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Flashcards in Rheum in STEP 1 Book Deck (51):
1

What happens to joints in Osteoarthritis?

Wear and tear destroys articular cartilage

2

What does Osteoarthritis look like in patients?

Sclerosis, bone spurs, Heberden nodules in DIPs, Bouchard nodes (PIP), no MCP involvement

3

What can predispose for osteoarthritis?

Age, obesity, and joint trauma

4

What should trigger you to an Osteoarthritis case?

Pain in weight bearing joints, cartilage loss begins medially, noninflammatory

5

How do you treat Osteoarthrits?

Acetaminophen
NSAIDS
Intra-articular glucocorticoids

6

What causes RA?

Autoimmune reaction mediated by cytokines and type 3 and 4 hypersensitivity reactions

7

What do the joints look like in RA?

Pannus formation
Subcutaneous rheumatoid nodules
Ulnar deviation of fingers
Swan neck and Boutonniere deformities

8

RA has strong association with HLA what?

HLA DR4

9

Patient key characteristics that can help focus in on RA?

Morning stiffness more than 30 minutes
Systemic symptoms
Symmetric joint involvement

10

Treatment for Rheumatoid Arthritis?

NSAIDS
Glucocorticoids
TNF-a inhibitors

11

Sjogren's syndrome destroys what?

Exocrine glands such as salivary and lacrimal with lymphocytic infiltration

12

What primary disorder can Sjogren's be associated with?

RA

13

Complications of Sjogren's?

Dental carries
Lymphoma (parotid enlargement)
Mucosa associated Lymphoid Tissue (MALT)

14

Patient findings in Sjogren's?

Inflammatory joint pain
Decreased tears or saliva
Antinuclear antibodies SS-A SS-B
Bilateral parotid enlargment

15

What crystal causes gout?

Monosodium urate crystals

16

What two things can cause hyperuricemia?

Underexcretion
Overproduction

17

Which is the more likely cause of hyperuricemia?

Underexcretion

18

Shape and color of gout crystals?

Needle shaped and yellow under parallel light, blue under perpendicular. - birefringent

19

Symmetric or asymmetric in gout?

Asymmetric

20

Classic manifestation of Gout?

Swollen, red, and painful MTP joint of big toe

21

In Gout tophi normally form where?

External ear, olecranon bursa, or Achilles tendon

22

Interaction between uric acid metabolism and alcohol?

Alcohol metabolites compete for same excretion sites in kidney as uric acid which leads to acid buildup in blood

23

Treatment for Gout?

NSAIDS
Glucocorticoids
Xanthine oxidase inhibitors

24

What crystals are involved in Psuedogout?

Calcium pyrophospahte

25

Which joint does Pseudogout normally hit?

Knee in those older than 50

26

What color are Pseudogout crystals?

Blue when parallel to the light

27

Disease associated with Psuedogout?

Hemochromatosis
Hyperparathyroidism
Osteoarthritis

28

Treatment for Pseudogout?

NSAIDS
Glucocorticoids
Colchicine for prophylaxis

29

Common causes for infectious arthritis?

Staph aureus
Streptococcus
Neisseria gonorrhoeae

30

How does Gonococcal arthritis present?

Migratory arthritis with asymmetric pattern

31

3 main symptoms of Gonococcal arthritis?

Synovitis (Knee)
Tenosynovitis (Hand)
Dermatitis (Pustules)
(STD mnemonic)

32

What are seronegative spondyloarthropathies?

Arthritis without RF, strong association with HLA B27 that occurs more often in males

33

What gene is coded for by HLA B27?

MHC Class 1

34

Diseases that fall into the category of Seronegative spondyloarthopathies? (PAIR mnemonic)

Psoriatic arthritis
Ankylosing Spondylosis
Inflammatory Bowel Disease
Reactive Arthritis (Reiter's Syndrome)

35

What does Psoriatic Arthritis present as?

Asymmetric and patchy involvement
Sausage fingers

36

Anylosing spondylosis presents as?

Chronic inflammatory disease of spine and sacroiliac joints, Stiff spine, vertebral fusion, uveitis, aortic regurgitation

37

Inflammatory bowel disease presents as?

Inflammatory diseases such as Chron's disease and ulcerative colitis often accompanied by ankylosing spondylitis or peripheral arthritis

38

Classic triad of Reiter's Syndrome? (Can't see, can't hear, can't bend my knee")

Conjunctivits
Urethritis
Arthritis

39

What can trigger Reiter's syndrome ?

Post-GI infection

40

Classic presentation of SLE?

Rash, joint pain, and fever

41

What type of hypersensitivity reaction is SLE?

Type 3

42

Common causes of death in SLE?

Cardiovascular disease (Wart like vegetations on heart valves)
Infections
Renal disease

43

Anti-dsDNA antibodies in SLE say what?

Poor prognosis (renal disease)
Specific

44

Antihistone antibodies sensitive for what?

Drug induced lupus

45

Immune complex formation causes what changes to complement?

Decrease in C3, C4, and CH50

46

How to you treat SLE?

NSAIDs
Steroids
Immunosuppressants
Hydroxychloroquine

47

What is Antiphospholipid syndrome?

Primary or secondary autoimmune disorder most commonly in SLE

48

What lab findings are there in Anti-phospholipid syndrome?

Lupus anticoagulant
Anti-cardiolipin
Anti-B2 glycoprotein antibodies

49

How do you treat Anti-phospholipid syndrome?

Systemic anticoagulation

50

Anticardiolipin and Lupus anticoagulant can cause what?

False positive VDRL and prolonged PTT

51

RASH OR PAIN mnemonic for SLE?

Rash
Arthritis
Soft Tissues
Hematologic disorders
Oral/nasopharyngeal
Renal Disease, Raynaud's
Photosensitivity, Positive VLDR
Antinuclear antibodies (ANA)
Immunosuppresents
Neurologic disorders