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Flashcards in Conditions Related to RA Deck (21):
1

What is the typical onset to seronegative rheumatoid arthritis of the elderly?

> 60y/o

2

What is the clinical presentation of seronegative rheumatoid arthritis of the elderly?

Sudden development of mild arthritis. If elderly male patients over 70 also show pitting in their hand and feet, it is called RS3PE (remitting symmetric seronegative synovitis with pitting edema).

3

What is the Tx of seronegative rheumatoid arthritis of the elderly?

Best controlled with low doses of prednisone.

4

What are the 3 components to the Still disease?

Fever
Rash
Arthritis

5

When is the onset to Adult Still disease?

between 16 and 35 years old

6

What is the clinical presentation of Adult Still disease?

Quotidian fever (fever spike w/ return to normal all in 1 day): 39* C
Arthralgia
Arthritis: 1/3 of patients have joint disease that is progressive and destructive.
Leukocytosis
Macular evanescent rash: appearance of a macular salmon-colored eruption on the trunk and extremities.
Serositis
Lymphadenopathy
Splenomegaly
Hepatomegaly

7

What are the lab abnormalities in Adult Still disease?

Seronegativity (negative rheumatoid factor and antinuclear antibody)

8

What is the Tx of Adult Still disease?

high doses of aspirin or indomethacin.

9

What is the triad of Felty syndrome?

Rheumatoid arthritis
Leukopenia
Splenomegaly

10

What is the onset to Felty syndrome?

occurs after 12 years or more of rheumatoid arthritis.

11

What are teh clinical features of Felty syndrome?

recurrent fevers with or without infection, weight loss, lymphadenopathy, skin hyperpigmentation, lower extremity ulcers, vasculitis, neuropathy, keratoconjunctivitis sicca, xerostomia, cytopenias.

12

What are the cause of mortality of Felty syndrome?

patients with Felty syndrome often have bacterial infections, especially of the skin and lungs but infection related to the cytopenia is the major cause of mortality. Hypocomplementemia (immune compromised) often occurs with active vasculitis and patients die of sepsis even with vigorous antibacterial treatment.

13

What are the lab fidnings in Felty syndrome?

High titers of rheumatoid factorsa re the rule, and a positive antinuclear antibody occurs in 2/3 of patients.

14

What is the Tx of Felty syndrome?

corticosteroids, methotrexate, granulocyte colony-stimulating factor, and splenectomy

15

What is the triad of Sjoren syndrome?

Arthritis (typically episodic polyarthritis) – connective tissue disease
Dry eyes – keratoconjunctivitis sicca with or w/o lacrimal gland enlargement
Dry mouth and dry mucous membranes – xerostomia w/ or w/o salivary gland enlargement

16

What are the histological findings of Sjoren syndrome?

CD4 lymphocytic infiltration and destruction of lacrimal salivary glands

17

What is the clinical presentation of Sjoren syndrome?

dry eyes and mouth

18

What is the predominant population of Sjoren syndrome?

middle-aged women

19

What are the lab findings of Sjoren syndrome?

polyclonal hypergammaglobulinemia, autoantibodies such as rheumatoid factor, antinuclear antibodies, and antibodies to extractable nuclear antigens (SS-A and SS-B).

20

What is the Tx of Sjoren syndrome?

only treats the symptoms. Pilocarpine, 5mb orally 4x daily to improve salivary and lacrimal gland function.

21

What is the associated malignancy in patients with Sjoren syndrome?

non-Hodgkin lymphoma