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Flashcards in Rheum - Random Deck (21)
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0
Q

Carpal tunnel syndrome presents with?

Signs?

A
#Pain in the hand worse at night 
#Atrophy of the thenar eminence
#Tinel Sign – reproduction of pain with tapping median nerve
 #phalen sign – reproduction of pain with flexion of the wrists
1
Q

Carpal tunnel syndrome associated with?

A
#Pregnancy
#RA
#Diabetes
#Hypothyroidism
#Amyloidosis
#Acromegaly
2
Q

Most accurate diagnostic test for carpal tunnel syndrome? Best initial therapy? Other therapies

A

Electromyography and nerve conduction testing

Wrist splints > Steroids > surgery

3
Q

Dupuytren’s contracture associated with? Medical therapy? When surgery?

A

Alcoholism and cirrhosis

#Triamcinolone
#lidocaine
#collagenase injection

When function is impaired

4
Q

Rotator cuff injury – history? Most accurate test? Treatment? When surgery?

A

Pain when lying on the shoulder

MRI

#NSAIDs, rest, physical therapy
#then steroids

Complete tear or not responding to therapy

5
Q

Patellofemoral syndrome – Where is the pain? Provoked by? Improves after?

X-ray findings? Treatment?

A
#In front of the knee or under the patella
#Pain worse when climbing stairs or walking after being seated for prolonged periods

Normal x-rays

Physical therapy and strength training

6
Q

Planter fasciitis versus tarsal tunnel syndrome? X-Ray May show?

A

Improves with use versus worsens with use

Bony spurs (but imaging is useless)

7
Q

CREST?

A
Calcinosis
Raynaud's
Esophageal dysmotility
Sclerodactyly
Telangiectasias
8
Q

Non-esophageal Gastrointestinal findings in scleroderma? Renal? Pulmonary? Cardiac?

A

Large mouth diverticula of intestines

hypertensive crisis

restrictive lung disease and pulmonary hypertension

Myocardial fibrosis, pericarditis, right ventricular hypertrophy and heart block

9
Q

Antibodies associated with scleroderma? ESR?

A

Anti-topoisomerase and Antiicentromere

Normal

10
Q

Scleroderma treatment?

Specific treatment for:

  1. Renal crisis
  2. Esophageal dysmotility
  3. Raynaud’s
  4. Pulmonary fibrosis
  5. Pulmonary hypertension
A

Methotrexate

  1. ACE inhibitor
  2. PPI
  3. Calcium channel blocker
  4. Cyclophosphamide
  5. Sildenafil, Bosentan, Prostacyclin analogs
11
Q

Dermatomyositis associated with which cancers?

A

Lung, G.I., ovarian, lymphoma

12
Q

Best initial Diagnostic tests for inflammatory myopathies? Most accurate test?

Anti-Jo antibody associated with?

A

CPK and aldolase

Muscle biopsy

Lung fibrosis

13
Q

Treatment for inflammatory myopathy?

Treatment for skin lesions in dermatomyositis?

A

Steroids > methotrexate/mycophenolate

Hydroxychloroquine

14
Q

Sjogren’s syndrome associated with?

A
#RA & SLE
#polymyositis
#Primary biliary cirrhosis
#Hashimoto's
15
Q

Most dangerous complication of Sjogren’s syndrome?

A

Lymphoma

16
Q

Best initial test for suspected Sjogren’s syndrome? Best initial blood test?

Most accurate test?

A

Schirmer test - filter paper is placed against the eye to observe amount of tears

SS-A and SS-B (Ro and La)

Lip or parotid gland biopsy for lymphoid infiltration

17
Q

Sjogren’s syndrome – best initial therapy?

A

Wasting mouth and eyes

18
Q

Complement levels in SLE versus Hep C?

A

SLE - decreased C3 (3 letters in SLE)

Hep C - decreased C4 (4 letters in Hep C)

19
Q

Best initial test for psoriatic arthritis?

Treatment?

A

X-ray of hand showing pencil in a cup deformity

NSAIDs then methotrexate then anti-TNF

20
Q

Pustular psoriasis on the penis? Suggests?

A

Keratoderma Blennorhagicum

Reactive arthritis

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