rheumatica
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pain and stiffness in shoulders
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labs of polymyalgia rheumatica
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elevated ESR
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treatment of polymyalgia rheumatica
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prednisone
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polymyositis symptoms
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proximal muscle weakness from CD8 induced injury (perifascicular)
often shoulders |
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dermatomyositis symptoms
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proximal muscle weakness
malar rash heliotrope rash shawl sign grotton's papules mechanic's hands increased risk of malignancy |
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lab findings for poly/dermatomyositis
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increased CK
increased aldolase positive ANA possible positive anti Jo1 |
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treatment of poly/dermatomyositis
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steroids
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scleroderma general
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progressive fibrosis and collagen deposition througout body
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common scleroderma sites
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skin (pffy taut skin)
renal pulm cardiovascular GI |
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diffuse scleroderma
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widespread skin involvement
rapid progression early visceral involvement associated anti Scl 70 (anti DNA topoisomerase) |
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CREST syndrome
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type of scleroderma:
Calcinosis Raynauds Esophageal dysmotility Sclerodactylyl Telangectasia *limited skin involvement *more benign *associated with anti centromere antibody |
