DU PA Introduction into Rheumatology
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each of the black spaces below before clicking
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| degenerative arthritis is the same thing as __ | osteoarthritis
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| the common theme of all rheumatological diseases is __ | inflammation
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| strictly refers to inflammation of a | joint
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| rheumatism refers to inflammation of | joints, bones, muscles, tendons, and ligaments, multiple organ involvement
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| more than __% of US adults were found to have arthritis | 21
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| __% of those with arthritis are women | 60
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| arthritis is now the leading cause of __ in the US | disability
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| some forms of degenerative disease have __ component | an inflammatory
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| the majority of rheumatologic diseases are __ in origin | immune-mediated
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| __ most commonly affected in non-inflammatory disease (mechanical disease) | axial skeleton
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| __ are most often affected in inflammatory disease | mobile joints of the extremities
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| the __ is most often involved in ankylosing spondylitis | enthesis
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| the point at which a tendon or ligament or muscle inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue | enthesis
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| muscle inflammation | myosis
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| microcrystalline arthritis | gout
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| hallmark of rheumatoid arthritis | synovitis
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| __ involves the bony endplate of a joint | osteonecrosis
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| __ involves cartilage degeneration | osteoarthritis
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| __ involves cartilage degeneration | degenerative arthritis
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| inflammation at ligamentous insertion into bone | enthesitis
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| hallmark of autoimmune disease | failure of self tolerance
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| Theory of autoimmunity in which microbes have what looks like host antigens → release of self-reactive T-cell clones | molecular mimicry
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| compare frequency of a mutation or polymorphism in affected population to that in matched control population, attempts to associate particular gene with particular disease | association studies
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| based on observation that genes closely arranged on the chromosome are inherited together, these studies look for polymorphisms that may be linked to complex diseases | linkage analysis
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| Most of the rheumatic diseases are __ and thus genetic susceptibility plays an important but variable role in pathogenesis | autoimmune diseases
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| Genes involved in rheumatic disease have low __ | predictive power
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| A cluster of genes on chromosome 6 that control immune function and regulate transplant rejection | major histocompatibility complex
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| the __ plays a critical role in immune function and antigen presentation | major histocompatibility complex
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| Genetic susceptibility plays an important, __, role in development of rheumatic diseases | but not exclusive
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| most common symptom of rheumatologic musculoskeletal disorder | stiffness with immobility (gel)especially in the morning
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| __ is improved with rest and worsened by activity | non-inflammatory
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| __ is worsened by inactivity | inflammatory pain (and stiffness)
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| rheumatoid arthritiis usually presents as | symmetric small bone involvement
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| __ is not usually a feature of rheumatoid disease (outside of inflammatory myopathy) | weakness
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| cardinal signs of inflammation on PE | warmth, effusion, decreased ROM in all planes
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| plasma proteins synthesized by the liver, cytokine-mediated systemic response to tissue injury, non-specific | acute phase reactants
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| 2 most commonly used acute phase reactants are the __ and the __ | erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)
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| normal ranges for ESR | 0-15mm/hr for men, 0-20mm/hr for women
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| normal range for CRP | <0.2 mg/dL
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| ESR is increased in | anemia, inflammation, female sex, pregnancy, elevated cholesterol, advanced age
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| ESR is decreased in | sickle cell disease, abnormalities of RBC size and shape
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| ESR is uneffected by | body temperature, recent meal, aspirin/NSAIDs, cachexia, steroid therapy
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| antibodies to a variety of nucleoproteins | antinuclear antibodies (ANA)
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| the higher the titer of ANA the more likely the patient | has a rheumatologic disease
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| diseases in which ANA testing is helpful | SLE, scleroderma, polymyositis, dermatomyosits, Sjogren’s syndrome, antiphospholipid syndrome, mixed connective tissue disease
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| diseases in which ANA testing not likely to be helpful | rheumatoid arthritis (RA), gout, spondyloarthropathies, osteoarthritis, fibromyalgia
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| Previously considered the gold standard in the evaluation of rheumatic disease but not widely used | synovial fluid analysis
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| Essential in infectious and crystal-induced arthropathies | synovial fluid analysis
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| Four categories of joint fluid | non-inflammatory, inflammatory, septic, hemorrhagic
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| noninflammatory joint fluid usually indicates | osteoarthritis
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| inflammatory joint fluid can indicate | gout, RA, SLE, AS, PsA, septic arthritis
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| hemorrhagic joint fluid can indicate | tumor, TB, trauma
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| useful in detecting infection, stress injuries and osteonecrosis | bone scan
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| __ any symptomatic joint | x-ray
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| __ are used for early changes in SI joints, axial disease | CT and MRI
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