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Clin Med II MHM - FINAL > Pope Need to Know > Flashcards

Pope Need to Know Flashcards

1
Q

Which rheumatological diseases are MC in men?

A

Gout

Ankylosing spondylitis

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2
Q

Which rheumatological diseases are MC in women?

A 
Fibromyalgia
Sjogren's
SLE
PMR
RA
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3
Q

Which rheumatologic disorders result in pain with exercise/movement?

A

OA and fibromyalgia

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4
Q

Pain is improved with exercise/movement in which rheumatologic disorders?

A

Ankylosing spondylitis

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5
Q

What are the diagnostic criteria of fibromyalgia?

A
  1. Widespread body pain (11 of 18 tender points)
  2. 3 or more quadrants
  3. 3 or more months duration
  4. No other cause
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6
Q

Non-pharm treatments of fibromyalgia

A

PIE
Pt education
Improved sleep
Exercise

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7
Q

Pharm treatments of fibromyalgia

A

ATP
Anti-depressants
Tramadol
Pregabalin

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8
Q

FDA approved treatments of fibromyalgia

A

Duloxetine
Pregabalin
Milnacipran

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9
Q

What are inflammatory vs. non-inflammatory rheumatologic diseases?

A

Inflamm: RA, gout, SPA

Non-inflamm: OA, fibromyalgia

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10
Q

Differences between inflammatory and non-inflammatory rheumatologic disorders?

A

Inflamm: AM stiffness more than 30 minutes, symptoms IMPROVE with activity

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11
Q

What indicates poor prognosis in RA?

A

High titer RF and/OR anti-CCP

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12
Q

If a patient has positive RF and anti-CCP, what is the likely diagnosis?

A

98% RA as long as they also have clinical s/s

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13
Q

Which joints are affected by RA?

A

2nd and 3rd MCPs, PIPs

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14
Q

What is the mainstay drug of RA?

A

MTX

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15
Q

What are the x-ray findings a/w RA?

A

Symmetric joint space loss
MCPs and PIPs affected
Corner erosions of small joints (mouse bites)

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16
Q

How do symptoms cluster in lupus?

A

CAR: Cutaneous, Articular, Renal
CTM: CNS, Thrombotic, Muscular

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17
Q

Which enzymes are muscle specific?

A

CK and aldolase

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18
Q

Which enzymes are muscle AND liver specific?

A

AST and LDH

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19
Q

Which enzymes are liver specific?

A

ALT

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20
Q

Which organs are affected by Sjogren’s?

A 
Exocrine glands (lacrimal, salivary)
Eyes
Lungs
Kidneys
Heart
Skin
Neural (CNS and PNS)
Hematopoietic
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21
Q

S/S of OA

A 
Pain with increasing use
Stiffness less than 30 mins
Limited ROM
Swelling
Crepitus
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22
Q

Body parts affected by OA

A

Hands (70%)
Spine (60%)
Knees (30%)
Hips (10%)

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23
Q

Where are men with OA MC affected?

A

Hips

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24
Q

Where are women with OA MC affected?

A

Hands and knees

25
Q

Which joints are involved in OA?

A

DIPs

26
Q

Define enthesitis and what it is a/w

A
  • Inflammation where a tendon/ligament inserts on bone

- Reactive arthritis

27
Q

Define synovitis and what it is a/w

A
  • Inflammation of synovial membrane

- OA

28
Q

MC cause of low back pain?

A

Idiopathic (70%)

29
Q

Treatment of low back pain

A
  • AVOID bed rest

- Anti-inflamm, opioids, muscle relaxants

30
Q

Differential categories of low back pain

A
  1. Mechanical
  2. Rheum
  3. Endocrine
  4. Neuro/Psych
  5. Neoplastic
  6. Referred
31
Q

Red flags with low back pain

A
  1. Over 50
  2. Trauma
  3. Neuro deficit
  4. Unexplained wt loss
  5. Substance abuse
  6. AS
  7. Night pain
  8. Malignancy hx
  9. Systemic steroids
  10. Fever over 100F
  11. Persistent pain
  12. Compensation issues
  13. Increased pain when recumbent
  14. Bowel and bladder dysfunction
32
Q

What do the spondyloarthropathies (SPA) include?

A

PARE

  • Psoriatic arthritis
  • AS
  • Reative arthritis
  • Enteropathic arthritis
33
Q

Extra-articular manifestations of SPA and when do they occur?

A

May occur prior to diagnosis

  • Acute anterior uveitis
  • IBD
  • Prostatitis
  • Aortic regurge
34
Q

What occurs with progression of spondyloarthritis?

A
  • Loss of spinal mobility

- Bamboo spine (fusion)

35
Q

Synovial fluid analysis consists of:

A

Three Cs

  1. Cell count
  2. Culture
  3. Crystal analysis
36
Q

What disease has monosodium urate crystals?

A

Gout

37
Q

What disease has calcium pyrophosphate dihydrate (CPPD) crystals?

A

Pseudogout

38
Q

What disease has basic calcium phosphate (BCP) crystals?

A

Calcific periarthritis (Milwaukee shoulder)

39
Q

MC way that gout develops?

A

Underexcretion of uric acid by the kidney (MC than overproduction)

40
Q

X-ray findings of gout

A

“Overhanging edges” and asymmetric erosions

41
Q

X-ray finding of pseudogout

A
  • Chondrocalcinosis

- Punctate linear deposits of CPPD crystals in the menisci and cartilage

42
Q

Who is MC affected by PMR?

A

Females over 50

43
Q

Clinical features of PMR

A
  • Symmetric proximal muscle pain and stiffness (shoulder, neck, pelvis)
  • Constitutional symptoms
44
Q

What areas of the body are MC affected by PMR?

A 
Shoulder girdle (90%)
Neck and pelvis (70%)
45
Q

Treatment of PMR

A

Low dose prednisone

46
Q

Who is MC affected by giant cell/temporal arteritis?

A

Over age 50

47
Q

Clinical features of giant cell/temporal arteritis?

A 
HA
Jaw claudication
PMR
Fever
Vision loss
48
Q

Treatment of giant cell/temporal arteritis

A

Prednisone ASAP - do NOT wait for biopsy results

49
Q

What is polyarteritis nodosa (PAN)?

A

Necrotizing inflammation of MEDIUM to SMALL arteries (but not the smallest vessels)

50
Q

What is PAN a/w?

A

HBV

51
Q

Which organs are affected by PAN?

A

Multiple BUT spares the lungs and glomerulus

52
Q

Clinical features of PAN

A
  • PNS
  • GI
  • Skin
  • NOT ANCA positive
53
Q

Best method of diagnosis for PAN

A

Tissue biopsy

54
Q

What is Henoch-Schoenlein purpura?

A

MC vasculitis in children

55
Q

Clinical features of Henoch-Schoenlein purpura?

A
  • Most have preceding URI

- Triad: palpable purpura, abdominal pain, glomerulonephritis

56
Q

What is the triad of Henoch-Schoenlein purpura?

A

GAPP
Glomerulonephritis
Abdominal pain
Palpable Purpura

57
Q

What is the prognosis of Henoch-Schoenlein purpura?

A

Self limited and excellent prognosis

58
Q

What is Takayasu’s arteritis? Who is MC affected and how does it present?

A
  • Inflammation of LARGE arteries (aorta and its major branches)
  • Asian women under 50
  • FUO, malaise, different BPs on R vs. L, bruit over R axilla
59
Q

What are symptoms a/w fibromyalgia (but not diagnostic)?

A 
Cognitive dysfunction
Autonomic dysfunction
Multiple sensitivities
Paresthesia
Severe fatigue
Insomnia 
Restless legs
Exercise intolerance
HA
Irritable bladder/bowel
Depression/anxiety
Dizziness
Endocrine imbalance

Clin Med II MHM - FINAL (16 decks)

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