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ICM Exam 2 Rheumatology (MC) > ICM - Rheum 4 > Flashcards

ICM - Rheum 4 Flashcards

1
Q

what anatomic site does gout (microcrystalline arthritis) affect?

A

joint space

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2
Q

cardiovascular exercise is important treatment/therapy in this disease

A

fibromyalgia

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3
Q

muscle strengthening is important treatment for these conditions

A

OA and LBP

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4
Q

treatment option for underlying immune defect in many autoimmune diseases

A

disease modifying anti-rheumatic drugs (DMARDS)

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5
Q

this calcium pyrophosphate deposition diseases is associated with OA (either result or cause)

A

chondrocalcionsis

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6
Q

matrix degrading enzymes responsible for collagen network degradation (cannot be reversed)

A

aggrecanases and collagenases (metalloproteinases)

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7
Q

Wolff’s hypothesis (of bone remodeling)

A

distribution/material of bone determined by magnitude/direction of load

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8
Q

stain that has high affinity for proteoglycans (paler staining of cartilage)

A

safranan O

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9
Q

can last for 15-30 min in OA….stiffness when first using the joint after period of rest

A

gelling

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10
Q

how many joints affected in OA?

A

one or few

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11
Q

knee in this position if lateral compartment degrades

A

valgus

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12
Q

commonalities among classification criteria of OA

A

pain in joint, aging, no inflammation, osteophytes

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13
Q

DDX for OA

A

CPPD, RA, infectious monoarticular disease, psoriatic arthritis

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14
Q

topical options for hand OA

A

capsacin or NSAID

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15
Q

oral treatments for hand OA

A

NSAIDs, COX 2 selective NSAID, tramadol (weak SSRI)

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16
Q

recommended pharmacological treatments for Hip and Knee OA

A

acetaminophen, NSAID, intraarticular corticosteroid, tramadol

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17
Q

this is hallmark of systemic onset JRA

A

quotidian fever (spiking 1-2x per day)

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18
Q

diagnostic for systemic onset JRA

A

fever and rash

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19
Q

description of rash in JRA

A

macular, evanescent, migratory rash on trunk and proximal extremities

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20
Q

extra-articlar manifestations of JRA

A

pericarditis, myocarditis, chronic uveiitis, growth retardation

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21
Q

polyarthritis JRA clinical features

A

PIP, MCP wrist (hands like adult RA), cervical spine disease, micrognathia (temporal mandibular disease)

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22
Q

oligoarthritis JRA clinical features

A

primarily knees/ankles/feet, uveitis (young females with ANA)

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23
Q

systemic JRA clinical features

A

quotidian fever, evaescent rash with Koebner phenomenon, hepatosplenomegaly/lymphadenopathy/pericarditis

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24
Q

describes rash in systemic JRA –> can be induced by rubbing or scratching the skin

A

Koebner phenomenon

25
Q

growth retardation of TMJ –> shortening of jaw/chin

A

micrognathia

26
Q

diagnostic criteria for JRA

A

6 weeks

27
Q

primary site of pathologic anatomy/inflammation in seronegative spondyloarthropathies

A

enthesis

28
Q

basic pathogenesis of seronegative spondyloarthropathies

A

fibrosis/ossification of enthesis (reducing ROM)

29
Q

seronegative spondyloarthropathy involving primarily axial spine, pain/stiffness –> leading to fusion

A

ankylosing spondylitis

30
Q

epidemiology if ankylosing spondylitis

A

male, young adult (by 20s), caucasian

31
Q

symptoms of ankylosing spondylitis…typically longer than 3 months

A

LBP (insidious onset, better with exercise, pain at night), morning stiffness, fatigue/weight loss/low fever

32
Q

extra-articular manifestations of ankylosing spondylitis

A

prostatitis (80%), iritis/conjunctivitis (25%), upper lobe fibrosis, CV disease

33
Q

DDX for ankylosing spondylitis

A

mechanical BP, OA, osteitis condensans IIii, Reiter’s syndrome, psoriatic arthritis

34
Q

special studies for ankylosing spondylitis

A

pelvic Xray (look at SI joint), MRI (and possibly HLA B27)

35
Q

treatment for ankylosing spondylitis

A

stretching/flexibility, NSAIDs, sulphasalazine (peripheral), TNF blockers

36
Q

triad of Reiter’s syndrome

A

urethritis, conjunctivitis, arthritis (> 1mo)

37
Q

time it takes for Reiter’s syndrome to develop after diarrheal illness or sexual exposure

A

2-4 weeks

38
Q

this condition is usually pauciarticular, affecting large joints, and the lower extremity; also sausaging or dactylitis of toes (due to swelling)

A

Reiter’s

39
Q

mucocutaneous manifestation of Reiters –>skin lesions on soles and palms, toes, glans penis

A

keratoderma blenorrhagica

40
Q

UG manifetation of Reiter’s….painless and superficial erosions on glans penis

A

circinate balantis

41
Q

venereal organisms that can cause Reiter’s

A

Chlamydia trachomatis and Mycoplasma

42
Q

HLA associated with Reiter’s

A

HLA B27

43
Q

late manifestations of Reiter’s

A

sacroiliitis, iridiocyclitis, CV (palpitations, murmurs, rub), peripheral neuropathy

44
Q

special studies for Reiter’s

A

joint aspiration, STD exam, SI xray (also CBC, WSR, UA, ANA, RF)

45
Q

mainstay of therapy for Reiter’s syndrome

A

NSAIDs

46
Q

mechanisms that estrogen may aggravate SLE

A

prolong survival autoimmune cells, increase CD4 CK production, stimulate B cells (to make Ab)

47
Q

ANA associated with limited scleroderma (CREST)

A

anti-centromere

48
Q

these are present in 100% of cases of drug induced SLE

A

antihistones

49
Q

lace-like, purple rash seen in SLE

A

livedo reticularis

50
Q

serositis manifestations of SLE

A

pleurisy and pericarditis

51
Q

hematologic manifestations of SLE

A

anemia, leukopenia, thrombocytopenia

52
Q

GN seen in SLE where immune deposits only in mesangial area

A

mesangial

53
Q

renal involvement in SLE….less that 50% glomerular tufts affected with segmental proliferation –> Ig in mesangium, subendothelial/subepithelial/intraBM areas

A

focal proliferative nephritis

54
Q

renal involvement in SLE…>50% glomerular tufts affected by hypercellularity (mesangial, endothelial, monocytes, PMN)

A

diffuse proliferative GN

55
Q

renal involvement in SLE…little cellular proliferation, uniform thickening of glomerular BM (Ig and complement along glomerular BM)

A

membranous GN

56
Q

Ab seen in sjogrens syndrome –> associated with ANA neg lupus, congenital lupus

A

anti Ro (SSA) and La (SSB)

57
Q

diagnostic criteria for SLE (Need 4/11)

A

renal, arthriris, serositis, hematologic, oral ulcers, neurlogical (seizures/psychosis), malar rash, ANA, immunologic disorder, discoid rash, sun sensitivity

58
Q

treatment for mild manifestations of SLE

A

antimalarials (hydroxychloroquin)

59
Q

cytotoxic medications for major organ involvement in SLE

A

azathioprine, cyclophosphamide

ICM Exam 2 Rheumatology (MC) (5 decks)

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