Rheumatology

Question 1

fingertip destruction in smoker

Answer 1

Buerger Disease

Question 2

pos treonema Ab test, dilation of aorta, death

Answer 2

syphylitic aneurysm

Question 3

chronic renal failure, smoker, inc BP and thickening of small renal vasculature with fibrinoid necrosis

Answer 3

malignant HTN

Question 4

Hep B & p-ANCA, biopsy w/ fibrinoid necrosis

Answer 4

polyarteritis nodosa

Question 5

rash with vasculitis after given sulfa drugs

Answer 5

hypersensitivity angiitis

Question 6

HA, vision problems, nodular enlargement of temporal artery in 70 year old

Answer 6

Giant cell arteritis

Question 7

double vision, fainting, narrowing of aortic branches, death in 30 year old

Answer 7

Takayasu arteritis

Question 8

asthma, skin lesions on feet, increase leukocytes and platelets, positive p ANCA

Answer 8

Churg Strauss

Question 9

oral ulcers, knee pain, penile ulcerations, conjunctivitis

Answer 9

Bechet Disease

Question 10

Sjogren syndrome w. purpuric rash

Answer 10

hypersensitivity vasculitis

Question 11

fever, rash on palms and soles, conjuctivitis, dry mucosa… 2 months later HF in 3 year old

Answer 11

Kawasaki Disease

Question 12

blanching hands in cold, diff swallowing food, smooth/tight skin on face, anti SCl-70 Abs

Answer 12

Scleroderma (w/ raynauds)

Question 13

palpable purpuric rash on buttocks and legs, IgA in small vessels

Answer 13

Henoch-Schonlein Purpura

Question 14

obese, back pain, finger pain in DIP which are enlarged

Answer 14

osteoarthritis

degeneration of articular cartilage

Question 15

arthritis to stroke. PIP shows pannus and synovial hyperplasia

Answer 15

RA

chronic inflam of synovium

Question 16

Ab in RA

Answer 16

RF is IgM against Fc of IgG

Question 17

young male with lower back pain - fusion of joint spaces in sacroiliac spine, neg RF & ANA

Answer 17

Ankylosing spondolytis

Question 18

seronegative spondyloarthropathies show which HLA type?

Answer 18

B27

Question 19

burning on urination, conjunctivitis, diarrhea in mexico that responded to NSAIDs

Answer 19

Reiter syndrome

Question 20

knee swelling with crystals and calcium pyrophosphate

Answer 20

pseudogout

Question 21

fever and pain in great toe with leukocytosis, hyperuricemia and lipidemia

Answer 21

gout

Question 22

what causes tophus in gout?

Answer 22

Ua accum leads to nodules that contain aggregates of macs

Question 23

what are some RFs for SLE?

Answer 23

EBV (and other viruses), estrogen, HLA B8, drugs

Question 24

pathogen of SLE?

Answer 24

autoreactive CD4+ T cells -> polyclonal B cell activation (hyperreactive) -> AutoAb production

Question 25

describe Type 3 hypersensitivity rxn and give examples

Answer 25

deposition of circulating immune complexes -> complement binds them and furthers immune response caused by SLE, RA and post-strep GN

Question 26

malaise, join pain, fever, malar rash, pink plaques, oral ulcers, purpuric papules on plaques, elev BUN/creatinine, dsDNA Abs

Answer 26

SLE | think kidneys, joints, serous membranes and skin

Question 27

rash on chest, fever, glandular deposition of IgA and C3 in dermis, hematuria/proteinuria, +ANA and then development of thromboembolitic complications

Answer 27

Antiphospholipid Ab syndrome from SLE | will have falsely elevated PTT and false pos syphylis test

Question 28

HA, diff swallowing, red lesions on mouth, skin thickening, stone facies

Answer 28

Scleroderma

Question 29

what is deposited in scleroderma

Answer 29

collagen

Question 30

CREST

Answer 30

in limited systemic scleroderma pt will have calcinosis, raynauds, esophageal dysfunction, sclerodactyly and telangiectasias

Question 31

dry mouth and eyes, salivary glands have lymphocytic infiltrate, and autoAbs in nucleus

Answer 31

Sjogren syndrome

Question 32

tingling fingertips, lymphadenopathy, hypergammaglobulinemia, pos ANA, responds to steroids, no dsDNA

Answer 32

mixed connective tissue disease