Rheum Flashcards
(136 cards)
Pt with morning stiffness and joint pain in multiple joints but excludes the DIP and Rh and Anti CCP are both negative. Dx and Tx
RA and treat with MTX
RA patient with oral ulcers on MTX. WTD
Give folic acid
RA patient with sudden onset of back of the knee pain. whats the Dx and how to treat
Ruptured popliteal cyts
Intra-articular steroids
RA patient who is postop quadriplegic
Atlanto-dontoid subluxation C1-C2
Long-standing RA with hoarseness of voice
Cricoarytenoid joint involvement
RA patient with long-standing disease including severe joint deformities. w.t.d before going in for elective hip surgery or any surgery under general anesthesia
Xray of the neck
RA pt with swelling in the knee. pt has fever
Tap the joint
RA pt on hydroxychloroquine. what general maintains needs to be done while on this medication
baseline eye exam now and one in 5 years
the leading cause of death in RA
Heart disease
Pt who comes to your office after being tapered off steroids from (Giant cell, polymyalgia rheumatica, or SLE) now has B/L symmetric joint pain and early morning stiffness with no DIP involvement. what is going on
Pt has RA
RA patient on MTX. what do you need to be following up on
CBC, sCr, AST Qq12 weeks
RA patient is maxed out on MTX dose of 25mg/week and still having symptoms. w.t.d next
PPD in prep for biologics
give pneumococcal and flu vaccine (if not already done when you start MTX)
don’t give live vaccines to pts with biologic DMARDs
NO DMARDs to patients with active infection
Young pt with pain in the PIP then MCP and then within a few hours the pain leaves his MCP and then PIP.
Palindromic Rheumatism. 1/2 of these patients will go on to have full-on RA. Tx them with DMARD
RA pt with necrotic ulceration of tips of fingers and foot drop
Rheumatoid Vasculitis
Long-standing RA with splenomegaly and neutropenia. pt could also have a history of recurrent skin and lung infections and skin ulcers. whats going on and how to treat
Felty syndrome and treat with DMARD and steroids
last resort for RA who is refractory to treatment for a long period of time
surgery on said joint
Young pt with polyarthritis and fever. Was sick weeks ago and is still having recurrent fevers that are occupied by a salmon-colored rash.
ferritin is high leukocytosis AST/ALT increased Rh-negative ANA negative
Juvenile idiopathic Rh arthritis
aka: Stills disease
What disease is most likely related to RA
Periodontal disease
Which viruses are most likely associated with RA
EBV, B19, HTLV-1, HHS-6 and HHS-8
How to diagnose Sjogren’s syndrome
Schirmer test
Blotting paper test ( test is + if 5mm wetting in tearing of the eyes in 5mins)
SSA and SSB antibodies. do Bx if these are negative
what are seronegative spondyloarthropathies
Rh Factor negative and HLA-27 positive
involves the spine
Asymmetric poly/oligoarthritis (< 4 joints)
Dactylitis can be seen
What are the two main types of seronegative spondyloarthropathies
Ankylosing Spondylitis and Reactive arthritis
pt with is long-standing Ankylosing Spondylitis now has renal disease. what happened
Renal Amyloidosis
Ankylosing Spondylitis pt with low back pain and decrescendo murmur
Aortitis involvement