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24 Cards in this Set
- Front
- Back
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113. How may Pulmonary involvement present in Rheumatoid arthritis?
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a. Usually pleural effusions (Very common).
b. Interstitial fibrosis may occur c. Pulmonary infiltrates d. Rheumatic nodules in lungs (similar to those on skin)- Can cavitates or becomes infected. |
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114. What is characteristic of pleural fluid in pleural effusions associated w/ Rheumatoid arthritis?!?!?
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a. Pleural fluid characteristically has very low glucose and low complement.
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115. What is characteristic of pulmonary fibrosis associated w/ Rheumatoid arthritis?
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a. Has a restrictive pattern on pulmonary function test
b. Has a honeycomb pattern on CXR. |
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116. How may Ocular involvement present in Rheumatoid arthritis?
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a. Episcleritis or scleritis
b. Scleromalacia- softening of the sclera; if not treated may perforate leading to blindness. c. Dry eyes (and dry mucous membranes in general); may develop Sjogren’s syndrome. |
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117. How may the nervous system be involved in Rheumatoid arthritis?
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a. Mononeuritic multiplex- infection of nerve trunk.
b. Pt cannot move the arm or leg; implies systemic vasculitis, which is a bad sign. |
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118. Triad of Felty’s syndrome?
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1. Neutropenia
2. Splenomegaly 3. RA |
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119. Other symptoms of Felt’s syndrome?
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a. Anaemia
b. Thrombocytopenia c. Lymphadenopathy d. Associated w/high titres of RF and extra-articular disease. e. Increased susceptibility to infection f. Usually occurs fairly late in the disease process. |
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120. Blood sx of Rheumatoid arthritis?
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a. Anaemia of chronic disease: Mild, normocytic, normochromic.
b. Thrombocytosis. |
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121. Vascular complications of Rheumatoid arthritis?
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a. A microvascular vasculitis- can progress to mesenteric vasculitis, PAN, or other vascular syndromes.
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122. What does focal enlargement represent in rheumatoid arthritis versus osteoarthritis?
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a. Soft tissue swelling rather than bony enlargement.
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123. One feature is pathognomonic for RA?
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a. Rheumatoid nodules.
b. They are nearly always present in seropositive patients (i.e., those with RF) |
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124. What is the importance of rheumatoid nodules in rheumatoid arthritis?
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a. Subcutaneus rheumatoid nodules occur over extensor surfaces. However, it may also occur in visceral structures such as the lungs, pleura, and pericardium.
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125. Criteria for diagnosing RA?
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a. A pt has RA if 4 or more of these 7 criteria are present at any time:
1. Morning stiffness for at least 6 weeks 2. Arthritis of 3 or more joints lasting at least 6 weeks: 1. MCP, PIP, wrist, elbow, knee, ankle, MIP joints. 3. Symmetric arthritis for at least 6 weeks 4. Arthritis of hand joints for at least 6 weeks- PIP, MCP, or wrist 5. Rheumatoid nodules 6. Serum RF 7. Radiographic changes consistent w/RA (erosions and periarticular decalcification). |
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126. What lab findings do you expect in RA?
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a. High titres of RF are associated w/more severe disease and are generally nonspecific.
b. RF is eventually present in 80% of pts w/RA (may be absent early in disease), but is also present in up to 3% of healthy population. c. Elevated ESR and C-reactive protein. d. Normocytic normochromic anaemia (anaemia of chronic disease). |
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127. Radiographs w/RA?
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a. Loss of juxtaarticular bone mass (periarticular osteoporosis) near the finger joints
b. Narrowing of joint space (due to thinning of articular cartilage) is usually seen late in the disease! c. Bone erosions at the margins of the joint!!! |
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128. Synovial fluid analysis for RA?
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a. It is nonspecific.
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129. Appearance of normal synovial fluid?
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a. Clear
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130. WBC and PMN in normal synovial fluid?
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a. WBC: <200
b. PMN: <25% |
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131. Appearance of synovial fluid with Non-inflammatory arthritis (OA/trauma)?
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a. Clear, yellow
b. Possibly red if traumatic |
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132. WBC and PMN in Non-inflammatory arthritis (OA/trauma)?
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a. WBC: <2,000
b. PMN: <25% |
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133. Other findings with Non-inflammatory arthritis (OA/trauma)?
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a. RBCs for trauma.
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134. Appearance of synovial fluid with inflammatory arthritis (RA, gout, pseudogout, Reiter’s syndrome)?
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a. Cloudy yellow
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135. WBC and PMN in inflammatory arthritis (RA, gout, pseudogout, Reiter’s syndrome)?
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a. WBC: >5,000
b. PMN: 50-70% |
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136. Other findings with inflammatory arthritis (RA, gout, pseudogout, Reiter’s syndrome)?
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a. Positively birefringent crystals w/pseudogout
b. Negatively birefringent crystals w/gout. |
