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