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Last EOR exam > Rheum & HEENT > Flashcards

Rheum & HEENT Flashcards

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1
Q

Autoimmune multi organ disorder of connective tissue

A

Systemic Lupus Erythematosus- SLE

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2
Q

what are risks of Systemic Lupus Erythematosus- SLE

A

genetic
enviromental- sun exposure, infection, estrogen
drugs- Procainamide, hydralazine, izonide & quinidine

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3
Q

What drugs cause Lupus

A

Procainamide
Hydralazine
Izonide
quinidine

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4
Q

Key terms for this diagnosis- female, joint pian, fever, facial rash, pericarditis, pleuritis, annular erythemic patches
glomerulonephritis, retitinis oral ulcers and alopecia

A

Systemic Lupus Erythematosus- SLE

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5
Q

what is the best initial test for Systemic Lupus Erythematosus-
what is the most specific

A

inital= Anti-necular antibody- ANA
not specific
most specific= anti double stranded DNA & Anti-smith

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6
Q

what test for lupus induced arterial/venous thrombosis

is best

A

Antiphosphlipid antibody syndrome APLS

risk of clots

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7
Q

women with lupus positive for Antiphosphlipid antibody syndrome have an increase for what?

A

Frequent miscarriages

livedo reticulars - purply rash

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8
Q

Treatment for Lupus

A 
Hydroxychloroquine for skin 
sun protection
NSAID's - for joint pain
acetaminophen- for joint pain
cytotoxic drugs- methotrexate, cyclophosphamide
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9
Q

Systemic connective tissue disorder with thickening of the skin, lungs, heart, kidney and GI tract

A

Scleroderma - systemic sclerosis

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10
Q

key terms for this diagnosis- tight shiny thickened skin, calcinosis cutis, raynaud’s, esophageal dysmolity, telangectasia

A 
Scleroderma 
CREST syndrome "limited" 
Calcinosis of the fingers
Raynauds
Esophageal dysmolitiy
Telangectasia
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11
Q

What is the best test for CREST syndrome ?

A

limited scleroderma

Anti-centromere antibody

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12
Q

What is the best test for scleroderma diffuse/multiple organ involvement

A

Anti-SCL-70 antibody

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13
Q

Treatment for acute Scleroderma

A

Steroids

raynaud’s-> vasodilators CCB’s

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14
Q

Autoimmune disease attacking the exocrine glands
slaviary glands leading to xerostoma, lacrimal glands keratoconjunctivitis sicca
parotid enlargement

A

Sjogren’s syndrome

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15
Q

what are secondary causes of Sjogren’s syndrome

A
  1. occurs with other autoimmune diseases

2. Viruses - aggration of lymphocytes

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16
Q

Sjogren’s syndrome has increase risk of what

A

Lymphoma

Non-Hodgkin’s lymphoma

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17
Q

what are the best tests for Sjogren’s syndrome

A

Anti- SS-A RO
Anti-SS-B LA
Schirmer test- decrease tear production

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18
Q

Schirmer test for what ?

A

Sjogren’s syndrome

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19
Q

Treatment for Sjogren’s syndrome

A
  1. artifical tears
  2. pilocarpine (cholinergic) for dry mouth
  3. Cevimeline
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20
Q

Key terms for this diagnosis- widespread muscular pain, fatigue, muscle tenderness, headaches, sleep/memory issues

A

Fibromyalgia

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21
Q

what are the terms to diagnosis Fibromyalgia

A

11/18 trigger points for 3 months

biopsy has “moth eaten” appearance

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22
Q

Treatment for Fibromyalgia

A 
Pregablin * FDA approved 
TCA's 
Amitripilyine 
imiparine 
nortitriptyline
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23
Q

Autoimmune Inflammatory condition causing synovitis, bursitis and tenosynovitis leading to aching/stiffness of proximal joints mainly on neck, shoulder and hips

A

Polymyalgia Rheumatica

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24
Q

Polymyalgia Rheumatica is closely related to what other disease

A

Giant cell arteritis

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25
key terms for this diagnosis- joint pain and stiffness for more than 30mins in the morning joints that hurt are pelvic, shoulder and hips No muscle weakness
Polymyalgia Rheumatica
26
Labs for Polymyalgia Rheumatica
no specific ESR + normochromic nomocytic anemia
27
autoimmune inflammatory muscle disease of symmetrical proximal limbs, neck and pharynx usually painless!
Polymyositis & Dermatomyositis (PMDM)
28
Labs positive Polymyositis & Dermatomyositis
Aldolase Creatine Kinase abnormal EMG Anti-Jo antibody
29
what test is specific for Polymyositis
Anti-SRP antibody
30
what test is specific for Dermatomyositis
Anti-Mi-2 antibody
31
Key terms for this diagnosis- heliotrope rash, gottron's papules, photosensitivie poikiloderma & alopecia
Dermatomyositis heliotropic rash- upper eyelid discoloration Gottron's papules- purple knuckles poikioderma- shawl, V-sign
32
What is the treatment for Polymyositis & Dermatomyositis
Steroids methotrexate Azathioprine Immunoglobin
33
Chronic inflammatory disease with persistent symmetric joint pain with bone erosion
Rheumatoid Arthritis
34
What is a pannus | and what disease is it seen in?
Granulation tissue that erodes into cartilage and bone | Rheumatoid Arthritis
35
what are risk factors of Rheumatoid Arthritis
Females and smoking
36
What joints are involved in Rheumatoid Arthritis
``` MCP wrist PIP Knee MTP shoulder ankle ```
37
Key terms for this diagnosis- symmetric joint pain that is worse with pain. lasting >60min in the morning Boutonniere and Swan neck deformities with ulnar deviation
Rheumatoid Arthritis
38
What is flexion at the PIP, hyperextension of DIP
Boutonniere
39
Flexion at the DIP joint hyperextension at the PIP joint
Swan neck deformity
40
key terms for this diagnosis- RA + slenomegaly + WBC decreased
Felty's syndrome
41
key terms for this diagnosis- RA + pneumoconiosis
Caplan syndrome
42
What is the best initial test for Rheumatoid Arthritis
Rheumatoid factor
43
What test is most specific for Rheumatoid Arthritis
Anti-Citrullinated peptide antibody
44
Anti-Citrullinated peptide antibody is the test for ?
Rheumatoid Arthritis
45
What will an x-ray show of Rheumatoid Arthritis
narrowed joint space - osteopenia with erosion's subluxation ulnar deviation of the hand
46
Treatment for Rheumatoid Arthritis
DMARD's Methotrexate NSAID's for pain low does steroid
47
Chronic disease due to articular cartilage damage and degeneration of joint spaces
Osteoarthritis
48
key terms for this diagnosis- obese, chronic disease with cartilage damage of knees, hips, cervical, lumbar spine, hip. sclerosis and osteophyte formation joints pain that gets worse throughout the day and hurts when it gets cold outside
Osteoarthritis
49
Key terms for this diagnosis- Heberden's node, bouchard nodes, narrow joint spaces in knees, hip cervical/lumbar spine
Osteoarthritis
50
what is the term for- palpable osteophytes at the DIP joints
Heberden's node's in Osteoarthritis
51
what is the term for- PIP osteophytes that is noninflammatory arthritis
Bouchard nodes in Osteoarthritis
52
Treatment for Osteoarthritis
acetaminophen steroid injections sodium hyalurontate glucosamine & chondroitin
53
what are the 3 types of Juvenile Idiopathic Arthritis
1. Pauci-Articular Oligoarticular 2. Systemic - acute febrile JIA 3. Polyarticular
54
Key terms for this diagnosis- teenager or child with joint pain in multiple sites - knees, ankles and small joints and eye pain
Pauci-Articular Oligoarticular Juvenile idopathic arthritis
55
what eye disorder is associated with Pauci-Articular Oligoarticular Juvenile idopathic arthritis
iridocyclitits- anterior uveitis - blurred vision - eye rendess - dark floaters - eye pain
56
key terms for this diagnosis- teenager or child with daily arthritis with high fevers with salmon-colored pink rash with koebner phenomenon. heaptosplenomegaly, lymphadenopathy, serositis pedericardial and pleural effusions
Systemic Juvenile idiopathic arthritis
57
What labs are postitive in JIA
RF + in 15% ANA ESR CRP
58
Treatment for Systemic Juvenile idiopathic arthritis
NSAID's Steroids Methotrexate and frequent eye exams for iridocyclitis
59
Systemic vasculitis of medium/small arteries leading to necrotizing inflammatory lesions microaneurysms leading to hemorrhage in the kidneys, CNS and skin
Polyarteritis Nodosa = PAN
60
Key terms for this diagnosis- man with History of Hepatitis B or C with renal filaure, fever, joint pain, loss of vision temporarlly (fugax), numbess or tingling in fingers, livedo reticularis, ulcers, gangrene, raynaud's phenomenon
Polyarteritis Nodosa = PAN
61
What labs are positive in Polyarteritis Nodosa
ESR, ANCA negative | Renal or mesenteric angiograhy to look for aneurysms
62
Treatment for Polyarteritis Nodosa
Steroids - cyclophosphamide | if hepatitis plasmapharesis
63
Chronic inflammatory arthropathy of the axial skeleton and sacroiliac joints with progressive stiffness
Ankylosing spondylitis
64
Key terms with this diagnosis- chronic low back pain in the morning and decreases with movement through out the day, arthritis in the fingers and toes
Ankylosing spondylitis
65
The best diagnostic test for Ankylosing spondylitis | what will imaging look like
HLA-B27 ESR bamboo spine- squaring of the vertebral bodies
66
Treatment for Ankylosing spondylitis
NSAID's Physcial therapy TNF-alpha inhibitor - Infliximab Steroids
67
History of HCV | Idiopathic cell-mediated autoimmune response in the mouth
Oral Lichen planus
68
key terms for this diagnosis- history of HCV | autoimmune, lacey white lesions in the mouth
Oral Lichen planus
69
What are Wickham Striae
Lacy white spots in the mouth seen with Oral Lichen planus
70
Treatment for Oral Lichen planus
local or oral steroids
71
What are risk factors for oral leukoplakia
tobacco cigareetts alcohol dentures
72
key terms for this diagnosis- precancerous hyperkeratosis due to chronic irritation painless white patches in the mouth that fail to scrape off
oral leukoplakia
73
most severe risk with oral leukoplakia
squamous cell carcinoma
74
Treatment for oral leukoplakia
Cryotherapy | Laser ablation
75
Key terms for this diagnosis- precancerous lesions similar to leukoplakia but with erythema
Erythroplakia
76
90% of Erythroplakia ______ cells
dysplastic or squamous cell carcinoma
77
what is the cause of oral hairy leukoplakia
Epstein Barr Virus | most commonly seen in HIV patients
78
key terms for this diagnosis- painless white plaues alone the lateral tongue boarder that are irregularly shaped with projections can not be scraped off
oral hairy leukoplakia
79
what is the difference between oral leukoplakia and oral hairy leukoplkia
OL- chornic irritation, white patches anywhere in the mouth OHL- EBV virus infected an immunocompent person causing white patches on the sides of their tongue * both can not be scraped off
80
Treatment for oral hairy leukoplkia
self-limiting | antiretrovirals
81
what are common reasons a person has oral candidiasis
``` systemic immunosuppresion HIV chemotheray inhaler without spacer antibiotic use dentures ```
82
Key terms for this diagnosis- Immunosuppressed patient with white spots in mouth that when scraped bleed and leave behind areas of erythema
oral candidiasis
83
Best diagnostic test for oral candidiasis
Poatassium Hydroxide - KOH = budding yeast wit hhyphae
84
Treatment for oral candidiasis
Nystatin* | Fluconazole
85
Key terms for this diagnosis- small round or oval painful ulcers with an erythematous halo
Aphthous ulcers - canker sore or ulcerative stomatitis
86
Treatment for Aphthous ulcers
Topical analgesics Topical steroid- Triamcinolone Cimetidine (H2 antagonist)
87
What is the most common cause of permanent blindness and vision loss in elderly
Macular Degeneration
88
What does the macula in the eye do ?
Central vision - color vision
89
What are the two types of Macular Degeneration
1. Dry- Atrophic | 2. Wet- Neovascular or Exudative
90
Key terms for this diagnosis- gradual blurring of central vision with small round yellow-white spots on the outer retina
Dry Macular Degeneration | * Drusens - white spots in the retina
91
What are Drusens
White spots in the retina | seen with Dry Macular Degeneration
92
Key terms for this diagnosis- progressive loss of central vision new abnormal vessels grow under central retina which leak and bleed leading to scaring.
Wet Macular Degeneration
93
what is more common wet or dry macular degeneration ?
Dry is more common and slower | wet is more rare and progresses more rapidly
94
What are s/s of macular degeneration?
Gradual in both eyes- blurry or loss of central vision scotomas- blind spots metamorphopsia- straight lines appear bent micropsia- affected eye objects can appear smaller
95
definition of this term Scotomas seen in what condition?
Blind spots | macular degeneration
96
definition of this term metamorphopsia seen in what condition?
straight lines appear bent | macular degeneration
97
definition of this term micropsia seen in what condition?
affected eye objects can appear smaller | macular degeneration
98
how can you monitior stability of macular degeneration
Amsler Grid
99
Treatment for macular degeneration Dry Wet
Dry- vitamines A, C, E and Zinc can slow progression | Wet- Bevacizumab- stop new vessel growth

Last EOR exam (6 decks)

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