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Board Review - C - MSK/Dermatology > MSK/Derm IV > Flashcards

MSK/Derm IV Flashcards

1
Q

osteoarthritis

A

mechanical damage of articular cartilage

subchondral cyst and bone spur

heberden node - DIP
bouchard node - PIP
no MCP involved

weight bearing joint
improved with rest

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2
Q

tx osteoarthritis

A

acetaminophen
NSAID
intra-articular glucocorticoid

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3
Q

rheumatoid arthritis

A

autoimmune destruction synovial joint - type III/IV HS

pannus - inflammatory graulation tissue
subQ rheumatic nodules - fibrinoid necrosis
ulnar devlation
swan neck and boutonniere deformity

PIP and MCP involvement

morning stiffnes >30 minute - improve with use

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4
Q

anti-cyclic citrulliniated peptid Ab

A

specific for rheumatoid arthritis

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5
Q

rheumatoid factor

A

anti IgG Ab

rheumatoid arthritis

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6
Q

tx rheumatoid arthritis

A 
NSAID
glucocorticoid
methotrexate
sulfasalazine
biologic - TNF-a
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7
Q

HLA with rheumatoid arthritis

A

HLA DR4

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8
Q

sjogren

A

autoimmune destruction exocrine gland

xerophthalmia - low tears
zerostomia - low saliva

SS-A and SS-G Abs

SS-A - anti Ro
SS-B - anti-La

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9
Q

complication of sjogren

A

dental caries

MALT lymphoma - parotid enlargement

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10
Q

gout

A

monosodium urate crystals

underexcretion uric acid (90%)
overproduction of uric acid (10%) - lesch nyhan, von gierke

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11
Q

gout crystals

A

negative birefringement

yellow in parallel

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12
Q

podagra

A

painful MTP joint big toe with gout

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13
Q

tophus

A

gout crystal buildup

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14
Q

acute tx gout

A

NSAID
colchicine
glucocorticoid

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15
Q

chronic gout tx

A

allopurinol

febuxostat

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16
Q

pseudogout

A

deposit calcium pyrophosphate

basophilic rhomboid crystals

positive birefringement
blue in parallel

17
Q

tx pseudogout

A

NSAID - sudden attack

glucocorticoid, colchicine - prophylaxis

18
Q

association with pseudogout

A

hemochromatosis
hyperPTH
osteoarthritis

19
Q

infectious arthritis

A

staph aureus
streptococcus
neisseria onorrhea

gonococcal - migratory with asymmetric pattern

20
Q

seronegative spondyloarthropathy

A

no rheumatoid factor
-no anti - IgG

HLA B27 association

often males

21
Q

psoriatic arthritis

A

seronegative SA

joint pain with psoriasis

sausage fingers - pencil in cup

22
Q

ankylosing spondylitis

A

seronegative SA

chronic inflammation spine and SI joint

ankylosis - stiff spine - fused joints

uveitis
aortic regurg

23
Q

inflammatory bowel disease

A

crohn and UC

often accompanied ankylosing spondylitis and peripheral arthritis

24
Q

reactive arthritis

A

reiter syndrome
seronegative SA

triad
-conjunctivitis
urethritis
arthritis

can’t see, can’t pee, can’t bend my knee

post GI - shigella, salmonella, yersinia, campylobacter, chlamydia

25
Q

SLE

A

rash, joint pain, fever

female african descent

26
Q

libman sack endocarditis

A

nonbacterial

wart like vegetation on both side valve

27
Q

lupus nephritis

A

type III hypersensitivity

nephritic - diffuse proliferative GN
nephrotic - membranous GN

28
Q

COD in SLE

A

cardiovasc
infection
renal disease

29
Q

lab SLE

A

ANAa
anti-dsDNA and anti-smith (specific)
antihistone
low complement

smith - to snRNPs

30
Q

tx SLE

A

NSAID
steroid
immunosuppressant
hydroxychloroquine

31
Q

antihistone Ab

A

sensitive for drug induced lupus

32
Q

false positive VDRL

A

anticardiolipin Abs
lupus anticoag

also caus prolonged PTT

33
Q

antiphospholipid syndrome

A

commonly with SLE

hx of thrombosis
spontaneous abortion
lupus anticoag Abs
anticardiolipin Abs
anti-B2 glycoprotein Abs

tx - anticoag

34
Q

sarcoidosis

A

noncaseating granulomas
elevated ACE
elevated CD4/CD8 ration

black females

bilateral adenopathy
hilar and mediastinal adenopathy

with restrictive lung disease, erythema nodosum, lupus pernio, bells palsy, uveitis, hyperCa

35
Q

hyper Ca with sarcoid

A

1-a hydroxylase mediated vit D activation in macrophages

36
Q

tx of sarcoidosis

A

steroids

37
Q

polymyalgia rheumatica

A

pain stiff shoulder and hip

women >50yo

temporal giant cell arteritis association

elevated ESR, CRP, normal CK

tx - rapid response to low dose corticosteroids

38
Q

fibromyalgia

A

female 20-50yo

chronic widespread MSK pain - stiff, paresthesia, poor sleep, fatigue

tx - exercise, antidepressant, anticonvulsant

Board Review - C - MSK/Dermatology (6 decks)

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