Flashcards in Rheum in STEP 1 Book Deck (51):
What happens to joints in Osteoarthritis?
Wear and tear destroys articular cartilage
What does Osteoarthritis look like in patients?
Sclerosis, bone spurs, Heberden nodules in DIPs, Bouchard nodes (PIP), no MCP involvement
What can predispose for osteoarthritis?
Age, obesity, and joint trauma
What should trigger you to an Osteoarthritis case?
Pain in weight bearing joints, cartilage loss begins medially, noninflammatory
How do you treat Osteoarthrits?
What causes RA?
Autoimmune reaction mediated by cytokines and type 3 and 4 hypersensitivity reactions
What do the joints look like in RA?
Subcutaneous rheumatoid nodules
Ulnar deviation of fingers
Swan neck and Boutonniere deformities
RA has strong association with HLA what?
Patient key characteristics that can help focus in on RA?
Morning stiffness more than 30 minutes
Symmetric joint involvement
Treatment for Rheumatoid Arthritis?
Sjogren's syndrome destroys what?
Exocrine glands such as salivary and lacrimal with lymphocytic infiltration
What primary disorder can Sjogren's be associated with?
Complications of Sjogren's?
Lymphoma (parotid enlargement)
Mucosa associated Lymphoid Tissue (MALT)
Patient findings in Sjogren's?
Inflammatory joint pain
Decreased tears or saliva
Antinuclear antibodies SS-A SS-B
Bilateral parotid enlargment
What crystal causes gout?
Monosodium urate crystals
What two things can cause hyperuricemia?
Which is the more likely cause of hyperuricemia?
Shape and color of gout crystals?
Needle shaped and yellow under parallel light, blue under perpendicular. - birefringent
Symmetric or asymmetric in gout?
Classic manifestation of Gout?
Swollen, red, and painful MTP joint of big toe
In Gout tophi normally form where?
External ear, olecranon bursa, or Achilles tendon
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
Treatment for Gout?
Xanthine oxidase inhibitors
What crystals are involved in Psuedogout?
Which joint does Pseudogout normally hit?
Knee in those older than 50
What color are Pseudogout crystals?
Blue when parallel to the light
Disease associated with Psuedogout?
Treatment for Pseudogout?
Colchicine for prophylaxis
Common causes for infectious arthritis?
How does Gonococcal arthritis present?
Migratory arthritis with asymmetric pattern
3 main symptoms of Gonococcal arthritis?
What are seronegative spondyloarthropathies?
Arthritis without RF, strong association with HLA B27 that occurs more often in males
What gene is coded for by HLA B27?
MHC Class 1
Diseases that fall into the category of Seronegative spondyloarthopathies? (PAIR mnemonic)
Inflammatory Bowel Disease
Reactive Arthritis (Reiter's Syndrome)
What does Psoriatic Arthritis present as?
Asymmetric and patchy involvement
Anylosing spondylosis presents as?
Chronic inflammatory disease of spine and sacroiliac joints, Stiff spine, vertebral fusion, uveitis, aortic regurgitation
Inflammatory bowel disease presents as?
Inflammatory diseases such as Chron's disease and ulcerative colitis often accompanied by ankylosing spondylitis or peripheral arthritis
Classic triad of Reiter's Syndrome? (Can't see, can't hear, can't bend my knee")
What can trigger Reiter's syndrome ?
Classic presentation of SLE?
Rash, joint pain, and fever
What type of hypersensitivity reaction is SLE?
Common causes of death in SLE?
Cardiovascular disease (Wart like vegetations on heart valves)
Anti-dsDNA antibodies in SLE say what?
Poor prognosis (renal disease)
Antihistone antibodies sensitive for what?
Drug induced lupus
Immune complex formation causes what changes to complement?
Decrease in C3, C4, and CH50
How to you treat SLE?
What is Antiphospholipid syndrome?
Primary or secondary autoimmune disorder most commonly in SLE
What lab findings are there in Anti-phospholipid syndrome?
Anti-B2 glycoprotein antibodies
How do you treat Anti-phospholipid syndrome?
Anticardiolipin and Lupus anticoagulant can cause what?
False positive VDRL and prolonged PTT