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PBR FlashCards > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

in what condition should you always order an arthrocentsis

A

concern for septic joint

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2
Q

what is WBC count in arthrocentsis in setting of inflammation or infection

A

> 2000

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3
Q

what is WBC count in setting of trauma in athrocentesis

A

<2000

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4
Q

what is wbc count in athrocentsis in lupus patient

A

> 5000

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5
Q

septic arhtritis wbc count on jointtap is

A

> 50,000

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6
Q

this condition is usually diagnosed in kids under the age of 16 and symptoms have to be present for at least 6 weeks. Involvement is usually the large joints and you wont see rhematoid nodules like you do in adults

A

JIA

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7
Q

what markers are present in JIA

A

ANA, RF can be seen but doesnt have to be if it is seen it is poorer prognosis

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8
Q

which kind of JIA is mainly in girls and involves 4 or less joints, silent eye issues are involved and although ANA is + RF is usually negative

A

Oligoarticular JIA

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9
Q

what exams need to be don in O-JIA

A

serial slit lamp because uveitis will be silent

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10
Q

what kind of JIA has involvement of 5 or more joints and is more common in young girls

A

polyarticular JIA

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11
Q

this kind of JIA is seen in both boys and girls and has the presence of a salmon-colored evanescent rash ( comes and goes quickly) that is present with spiking fevers, HSP and extremely high leukocytosis.

A

systemic JIA

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12
Q

which JIA is associated with Koebner Phenomena (linear skin lesions appearing along sites of injury, rubbing or scratching)

A

systemic JIA

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13
Q

how to treat polyarthritis

A

start with NSAIDs for a few weeks and then move on to DMARDS (methotrexate) or tnf inhibitors

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14
Q

children who have to take methotrexate also need what

A

folic acid or leucovorin (folinic acid)

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15
Q

which antibodies are present in SLE

A

anti-DNA and anti- Smith ( most diagnostic and specific)

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16
Q

in SLW complement is

A

low ( low C4,C3 and CH50)

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17
Q

what is the condition associated with SLE that consists of micro ischemia and seizures that can result in neuropsychiatric manifestations?

A

Lupus cerebritis

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18
Q

how to dx lupus cerebritis

A

CT or MRI will show brain lesions.

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19
Q

what meds are used to treat lupus

A
  • NSAIDs if mild
  • steroids
  • hydroxychloroquine
  • methotrexate
20
Q

what is associated with neonatal lupus

A

third degree heart block with bradycardia or hydrops fetalis

21
Q

how to dx neonatal lupus

A

Anti - Ro/La antibodies of mom

22
Q

what kind of drugs cause drug induced luus

A
  • lithium
  • hydralazine
  • quinidine
  • sulda drugs
  • antiseizure medication
23
Q

what is the chronic inflammatory condition that involves fusion of the spine and inflammation of the hips, more common in boys

A

juvenile ankylosing spondylitis

24
Q

when is pain worse in ankylosing spondylitis

A

with rest

25
Q

give an example of a seronegative spondyloarthropathy

A

reactive arthritis ankylosing spondylitis ( inflamm markers are normal, ANA is negative and ESR is only slightly elevated)

26
Q

iritis, urethritis and arthritis

A

reactive arthritis

27
Q

aphthous ulcers, genital ulcers, GI symptoms, arthritis and uveitis

A

bechet’s syndrome

28
Q

describe onset and key features of psoriatic juvenile idiopathic arthritis

A

presnts in children less than 6, more common in grils and presents with
- dactylitis
- arthritis or wrists hands and feet
- older children can have enthesitis ( pain at insertion sites)
- 50% of kids will have psoriass

29
Q

any child with psoriatic JIA can have what

A

uveitis

30
Q

what kind of weakness and nail findings will someone with dermatomyositis have

A

telengiectasia of the nails and proximal mucle wekaness

31
Q

how to dx dermatomyositis

A

mucsle bx

32
Q

what is high in dermatomyositis

A

CK level

33
Q

what condition can be associated with calcinosis cutis ( calcium depositis in skin)

A

dermatomyositis

34
Q

this disease presents with early pink, blanching flat or urticarial rash that turns into palpable purpura

A

HSP

35
Q

plt count is what in HSP

A

nl

36
Q

sometimes hsp initially presents how

A

abdominal pain (colic), blood in stool, intussusception, GB hydrops

37
Q

biopsy of hsp would show

A

deposits of IgA, IgG and C3

38
Q

how to treat HSP

A

self limited can give NSAIDs if kidneys aren’t affected, severe cases might need IV steroids.

39
Q

multisystem complaints + hilar LAD should make you think of

A

sarcoidosis

40
Q

hilar LAD and peribronchial infiltrates that show noncaesating granulomas when bx is due to

A

sarcoidosis

41
Q

what is sjrogen caused by

A

lymphocytic infiltration of exocrine glands

42
Q

how to dx sjrogens

A

schirmers test ( paper to eye, lack of tear production)

43
Q

how to confirm dx of sjrogrens

A

bx of salivary gland will show lymphocytic infiltration

44
Q

wegners granulomatosis presents wih

A

multisystem vasculitis
sinusitis
lung issue
kidney issue
(+C-ANCA)

45
Q
A

PBR FlashCards (13 decks)

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