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Flashcards in Rheumatologic Diseases Deck (87)
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1

Body stores of uric acid can be due to ____ or ____

Low excretion* or overproduction

2

Meds that can cause gout

Diuretics, ACEI, ARB, ASA

3

How long do gout attacks last?

A few days - 2 wks

4

Do all hyperuricemia pts develop gout?

NO, and some can have hyperuricemia for 15-20 yrs before 1st gout attack

5

How to diagnose gout

Arthrocentesis and joint aspiration to see crystals
- Negative birefringence, needle shaped

6

Is serum uric acid level diagnostic of gout?

NO

7

Tophaceous gout

Collection of solid uric acid in soft tissue

8

How to treat acute gout attack? (1st, 2nd, 3rd line)

#1: NSAIDs (NOT ASA)
#2: Colchicine
Last line: steroid injection in joint (make sure there is no infection)

9

Pseudogout

Ca++ pyrophosphate dehydrate crystal deposition

10

What can cause pseudogout?

Surgery, acute illness
Younger pts: underlying dz

11

How is pseudogout similar to gout?

Acute onset
Both cause acute inflammatory arthritis
Episodes last a few days - a few wks

12

How is pseudogout different from gout?

Less painful

13

How to diagnose pseudogout

- Arthrocentesis CPPD crystals: rhomboid w/ [+] birefringence
- Xray: chondrocalcinosis

14

How to treat pseudogout

Steroids

15

Can be associated w/ hep B or C

Polyarteritis Nodosa (PAN)

16

Systemic necrotizing vasculitis that affects muscular arteries

Polyarteritis Nodosa (PAN)

17

What systems does PAN typically affect?

Kidneys, skin, joints, muscle, peripheral nerves, GI

18

How to diagnose PAN

Biopsy or arteriography

19

Polymyositis

Symmetrical painless skeletal muscle weakness

20

How to diagnose polymyositis

Muscle bx

21

Sx of polymyositis

- Heliotrope eruption
- Shawl sign
- Mechanic's hands--cracked and dirty appearance

22

Most common form of juvenile rheumatoid

Oligoarticular

23

# of joints affected in oligoarticular vs. polyarticular

Oligoarticular: 4 or fewer joints
Polyarticular: 5+ joints

24

Joints most affected by osteoarthritis (3)

Hips
Knees
Hands

25

When does a pt w/ OA experience worsened PAIN and STIFFNESS

Pain--worse w/ movement
Stiffness--after inactivity

26

Heberden's nodes

Bony enlargement of DIP

27

Bouchard's nodes

Bony enlargement of PIP

28

Which is more common in OA, Heberden's or Bouchard's nodes?

Heberden's nodes

29

How to diagnose OA

Clinical

30

4 C's to evaluate for in synovial fluid

Color=pale yellow
Clarity=viscous, not opaque
Crystals
Cells=inf