Osteoarthritis
Gout
CPPD and Septic
Spondyloarthropathies
Meds and Lifestyle
100
Is this an acute or chronic disease?
CHRONIC!
100
Describe what Gout is?
the joint space gets disrupted by the accumulation of monosodium urate crystals inside the joint space
100
CPPD is commonly known as?
Pseudo-Gout
100
An inflammatory disorder thought to develop in response to prior infections affecting the gastrointestinal tract or genitourinary systems is called ___ Arthritis.
Reactive arthritis
100
What vitamin is Folic Acid?
What is Vitamin B9?
200
Osteoarthritis involves the breakdown of what type of cartilage?
Hyaline/Articular Cartilage
200
Is serum urate level alone diagnostic of gout-- TRUE OR FALSE?
FALSE!
200
What would Arthrocentesis fluid reveal in septic joint arthritis--- Opaque or dark? How many PMNs?
Opaque and often greater than 80-90%
200
What type of arthritis is characterized by a classic triad of eye pain (conjunctivitis), pain on urination (urethritis), and joint pain (arthritis)?
Reactive Arthritis
200
What specific osteoporosis does smoking increase the risk for?
What is femoral neck osteoporosis?
300
Describe Osteoarthritis presentation?
EX: Does pain worsen with activity? Yes or No
YES! "wear and tear"
300
What would you see under a microscope for patients with acute gout symptoms?
Unique joint fluid findings in gout are needle-shaped negative birefringent crystals
2 reflections of polarized light!
If polarized light hits a crystal, you see Yellow when crystal is parallel to axis of the polarization
you see Blue when perpendicular to polarization axis
300
90% of Septic Joint Arthritis involves how many joints?
1! Monoarthritis
300
Psoriatic Arthritis is Asymmetric or Symmetric presentation?
Asymmetric!
300
How much greater is the risk for developing RA in smokers vs non-smokers?
What is twice as high in non-smokers
400
What hand joints are involved in osteoarthritis and is presentation Asymmetric or Symmetric?
DIPS, PIPS, and 1st CMC joint
ASSYMETRIC!
(HINT: You get osteoarthritis towards the end of your life, so you see it at the end of your hand joints!)
400
Name a trigger for Gout attacks?
Foods: Red meat, organ meat, seafood, and fructose all lead to high uric acid levels and should be restricted in patients with gout.
and
Alcohol: Ethanol metabolism accelerates adenosine triphosphate degradation into uric acid precursors and can sometimes reduce renal excretion of uric acid.
400
What may you see on an X-ray that points towards CPPD?
May see chondrocalcinosis aka a thin area of calcium pyrophosphate deposition at the articular cartilage
(end of bone)
400
Patients with ______ often have x-rays that reveal a bamboo spine, the phrase used to describe the vertebral fusion that can occur
ankylosing spondylitis
400
What 4 cytokines are induced by Cigarette Smoke Condensate (CSC)?
What are IL-1a, IL-1B, IL-6, IL-8?
500
What is the synovial fluid WBC count in patients with osteoarthritis?
200- 2000 cells/mm3
500
What entails Chronic Gout?
Chronic: seen with longstanding hyperuricemia and can lead to form Tophi (depositions of monosodium urate crystals within the skin, joints, and subcutaneous tissues), may eventually lead to cause kidney stones and failure.
500
What do you see under polarized light in patients with CPPD (Pseudo-Gout)?
EX: shape?
(+) birefringent rhomboid forms under polarizing microscope
500
Free 100 points
sorry or maybe it's a yay?
500
What is the more clinically seen enzyme inhibited by methotrexate?
What is AICAR transformylase