Rheum Flashcards
(78 cards)
1
Q
def. arthritis
A
evidence of joint effusion or >2 of tenderness, pain on movement, limited ROM or increased warmth
2
Q
def. arthritis
A
evidence of joint effusion or >2 of tenderness, pain on movement, limited ROM or increased warmth
3
Q
key to joint assessment
A
must RO infection
4
Q
important Hx for joint pain
A
OPQRST
- morning stiff
- weight bearing
- systemic Sx
- rashes
5
Q
red flags for joint pain
A
- fever
- pinpoint pain
- pain out of proportion
- night pain
- weight loss
- erethyma
6
Q
invest. for joint pain
A
- CBC and diff
- smear
- CRP/ESR
- autoimmune workup
- synovial fluid
7
Q
7 major cats. causing joint pain and important examples p235
A
- malig
- trauma/overuse
- osgood shlatter - infection
- septic arth.
- osteomyelitis
- transeint synovitis - heme
- SCD, hemophillia - inflamm
- juvenile arth
- SLE
- HSP - non-inflamm
- growing pain
- fibro - ortho/mech
- slipp capital
- Legg calve perthes
8
Q
def. septic arth
A
direct entry of organism into joint - mostly S aureua and strep
9
Q
present of septic arth
A
acute monoarth
- swelling, warm, red
- fever chills
10
Q
invest of septic arth
A
- high WBCS
- high CRP and ESR
- aspirate and culture joint
11
Q
mgmt of septic arth
A
- IV abx
- drain joint
12
Q
def. osteomylitis
A
heme spread of pathos into bone
- most often long bones
- same bugs as joints
13
Q
invest of osteomyl
A
- high WBCS
- high CRP and ESR
- bone scan
14
Q
mgmt of oseto
A
- IV abx, followed by oral
15
Q
def. transient synovitis
A
benign, self limited, sterile inflammation leading to joint effusion
16
Q
etiology of transient
A
- unknwn, but often after viral
17
Q
clinical presentation
A
- sudden onset of painful hip
- most common in boys 3-8
- generally well with low grade fever
18
Q
mgmt of transient synovitis
A
bed rest and anti-inflammatories
19
Q
def. slipped capital femoral
A
- ant. displacement of femoral head to neck
- urgent ortho consult
20
Q
present of slipped capital femoral
A
- limb in external rotation and flexion
- overweight males 10-14
- may have endo issues
21
Q
invest of slipped capital femoral
A
- xray
- TSH
22
Q
def. Legg-calves perthes
A
- self limited, avasc. necrosis of cap femoral epiphysis
23
Q
present of Legg-calves perthes
A
painful limp and decreased ROM
- boy 4-10
24
Q
invest of Legg-calves perthes
A
xray or MRI
25
mgmt of Legg-calves perthes
supportive or abduction splints
| - surgical osteotomy
26
def. osgood schlatter
overuse of patellar tendon causes bone microavulsion
27
present of osgood schlatter
pain and swelling over tibial tuberosity
28
mgmt of osgood schlatter
rest and alter activities
29
def. growing pain
intermittent, non-articular pain in childhood with normal exam findings
30
present of growing pains
pain at night
often calf
3-10
relveived by heat/massage/mild anal
31
def. (diagnostic) for JIA
32
5 JIA subtypes
1. systemic
- fever
- rash
- HSM
2. oliogarth
- 5 joints
- usually symmetric
- RF -
4. psortiatic
- knees, small joints of hand and feet
- scaly scalp lesions
- nail changes - pitting, hyperkeratosis
- dactylitis
5. entesitis related
- tendon, ligament or joint capsule at point of insertion
- esp . older boys with asymmetric involvment
- HLAB27
33
classification of SLE
MDSOAPBRAIN
| - p 239
34
present of HSP
- non-thrombopenic purpura
- abdo pain
- arthritis and artralgia
35
present of HSP
- non-thrombopenic purpura
- abdo pain
- arthritis and artralgia
36
key to joint assessment
must RO infection
37
important Hx for joint pain
OPQRST
- morning stiff
- weight bearing
- systemic Sx
- rashes
38
red flags for joint pain
- fever
- pinpoint pain
- pain out of proportion
- night pain
- weight loss
- erethyma
39
invest. for joint pain
- CBC and diff
- smear
- CRP/ESR
- autoimmune workup
- synovial fluid
40
7 major cats. causing joint pain and important examples p235
1. malig
2. trauma/overuse
- osgood shlatter
3. infection
- septic arth.
- osteomyelitis
- transeint synovitis
4. heme
- SCD, hemophillia
5. inflamm
- juvenile arth
- SLE
- HSP
6. non-inflamm
- growing pain
- fibro
7. ortho/mech
- slipp capital
- Legg calve perthes
41
def. septic arth
direct entry of organism into joint - mostly S aureua and strep
42
present of septic arth
acute monoarth
- swelling, warm, red
- fever chills
43
invest of septic arth
- high WBCS
- high CRP and ESR
- aspirate and culture joint
44
mgmt of septic arth
- IV abx
| - drain joint
45
def. osteomylitis
heme spread of pathos into bone
- most often long bones
- same bugs as joints
46
invest of osteomyl
- high WBCS
- high CRP and ESR
- bone scan
47
mgmt of oseto
- IV abx, followed by oral
48
def. transient synovitis
benign, self limited, sterile inflammation leading to joint effusion
49
etiology of transient
- unknwn, but often after viral
50
clinical presentation
- sudden onset of painful hip
- most common in boys 3-8
- generally well with low grade fever
51
mgmt of transient synovitis
bed rest and anti-inflammatories
52
def. slipped capital femoral
- ant. displacement of femoral head to neck
| - urgent ortho consult
53
present of slipped capital femoral
- limb in external rotation and flexion
- overweight males 10-14
- may have endo issues
54
invest of slipped capital femoral
- xray
| - TSH
55
def. Legg-calves perthes
- self limited, avasc. necrosis of cap femoral epiphysis
56
present of Legg-calves perthes
painful limp and decreased ROM
| - boy 4-10
57
invest of Legg-calves perthes
xray or MRI
58
mgmt of Legg-calves perthes
supportive or abduction splints
| - surgical osteotomy
59
def. osgood schlatter
overuse of patellar tendon causes bone microavulsion
60
present of osgood schlatter
pain and swelling over tibial tuberosity
61
mgmt of osgood schlatter
rest and alter activities
62
def. growing pain
intermittent, non-articular pain in childhood with normal exam findings
63
present of growing pains
pain at night
often calf
3-10
relveived by heat/massage/mild anal
64
def. (diagnostic) for JIA
65
5 JIA subtypes
1. systemic
- fever
- rash
- HSM
2. oliogarth
- 5 joints
- usually symmetric
- RF -
4. psortiatic
- knees, small joints of hand and feet
- scaly scalp lesions
- nail changes - pitting, hyperkeratosis
- dactylitis
5. entesitis related
- tendon, ligament or joint capsule at point of insertion
- esp . older boys with asymmetric involvment
- HLAB27
66
classification of SLE
MDSOAPBRAIN
| - p 239
67
def. HSP
most common in childhood
- IgA immune depostition
- small vessels of skin, GI, kidneys, joints and CNS
68
present of HSP
- non-thrombopenic purpura
- abdo pain
- arthritis and artralgia
69
invest of HSP
clinical Dx
| - can do CBC lytes to help RO
70
mgmt of HSP
- supportive
- anti-inflamm
- steroids
71
def. kawasakis
acute, self limited medium vasculitis
| - 3 mos to 5 years
72
presentations of. kawasakis
- may have infect. trigger
- high spiking remittant fever
-
73
Dx for complete def. kawasakis
Fever for 5 days and 4 of:
1. bilat. conjunctivitis
2. mucositis - strawberry tongue
3. polymorphous rash
4. changes in hands and feet - red or edema
5. cervical adenopathy
74
Dx of incomplete
fever + 3 or less
75
lab findings for kawasakis
- high WBC
- anemia
- high ESR/CRP
- high platelets
- high tranaminas
- low albumin
76
invest. for def. kawasakis
- echo for heart probs
- need to look out for aneurysms
-
77
mgmt of kawasakis
IVIG and ASA (high dose)
if coronry issues - anti-coag
if IVIG fails, try once more
- if fails, pred
78
outpatietn mgmt of. kawasakis
- f/u ECHO in 6 wks
| - delay live viruses for 1 year
