Medical Management Of Rheumatic Diseases Flashcards
(20 cards)
What is the primary clinical feature that differentiates Rheumatoid Arthritis (RA) from Osteoarthritis (OA)?
RA is characterized by symmetric joint inflammation primarily affecting small joints, while OA is a degenerative disorder that affects weight-bearing joints and is not associated with systemic inflammation.
Describe the typical clinical presentation of a patient with Rheumatoid Arthritis (RA).
Insidious onset, prolonged morning stiffness (>1 hour), symmetric polyarthritis involving small joints, and extraarticular manifestations such as subcutaneous nodules and TMJ involvement.
What are the diagnostic criteria for Rheumatoid Arthritis (RA)?
Diagnosis requires at least 4 of the following: Morning stiffness, arthritis of 3 or more joints, arthritis of hand joints, symmetric arthritis, rheumatoid nodules, serum rheumatoid factor, and radiographic changes.
What are the first-line pharmacological treatments for Osteoarthritis (OA)?
First-line treatments include acetaminophen, NSAIDs, and intra-articular corticosteroids for symptom management.
Which laboratory tests are highly specific for Systemic Lupus Erythematosus (SLE)?
Anti-dsDNA and anti-Smith antibodies are highly specific for SLE, whereas ANA is sensitive but not specific.
What is the most common cardiac manifestation of SLE?
Libman-Sacks endocarditis, a form of nonbacterial verrucous endocarditis.
What are the components of CREST syndrome in limited Scleroderma?
Calcinosis, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia.
What is the characteristic skin lesion associated with Lyme Disease?
Erythema migrans, a target or bull’s eye-shaped lesion.
What are the three stages of Lyme Disease and their associated clinical features?
Early Localized: Erythema migrans, flu-like symptoms.
Early Disseminated: Neurologic and cardiac manifestations.
Late Disease: Chronic arthritis and neuroborreliosis.
What is the primary treatment for acute Lyme Disease?
Oral doxycycline for 3-4 weeks. Alternatives include amoxicillin or cefuroxime.
What are the common oral findings in Sjögren’s Syndrome?
Xerostomia, dental caries, angular cheilosis, and oral candidiasis.
How is fibromyalgia diagnosed based on the 2010 ACR criteria?
Widespread pain lasting more than 3 months, with 11 of 18 tender points and symptoms such as fatigue, sleep disturbances, and cognitive difficulties.
What is the primary genetic marker associated with Ankylosing Spondylitis?
HLA-B27.
What are the key differences between primary and secondary Sjögren’s Syndrome?
Primary SS involves keratoconjunctivitis sicca and salivary gland dysfunction without systemic disease; Secondary SS is associated with conditions like RA or SLE.
What is the primary cause of sclerodactyly in Scleroderma?
Fibrosis and thickening of the skin leading to joint contractures.
What are the common systemic manifestations of Ehlers-Danlos Syndrome (EDS)?
Hypermobility, joint dislocations, poor wound healing, vascular fragility, and chronic pain.
What are the primary treatment modalities for Ankylosing Spondylitis?
NSAIDs, DMARDs (sulfasalazine), TNF-alpha inhibitors, physical therapy, and exercise.
What are the characteristic findings in amyloidosis and how is it diagnosed?
Amyloid deposits in tissues, diagnosed via tissue biopsy and histological staining.
What is the recommended treatment for severe, refractory fibromyalgia?
Gabapentin, pregabalin, SSRIs, physical therapy, and cognitive behavioral therapy. Opioids are not recommended.
What is the clinical significance of anti-SSA (Ro) and anti-SSB (La) antibodies in Sjögren’s Syndrome?
Indicative of Sjögren’s Syndrome and associated with increased risk of congenital heart block in offspring.
