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Internal Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Human leukocyte serotype-B27 is risk for…

A
  1. Ankylosing spondylitis
  2. Psoriatic arthritis
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2
Q

Ankylosing spondylitis heart complication

A

Aortic regurgitation

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3
Q

Ankylosing spondylitis - signs

A
  1. Arthritis (sacroiliitis)
  2. Reduced spine mobility and chest expansion
  3. Enthesitis
  4. Dactylitis
  5. Uveitis
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4
Q

Granulomatosis with polyangiitis

A

Small-vessel vasculitis

Upper airway: nasal septal necrosis, destructive sinusitis
Lower airway: diffuse alveolar hemorrhage
Renal: microscopic hematuria with crescentic glomerulonephritis

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5
Q

RA cervical myelopathy (atlantoaxial joint instability) - signs

A
  1. Slowly progressive spastic quadriparesis
  2. Painless sensory deficits in hands or feet
  3. UMN signs
  4. Hoffman sign - flicking middle fingernail elicits flexion and adduction of thumb

Cord compression can occur from neck extension during intubation

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6
Q

Sarcoidosis - neurologic manifestations due to granulomatous infiltration

A
  1. Facial nerve palsy
  2. Neuroendocrine (central diabetes insipidus)
  3. Generalized seizures
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7
Q

Sarcoidosis - extrapulmonary

A
  1. Bilateral parotid gland swelling
  2. Hypercalcemia (1-alpha hydroxylase by macrophages in lung granulomas
  3. Constitutional (e.g. fevers)
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8
Q

Scleroderma renal crisis - treatment

A

Captopril - short-acting ACE inhibitor that can be rapidly uptitrated
Can be used even if creatinine is elevated

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9
Q

What medication should be avoided in systemic sclerosis?

A

Glucocorticoids - lead to salt and water retention, potentially causing scleroderma renal crisis

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10
Q

Initial treatment of dermatitis herpetiformis

A

Dapsone

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11
Q

Rapid onset psoriasis is associated with…

A
  1. HIV
  2. Strep pharyngitis (guttate psoriasis)
  3. Medications (systemic glucocorticoid withdrawal, antimalarial, lithium, beta blocker)
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12
Q

Pemphigus vulgaris vs bullous pemphigoid

A

PV: Age 40-60, anti-desmosome, flaccid bullae, mucosal involvement

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13
Q

Nail pitting is specific for…

A

Psoriatic arthritis

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14
Q

Where are Behcet syndrome ulcers?

A

Oral
Scrotum, vulva - red open sores

Pathergy test - insert 20-gauge needle obliquely and assess for >=2mm papule 24-48h later

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15
Q

What does negatively birefringent mean?

A

Yellow when parallel to polarizing light
Gout: negatively birefringent, needle-shaped

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16
Q

Giant cell arteritis - feared complications

A
  1. Sudden, irreversible, painless vision loss - due to anterior ischemic optic neuropathy
  2. Aortic aneurysm
17
Q

Causes of amyloidosis types, effects

A
  1. AL - clonal plasma cells
  2. AA - secondary to chronic inflammation
  3. ATTR - age-related or hereditary
  4. AB2-m - dialysis-related

Nephrotic syndrome (AL & AA)
Hepatomegaly w/wo splenomegaly (AL & AA)
Restrictive cardiomyopathy (AL & ATTR)
Carpel tunnel syndrome, scapulohumeral periarthritis (AB2-m)
Peripheral/autonomic neuropathy
Periorbital purpura, waxy skin, macroglossia

18
Q

Amyloid transthyretin leads to what clinical presentation?

A

Restrictive cardiomyopathy

19
Q

Amyloid light chain leads to what presentation?

A

Nephrotic syndrome
Hepatomegaly w/wo splenomegaly
Restrictive cardiomyopathy

20
Q

AA amyloidosis leads to what presentation?

A

Nephrotic syndrome
Hepatomegaly w/wo splenomegaly

21
Q

What is a risk of SLE, particularly with long-term glucocorticoids?

A

Avascular necrosis - use MRI since X-ray in early months is insensitive

22
Q

Violaceous, sometimes scaly lesions of elbows, knees, and MCP and PCP joints

A

Gottron sign/papule, pathognomonic for dermatomyositis

23
Q

Behcet syndrome - symptoms

A

Recurrent, painful oral and genital ulcers
Uveitis
Erythema nodosum
Pathergy
Vasculitis and thrombosis

24
Q

Erythema nodosum - workup

A

CBC, CMP
Antistreptolysin-O Ab
TB skin testing
Chest x-ray (evaluate for sarcoidosis)

25
Q

Erythema nodosum associated diseases

A

Strep, TB, endemic fungal (e.g. histoplasmosis)
Sarcoidosis, IBD, Behcet

Internal Medicine (23 decks)

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