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MES > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Rheumatoid Arthritis (Summary)

A

PIC ASS

Polyarthritis
Inflammatory
Chronic

Autoimmune
Symmetrical
Systemic

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2
Q

RA Gene Anomaly

A

HLA-DR4 & HLA-DR1

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3
Q

Cardinal Signs of Inflammation

A

Calor (Heat)
Dolor (Pain)
Rubor (Redness)
Tumor (Swelling)
Functio Laesa (Loss of Function)

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4
Q

RA Extra-articular Manifestation: EYES

A

Keratoconjunctivitis sicca/Xeropthalmia (Dry Eyes)

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5
Q

RA Extra-articular Manifestation: NERVES

A

Mononeuritis Multiplex

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6
Q

RA Extra-articular Manifestation: LUNGS

A

Interstitial Lung Dse
Pleuritis
Pleural Effusion
Caplan Syndrome

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7
Q

RA Extra-articular Manifestation: HEART

A

Pericarditis

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8
Q

RA Extra-articular Manifestation: BLOOD

A

Felty’s Syndrome

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9
Q

Felty’s Syndrome

A

Splenomegaly
Anemia
Neutropenia
Thrombocytopenia
Arthritis

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10
Q

RA Extra-articular Manifestation: SKIN

A

Rheumatoid nodules

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11
Q

MC Location of Rheumatoid nodules

A

Elbow

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12
Q

Joint spared in RA

A

DIP

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13
Q

RA Articular Manifestation: TMJ

A

Limited mouth opening

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14
Q

RA Articular Manifestation: C1 -C2

A

Subluxation

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15
Q

RA Articular Manifestation: Thumb

A

(Z-Thumb)
Hyperextended IP
Flexed MCP
Subluxed MCP

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16
Q

RA Articular Manifestation: Hand

A

Swan-Neck
Boutonniere

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17
Q

RA Articular Manifestation: WRIST

A

(+) Piano Keys Sign
Distal Radioulnar Instability

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18
Q

RA Articular Manifestation: ELBOW

A

Flexion contracture

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19
Q

RA Articular Manifestation: KNEE

A

Synovitis
Baker’s Cyst

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20
Q

RA Articular Manifestation: FOOT

A

Pes Planus

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21
Q

Stages of Joint Inflammation

A

Synovitis
Pannus formation
Ankylosis

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22
Q

1987 ACR Classification

A

Rheumatoid factor inc
Finger/Hand involvement

Rheumatoid nodules
Involvement of 3 or more joints
Stiffness in the morning
Erosions/decalcifications
Symmetric

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23
Q

2010 ACR Classification

A

Refer to Table

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24
Q

Functional Capacity in RA: CLASS 1

A

Complete fxnl capacity

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25
Q

Functional Capacity in RA: CLASS 2

A

Adequate fxnl capacity despite discomfort/LOM

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26
Q

Functional Capacity in RA: CLASS 3

A

Adequate fxnl capacity only few or none of the usual duties

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27
Q

Functional Capacity in RA: CLASS 4

A

Bedridden, confined to w/c, little or no self-care

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28
Q

Types of JIA

A

Polyarticular
Oligoarticular (Pauciarticular)
Systemic (Still’s Dse)

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29
Q

JIA
Persistent pain in ____ joints; for at least ____ weeks; commonly seen in _____

A

1 or more joints
6 weeks
<16 y/o girls

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30
Q

Tests for JIA

A

CRP & ESR elevated
(+) HLA-B27
(+) ANA
(+) Rheumatoid Factor

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31
Q

Characteristics of SLE

A

Discoid rash
Oral ulcers
Photosensitivity
ANA
Malar/Butterfly rash
Immunologic dse
Neurologic dse
Renal dse
Arthritis
Serologic
Hematologic (Felty’s)

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32
Q

Most sensitive test in SLE

A

(+) Anti-nuclear antibody

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33
Q

Non-erosive, reversible arthritis seen in SLE

A

Jaccoud’s Arthritis

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34
Q

Pathophysio of Scleroderma

A

Too much collagen production causing scarring/thickening of tissues

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35
Q

Types of Scleroderma

A

Localized
Diffused cutaneous systemic sclerosis
Limited cutaneous systemic sclerosis

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36
Q

CREST Syndrome

A

Calcinosis
Raynaud’s phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasia

37
Q

Tests for Scleroderma

A

Anti-centromere (limited)
Anti SCL 70 or Anti-topoisomerase (diffused)

38
Q

Pathophysiology for Polymyositis

A

CD8 cells against ENDOmysium
Test: Anti Jo-1

39
Q

Pathophysiology for Dermatomyositis

A

CD4 cells against PERImysium
Test: Anti Mi-2

40
Q

Pathognomonic skin findings in Dermatomyositis

A

Gottron papules
Heliotrope rash

41
Q

Type 1 PM/DM

A

Primary Idiopathic Polymyositis

42
Q

Type 2 PM/DM

A

Primary Idiopathic Dermatomyositis

43
Q

Type 3 PM/DM

A

PM/DM with Malignancy

44
Q

Type 4 PM/DM

A

PM/DM in Children

45
Q

Type 5 PM/DM

A

PM/DM with other Vascular Disease

46
Q

Type 6 PM/DM

A

Inclusion Body Myositis

47
Q

Exocrine gland destruction secondary to lymphocyte infiltration

A

Sjogren’s Syndrome

48
Q

Triad of Sjogren’s

A

Xeropthalmia (Dry Eyes)
Xerostomia (Dry Mouth)
Arthritis

49
Q

bilateral parotid gland enlargement

A

Mikulicz Syndrome

50
Q

painful intercourse d/t dry vagina

A

Dyspareunia

51
Q

Tests for Sjogren’s

A

Anti-Ro/SSA antibodies
Anti-La/SSB antibodies
Schirmer Test
Lip/Parotid gland biopsy

52
Q

Most dangerous complication related to Sjogren’s

A

Non-Hodgkin Lymphoma

53
Q

inflammation of sites where tendons and/or ligaments insert into the bone

A

Enthesitis

54
Q

Arthritis mutilans

A

(+) Telescoping Sign (Opera glass hand)

55
Q

Psoriatic Arthritis (X ray)

A

Pencil in cup deformity

56
Q

Characteristics of Psoriatic Arthritis

A

Telescoping Sign
Auspitz Sign
DIP joint affectation
Onycholysis
Koebner Phenomenon
Asymmetric

57
Q

Hallmark of Ankylosing Spondylitis

A

Bilateral Sacroiliitis

58
Q

Calcification of annulus fibrosus

A

Syndesmophytes

59
Q

Ankylosing Spondylitis (X ray)

A

Squaring of vertebral bodies
Syndesmophytes
(+) Bamboo spine (late stage)

60
Q

Ankylosing Spondylitis
(Extra-articular manifestations)

A

Aortic regurgitation
Acute anterior uveitis

60
Q

Triad of Reactive Arthritis

A

Arthritis (Oligoarticular)
Conjunctivitis
Urethritis

61
Q

MC bacteria in genitals causing Reactive Arthritis

A

Chlamydia

62
Q

MC bacteria in bowel causing Reactive Arthritis

A

Campylobacter
Salmonella

63
Q

Types of Inflammatory Bowel Disease

A

Ulcerative Colitis (MC: rectum)
Chron’s dse (MC: ileum & colon)

64
Q
A
65
Q
A
66
Q
A
67
Q
A
68
Q

Affects peripheral & axial joints (MC: Knee)

A

Enteropathic Arthritis

68
Q

Findings in Polymyalgia Rheumatica

A

Auntie (F>M)
Uber HighESR & CRP
Negative (Seronegative)
Temporal arteritis/Giant cell arteritis
In the morning, pain & stiffness
Elderly (>50 y/o)

Proximal joint (MC: Shoulder)
cOrticosteroids
Low dose
Yun ang Hallmark

68
Q

Hallmark of Polymyalgia Rheumatica

A

Low dose Corticosteroids

69
Q

Hallmark of Gout

A

Tophi

70
Q

Hallmark of Pseudogout

A

Chondrocalcinosis

71
Q

Crystals (Gout)

A

Monosodium urate (uric acid)

72
Q

Crystals (Pseudogout)

A

Calcium pyrophosphate dihydrate

73
Q

Joint involvement (Gout)

A

MC: 1st MTP (Podagra)
Knee (Gonagra)
Wrist (Cheiragra)

74
Q

Joint involvement (Pseudogout)

A

MC: Knee
Wrist, Shoulder, MCP (2nd & 3rd)

75
Q

Hallmark of Osteoarthritis

A

Asymmetric loss of cartilage space

76
Q

MC Clinical finding in Osteoarthritis

A

Crepitus

77
Q

MC Joint Involvement in OA

A

Knee

78
Q

MC Spine Involvement in OA

A

C5-C6

79
Q

Kellgren & Lawrence Classification
(Grade 0)

A

No x-ray changes

80
Q

Kellgren & Lawrence Classification
(Grade 1)

A

Doubtful joint space narrowing

81
Q

Kellgren & Lawrence Classification
(Grade 2)

A

Possible joint space narrowing
Definite osteophytes

82
Q

Kellgren & Lawrence Classification
(Grade 4)

A

Marked narrowing of joint space
Large osteophytes
Definite deformity

82
Q

Kellgren & Lawrence Classification
(Grade 3)

A

Definite narrowing of joint space
Moderate multiple osteophytes
Possible deformity

82
Q

FIBROmyalgia Findings

A

Fatigue; F>M
Insomnia
Blues (Depression, Anxiety)
Rigidity (Stiffness)
Ouch (Pain)

82
Q

Tender Points (Fibromyalgia)

A

Occiput
Lower cervical
Trapezius
Shoulder
Supraspinatus
2nd rib
Lateral epicondyle
Buttocks/Gluteals
Greater trochanter
Knee

MES (7 decks)

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