Rheumatology

Question 1

in what condition should you always order an arthrocentsis

Answer 1

concern for septic joint

Question 2

what is WBC count in arthrocentsis in setting of inflammation or infection

Answer 2

> 2000

Question 3

what is WBC count in setting of trauma in athrocentesis

Answer 3

<2000

Question 4

what is wbc count in athrocentsis in lupus patient

Answer 4

> 5000

Question 5

septic arhtritis wbc count on jointtap is

Answer 5

> 50,000

Question 6

this condition is usually diagnosed in kids under the age of 16 and symptoms have to be present for at least 6 weeks. Involvement is usually the large joints and you wont see rhematoid nodules like you do in adults

Answer 6

JIA

Question 7

what markers are present in JIA

Answer 7

ANA, RF can be seen but doesnt have to be if it is seen it is poorer prognosis

Question 8

which kind of JIA is mainly in girls and involves 4 or less joints, silent eye issues are involved and although ANA is + RF is usually negative

Answer 8

Oligoarticular JIA

Question 9

what exams need to be don in O-JIA

Answer 9

serial slit lamp because uveitis will be silent

Question 10

what kind of JIA has involvement of 5 or more joints and is more common in young girls

Answer 10

polyarticular JIA

Question 11

this kind of JIA is seen in both boys and girls and has the presence of a salmon-colored evanescent rash ( comes and goes quickly) that is present with spiking fevers, HSP and extremely high leukocytosis.

Answer 11

systemic JIA

Question 12

which JIA is associated with Koebner Phenomena (linear skin lesions appearing along sites of injury, rubbing or scratching)

Answer 12

systemic JIA

Question 13

how to treat polyarthritis

Answer 13

start with NSAIDs for a few weeks and then move on to DMARDS (methotrexate) or tnf inhibitors

Question 14

children who have to take methotrexate also need what

Answer 14

folic acid or leucovorin (folinic acid)

Question 15

which antibodies are present in SLE

Answer 15

anti-DNA and anti- Smith ( most diagnostic and specific)

Question 16

in SLW complement is

Answer 16

low ( low C4,C3 and CH50)

Question 17

what is the condition associated with SLE that consists of micro ischemia and seizures that can result in neuropsychiatric manifestations?

Answer 17

Lupus cerebritis

Question 18

how to dx lupus cerebritis

Answer 18

CT or MRI will show brain lesions.

Question 19

what meds are used to treat lupus

Answer 19

• NSAIDs if mild
• steroids
• hydroxychloroquine
• methotrexate

Question 20

what is associated with neonatal lupus

Answer 20

third degree heart block with bradycardia or hydrops fetalis

Question 21

how to dx neonatal lupus

Answer 21

Anti - Ro/La antibodies of mom

Question 22

what kind of drugs cause drug induced luus

Answer 22

• lithium
• hydralazine
• quinidine
• sulda drugs
• antiseizure medication

Question 23

what is the chronic inflammatory condition that involves fusion of the spine and inflammation of the hips, more common in boys

Answer 23

juvenile ankylosing spondylitis

Question 24

when is pain worse in ankylosing spondylitis

Answer 24

with rest

Question 25

give an example of a seronegative spondyloarthropathy

Answer 25

reactive arthritis ankylosing spondylitis ( inflamm markers are normal, ANA is negative and ESR is only slightly elevated)

Question 26

iritis, urethritis and arthritis

Answer 26

reactive arthritis

Question 27

aphthous ulcers, genital ulcers, GI symptoms, arthritis and uveitis

Answer 27

bechet's syndrome

Question 28

describe onset and key features of psoriatic juvenile idiopathic arthritis

Answer 28

presnts in children less than 6, more common in grils and presents with - dactylitis - arthritis or wrists hands and feet - older children can have enthesitis ( pain at insertion sites) - 50% of kids will have psoriass

Question 29

any child with psoriatic JIA can have what

Answer 29

uveitis

Question 30

what kind of weakness and nail findings will someone with dermatomyositis have

Answer 30

telengiectasia of the nails and proximal mucle wekaness

Question 31

how to dx dermatomyositis

Answer 31

mucsle bx

Question 32

what is high in dermatomyositis

Answer 32

CK level

Question 33

what condition can be associated with calcinosis cutis ( calcium depositis in skin)

Answer 33

dermatomyositis

Question 34

this disease presents with early pink, blanching flat or urticarial rash that turns into palpable purpura

Answer 34

HSP

Question 35

plt count is what in HSP

Answer 35

nl

Question 36

sometimes hsp initially presents how

Answer 36

abdominal pain (colic), blood in stool, intussusception, GB hydrops

Question 37

biopsy of hsp would show

Answer 37

deposits of IgA, IgG and C3

Question 38

how to treat HSP

Answer 38

self limited can give NSAIDs if kidneys aren't affected, severe cases might need IV steroids.

Question 39

multisystem complaints + hilar LAD should make you think of

Answer 39

sarcoidosis

Question 40

hilar LAD and peribronchial infiltrates that show noncaesating granulomas when bx is due to

Answer 40

sarcoidosis

Question 41

what is sjrogen caused by

Answer 41

lymphocytic infiltration of exocrine glands

Question 42

how to dx sjrogens

Answer 42

schirmers test ( paper to eye, lack of tear production)

Question 43

how to confirm dx of sjrogrens

Answer 43

bx of salivary gland will show lymphocytic infiltration

Question 44

wegners granulomatosis presents wih

Answer 44

multisystem vasculitis sinusitis lung issue kidney issue (+C-ANCA)