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Flashcards in Arthritis - Johnston, Smith Deck (24)
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1

RF -- spinal finding

Fused C1 and C2

2

RF --> tender red/purple papules that become non-healing necrotic ulcers

Pyoderma gangrenosum

3

CV associations w/ RF

Vasculitis, CAD, HF

4

Caplan syndrome


What on CXR?

RA + pneumoconiosis + pulmonary nodules

Hyperlucency (dark, air-trapping)

5

Felty syndrome

RA, splenomegaly, pancytopenia

6

RA is the most common cause of secondary ____

Sjogren's

7

Diagnosing Sjogrens

Schirmer's test (eye water), slit-lamp test

8

RA --> what causes joint destruction?

Pannus formation --> bone erosion and joint fusion

9

RA -- genetics

HLA-DRB4

10

A classification criteria score of ___ confirms RA

What are the criteria? (LOOK UP)

6/10

11

Must have active inflammation for ___ to make diagnosis

6+ weeks

12

First line DMARDs?

What is the 2nd one?

Methotrexate, Leflunomide

Leflunomide = pyrimidine antagonist - used in treatment of RA (instead of MTX)

13

If pregnant w/ RA, treatment?

Anti-malarial (hydroxychloroquine), Sulfasalazine

14

Biologic DMARDs -- risks?

Drugs?

Infection (ex. TB reactivation), neoplasia, MS, autoimmune

Etanercept, infliximab, adalimumab, rituximab

15

Commonalities to the SNSAs

- SPINE + symmetric SI JOINTS
- HLA-B27
- RF negative, ACCP negative
- Morning stiffness
- Asymmetry
- New bone formation
- Ankylosis
- Enthesitis
- Uveitis

16

SNSAs - how to see erosions?

How to see inflammation?

CT

MRI

17

General treatment for SNSAs

PT/exercise
NSAIDs
Biologic DMARD - for joint damage halting

18

Young male, reduced lumbar flexion, dorsal kyphosis, less chest expansion

Signs on imaging?

Potential complication?

Ankylosing spondylitis

Squaring, shiny corners, bamboo spine, SI joint pseudo-widening and sclerosis/fusion

Cauda equina syndrome -- bowel/bladder problems

19

What is DISH? Signs (5)

Diffuse idiopathic skeletal hyperostosis
- Males > 50 w/ DM
- Multiple flowing osteophytes
- 4+ vertebrae calcification
- NO SI JOINT
- Ligament calcification

20

Male, LE arthritis, asymmetrical SI joint, rash on penis, sausage finger, painless plaque lesions on palms and soles

Classic triad for this?

Causes?

What are the specific findings above called? (3)


Treatment?

Reactive arthritis

Urethritis, conjunctivitis, arthritis

Chlamydia or GI bug

- Circinate balanitis
- Keratoderma blennorrhagicum
- Dactylitis

Self-limited, NSAID, steroid, OR Azithromycin/Doxycycline (if Chlamydia)

21

Pitting nails, pencil-in-cup deformities

Treatment?

Psoriatic arthritis

Sulfasalazine

22

Patient w/ IBD, large joint arthritis of LE, small joint arthritis of UE, SNSA signs

Potential extra-arthritis signs? More likely in what?

Enteropathic arthritis

Skin = PG, EN
Uveitis
GI
Nephrolithiasis
Thrombotics
Bone issues

MORE LIKELY IN CD (rather than UC)

23

SMOADs - names?

Symptom-modifying OA drugs = "OSTEO BIFLEX"
- MMPI, Risedronate, Doxy, Glucosaime, Chondroitin)

24

When does Medicare kick in?

How do you surgically approach a hip for OA?

65 y/o

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