2-uWorld Flashcards
(29 cards)
Is a good clock test for hemochromatosis?
Transferrin sat
Synovial fluid WBC in septic bursitis versus septic arthritis
> 5000
> 50,000
Patients with polymyositis and dermatomyositis are 5 fold increase in risk of___and therefore should require this as a result
High risk of malignancy
Go through cancer screening i.e. mammogram, colonoscopy
CA125, CA 19-9
Urinalysis for hematuria
PSA
Endoscopy
CT chest abdomen pelvis
Apparently cutaneous small vessel vasculitis as seen with palpable purpura can be induced by___with examples of this and___
Result of drug i.e. 7 to 10 days after initiation of penicillin, cephalosporin, phenytoin, NSAIDs
Infection i.e. 7 to 10 days after hepatitis B, hep C, HIV
Can complete recovery be possible with adhesive capsulitis AKA frozen shoulder?
Yes complete recovery in patients can take up to 6 to 18 months
What is the treatment of choice for frozen shoulder
Stretching exercises to improve range of motion
I.e. pendulum type swing or hand-held weights, stretching the arm by walking the fingers up the wall, rubbing at the lower back with a towel with both hands
Pathophysiology of frozen shoulder
Chronic inflammation, fibrosis, Contracture of joint capsule
How you diagnosed frozen shoulder?
Clinically, on passive and active range of motion there is >50% reduction of both
There is more shoulder stiffness than pain
Risk factors For frozen shoulder AKA adhesive capsulitis
Diabetes
Stroke
Rotator cuff tendinopathy
Subacromial bursitis
Humeral head fracture
When should you add steroid injection for adhesive capsulitis?
Patient has tried range of motion exercises for 6 to 8 weeks without any improvement
Especially if patient has concurrent rotator cuff or bicep tendinopathy
What medications help in an acute short-term relief for rheumatoid arthritis?
NSAIDs and glucocorticoids
Is a possible for patient with rheumatoid arthritis to have negative rheumatoid factor?
Yes you can have rheumatoid factor negative also known as seronegative rheumatoid arthritis
Generally they have a less aggressive course
Why is it so important to have DMARD and rheumatoid arthritis chronic management?
DMARD help prevent long-term joint damage and functional impairment
What are first-line DMARD for rheumatoid arthritis? Outside of methotrexate obviously
Hydroxychloroquine
Leflunomide
Sulfasalazine
Tenderness with foot dorsiflexion
Plantar fasciitis
Patient comes in with pain, paresthesias, numbness to the sole of the foot, what maneuvers should you do and what are you looking for with this?
Palpate behind medial malleolus, tenderness there remains tenderness on the posterior tibial nerve which means tarsal tunnel syndrome
First diagnosis to think 1 patient says they have pain on foot after stepping out of bed
Plantar fasciitis
Treatment for plantar fasciitis
What is the neck step if all of these measures fail
Stretching exercises
Short-term NSAIDs
Silicone heel shoe inserts
If all these fail: Steroid injections
Shockwave therapy and surgery are reserved for those who have failed conservative measures in 6 months to a year
Numbness or pain between the 3rd and 4th toe
Clicking sensation when palpating space between 3rd and 4th toe while squeezing the metatarsal joints
Morton’s neuroma
Burning pain 2 to 6 cm above the posterior calcaneus
Achilles tendinopathy
Risk factors for pseudogout
Hypothyroidism
Hemochromatosis
Renal osteodystrophy
Hyperparathyroidism/recent parathyroidectomy
Chest x-ray show on gout versus pseudogout
Gout-subcortical bone cysts possible bony erosions
Pseudogout-chondrocalcinosis
Synovial fluid analysis for gout versus pseudogout
Doubt-needle shaped negative birefringence uric acid crystals
Pseudogout-rhomboid positive Birefringence calcium pyrophosphate crystals
Describe clinical features of Felty syndrome
Neutropenia
Splenomegaly
Rheumatoid arthritis
