Orthopedics/Rheumatology High Yield Flashcards

1
Q

What is Gout

A

Uric Acid Deposition in soft tissue, joints, bones

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2
Q

What is a common cause of Gout

A

Purine rich foods like alcohol, liver, oily fish, yeast

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3
Q

Sx of Gout

A

Podagra: 1st MTP joint is red and painful

Tophi Deposition: Collection of solid uric acid in soft tissue

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4
Q

Dx of Gout

A

Arthrocentesis: Negative Bifringent Needle Shape Urate Crystals
Xrays: Rat Bite, Punched out Erosions

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5
Q

Tx of Gout

A

NSAIDS (indomethacin)
Colchicine 2nd line
For chronic: Allopurinol

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6
Q

What is Pseudogout

A

Calcium Pyrophosphate deposition in joints
Knee is red, swollen and tender
See Cartilage Calcifications (Chondrocalcinosis)

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7
Q

Dx of Pseudogout

A

Arthrocentesis: Positively birefringenet, Rhomboid Shaped CPP Crystals

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8
Q

Tx of Pseudogout

A

Corticosteroids are 1st line
NSAIDS
Colchicine for prophylaxis

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9
Q

What is Sjogren’s Syndrome

A

Autoimmune disorder attacking exocring glands

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10
Q

Sx of Sjogren’s Syndrome

A

Salivary: Xerostoma (dry mouth)
Lacrimal: Keratoconjunctivitis sicca (dry eyes)
Parotid Enlargement

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11
Q

Dx of Sjogren’s Syndrome

A
ANA
AntiSS-A
AntiSS-B
Positive RF
Shirmer Test (decreased tear production)
Biopsy of gland
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12
Q

Tx of Sjogren’s Syndrome

A

Artificial Tears, Pilocarpine

Cevimeline stimulates muscarinic cholinergic receptors

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13
Q

What is Polymyositis

A

Idiopathic inflammatory muscle disease of proximal limbs, neck, pharynx

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14
Q

Sx of Polymyositis

A

Progressive symmetrical proximal muscle weakness (not painful)
Dysphagia, Skin Rash, Polyarthrlagias, Muscle Atrophy (difficulty combing hair, climbing stairs)

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15
Q

Dx of Polymyositis

A

Aldolase
Anti-SRP antibody
Muscle Biopsy: See inflammation around the individual muscle fiber (endomysial involvement)

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16
Q

Tx of Polymyositis

A

High dose steroids

Methotrexate

17
Q

What is Reactive Arthritis (Reiter’s Syndrome)

A

Autoimmune response to infection

18
Q

Sx of Reactive Arthritis

A

Can’t see, can’t pee, can’t climb a tree
Conjunctivitis/Uveitis, Urethritis, Asymmetric inflammatory arthritis
Sausage toes/fingers

19
Q

What infections preceded Reactive Arthritis

A

Chlamydia, Gonoarrhea, GI (Salmonella, Shigella)

20
Q

Dx of Reactive Arthritis

A

HLA-B27

Synovial Flud WBC will be

21
Q

Tx of Reactive Arthritis

A

NSAIDS

22
Q

What is Scleroderma

A

Systemic connective tissue disorder

Thickened skin, lung, heart, kidney, GI tract

23
Q

Sx of Scleroderma

A

Tight, Shiny, Thickened skin due to fibrous collagen buildup
CREST syndrome
Calcinosis cutis, Raynaud’s Phenomenon, Esophageal MOtility disorder, Sclerodactyly, Telangectasis
Pulmonary HTN

24
Q

Dx of Scleroderma

A

Anti-Centromere AB
Anti-SCL-70 antibodies
Positive-ANA

25
Q

Tx of Scleroderma

A

DMARDS, Steroids

Vasodilators for Raynaud’s: CCB, Prostacyclin