Flashcards in Pope Need to Know Deck (59):
Which rheumatological diseases are MC in men?
Which rheumatological diseases are MC in women?
Which rheumatologic disorders result in pain with exercise/movement?
OA and fibromyalgia
Pain is improved with exercise/movement in which rheumatologic disorders?
What are the diagnostic criteria of fibromyalgia?
1. Widespread body pain (11 of 18 tender points)
2. 3 or more quadrants
3. 3 or more months duration
4. No other cause
Non-pharm treatments of fibromyalgia
Pharm treatments of fibromyalgia
FDA approved treatments of fibromyalgia
What are inflammatory vs. non-inflammatory rheumatologic diseases?
Inflamm: RA, gout, SPA
Non-inflamm: OA, fibromyalgia
Differences between inflammatory and non-inflammatory rheumatologic disorders?
Inflamm: AM stiffness more than 30 minutes, symptoms IMPROVE with activity
What indicates poor prognosis in RA?
High titer RF and/OR anti-CCP
If a patient has positive RF and anti-CCP, what is the likely diagnosis?
98% RA as long as they also have clinical s/s
Which joints are affected by RA?
2nd and 3rd MCPs, PIPs
What is the mainstay drug of RA?
What are the x-ray findings a/w RA?
Symmetric joint space loss
MCPs and PIPs affected
Corner erosions of small joints (mouse bites)
How do symptoms cluster in lupus?
CAR: Cutaneous, Articular, Renal
CTM: CNS, Thrombotic, Muscular
Which enzymes are muscle specific?
CK and aldolase
Which enzymes are muscle AND liver specific?
AST and LDH
Which enzymes are liver specific?
Which organs are affected by Sjogren's?
Exocrine glands (lacrimal, salivary)
Neural (CNS and PNS)
S/S of OA
Pain with increasing use
Stiffness less than 30 mins
Body parts affected by OA
Where are men with OA MC affected?
Where are women with OA MC affected?
Hands and knees
Which joints are involved in OA?
Define enthesitis and what it is a/w
-Inflammation where a tendon/ligament inserts on bone
Define synovitis and what it is a/w
-Inflammation of synovial membrane
MC cause of low back pain?
Treatment of low back pain
-AVOID bed rest
-Anti-inflamm, opioids, muscle relaxants
Differential categories of low back pain
Red flags with low back pain
1. Over 50
3. Neuro deficit
4. Unexplained wt loss
5. Substance abuse
7. Night pain
8. Malignancy hx
9. Systemic steroids
10. Fever over 100F
11. Persistent pain
12. Compensation issues
13. Increased pain when recumbent
14. Bowel and bladder dysfunction
What do the spondyloarthropathies (SPA) include?
Extra-articular manifestations of SPA and when do they occur?
May occur prior to diagnosis
-Acute anterior uveitis
What occurs with progression of spondyloarthritis?
-Loss of spinal mobility
-Bamboo spine (fusion)
Synovial fluid analysis consists of:
1. Cell count
3. Crystal analysis
What disease has monosodium urate crystals?
What disease has calcium pyrophosphate dihydrate (CPPD) crystals?
What disease has basic calcium phosphate (BCP) crystals?
Calcific periarthritis (Milwaukee shoulder)
MC way that gout develops?
Underexcretion of uric acid by the kidney (MC than overproduction)
X-ray findings of gout
"Overhanging edges" and asymmetric erosions
X-ray finding of pseudogout
-Punctate linear deposits of CPPD crystals in the menisci and cartilage
Who is MC affected by PMR?
Females over 50
Clinical features of PMR
-Symmetric proximal muscle pain and stiffness (shoulder, neck, pelvis)
What areas of the body are MC affected by PMR?
Shoulder girdle (90%)
Neck and pelvis (70%)
Treatment of PMR
Low dose prednisone
Who is MC affected by giant cell/temporal arteritis?
Over age 50
Clinical features of giant cell/temporal arteritis?
Treatment of giant cell/temporal arteritis
Prednisone ASAP - do NOT wait for biopsy results
What is polyarteritis nodosa (PAN)?
Necrotizing inflammation of MEDIUM to SMALL arteries (but not the smallest vessels)
What is PAN a/w?
Which organs are affected by PAN?
Multiple BUT spares the lungs and glomerulus
Clinical features of PAN
-NOT ANCA positive
Best method of diagnosis for PAN
What is Henoch-Schoenlein purpura?
MC vasculitis in children
Clinical features of Henoch-Schoenlein purpura?
-Most have preceding URI
-Triad: palpable purpura, abdominal pain, glomerulonephritis
What is the triad of Henoch-Schoenlein purpura?
What is the prognosis of Henoch-Schoenlein purpura?
Self limited and excellent prognosis
What is Takayasu's arteritis? Who is MC affected and how does it present?
-Inflammation of LARGE arteries (aorta and its major branches)
-Asian women under 50
-FUO, malaise, different BPs on R vs. L, bruit over R axilla