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Rheumatology Flashcards

(52 cards)

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1
Q

Polyatricular symmetric arthritis seen in

A

RA
SLE
Hep B
Parvovirus B19

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2
Q

Monoarticular arthritis seen in

A 
Osteoarthritis
Crystal induced (Gout, pseudogout)
Septic( gonococcus)
Traumatic
Hemarthrosis
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3
Q

What is migratory polyarthritis

A

Shifting of inflammation and pain from one joint to another and relieve of previous joint

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4
Q

Migratory arthropathy is seen in

A

Rheumatic fever
Disseminated gonoccocal
Lymes ds

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5
Q

Oligoarticular assymetric

A

Osteoarthritis of small joints of hands
Ankylosing spondylitis
Rarely polyarticular gout

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6
Q

Features of joint inflammation

A 
Joint stiffness in morning >1hr
Erythema
Warmth
Inc ESR
Inc CRP
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7
Q

Eg of inflammatory arthritis

A

RA

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8
Q

What should be checked in synovial fluid

A

3cs:crystals
Cells
Culture
Gram stain

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9
Q

Diff bw crystals of gout and psedogout

A

Gout:negative birefringent, needle shaped

Pseudogout: positive, rhomboid shape

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10
Q

What is wbc range in synovial fluid of inflammatory arthritis

A

5000-50000 WBC/mm3

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11
Q

Wbc in septic arthritis

A

> 50,000 wbc/mm3

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12
Q

4 basic questions to be asked in case of evaluating a patient with arthrits

A
  1. distribution(asymm/symmetric) and no. Of joints (mono/poly)
  2. symptons acute/chronic
  3. systemic symptoms
  4. evidence of joint inflammation
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13
Q

Can ANAs be found in normal people?

A

Yes in 5% of normal person(especially speckled pattern)

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14
Q

ANA pattern in SLE

A

Peripheral/rim

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15
Q

Centromere ANA pattern seen in

A

CREST (c to remember)

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16
Q

ANA pattern seen in systemic sclerosis

A

Nucleolar

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17
Q

ANA mostly found in SLE

A

Anti dsDNA
Anti SM
Anti Ro

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18
Q

Specific ANA in drug indiced lupus

A

Anti -histone

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19
Q

ANA in CREST

A

Anti centromere

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20
Q

Anti RNP specific to

A

Mixed connective tissue ds(100%)

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21
Q

What is RF

Study These Flashcards
A

Is an autoantibody against Fc portion IgG

22
Q

Can RF be found in normal individuals

23
Q

cANCA and pANCA found in

Study These Flashcards
A

C-wegeners granulomatosis

P- PAN, churg stauss

24
Q

What are the common lab abnormalities ass with Anti phospholipid Ab syn

Study These Flashcards
A
  1. Prolonged PTT

2. False positive RPR/VDRL

25
Distribution of joints affected in RA
Symmetric Mostly of hands-wrist ,MCP, PIP. NEVER: DIP joints of lower back (but cervical involovement seen in 25-80% :atlantoaxial subluxation)
26
Felty and kaplan syndrome
RA+ splenomegaly + neutropenia RA+ pneumoconiosis
27
Predominant infilterating cell in RA
T lympocyte
28
Boutonnaires and swan neck deformity seen in
RA
29
Most likely reason in patient with RA who complains of occipital headache and upper extremity tingling sensation
Atlantoaxial subluxation
30
Most likely reason in patient with RA who complains of occipital headache and upper extremity tingling sensation
Atlantoaxial subluxation
31
Most common cause of disability in SLE
Lupus nephriti
32
Rash of SLE
Maculopapular which is photosensitive , leaves no scar Butterfly shape Not seen in drug induced lupus
33
Rash of DLE
Face and scalp Circular rash Raised rim Disfiguring (central atrophy and scarring)
34
Pregant SLE patients need to bd screened for which Ab
Anti Ro/SSA Passively cross placenta Cause neonatal lupus and heart block
35
Symmetric polyarticular joint involvement in
``` RA SLE SSc Sjorgen Hep B Parvovirus B 19 ```
36
What is CREST syndrome
``` C calcinosis R Raynauds E esophageal dysmotility S sclerodactyly T telengiectasia ```
37
What is primary raynauds phenomenon
Also called raynauds ds Without associated underlying disease Secondry: associated with disease eg scleoderma
38
How to differntiate be 1 and 2 raynauds on examination
Done by nailfold cappiloscopy test Enlarged,dilated or absent nailfold capillaries noted in scleoderma and other AI ds.
39
What are seronegative arthropathies
AS Reactive Psoriatic Enteropathic arthropathy Called so because of absence of ANA and RF
40
Most common presentation of AS
Chronic lower back pain | Morning stiffness lasting atleast 1 hr improves with exercise
41
MC extraarticular manifestation of AS
Anterior uveitis | Aortic insufficiency leading to chf and 3 degree heart block
42
Reiters syndrome
Reiter’s Syndrome is a reactive arthritis that develops in response to an infection and characterized by a triad of arthritis, conjunctivits, and nonspecific urethritis. Reiter syndrome) occurs after a nongonococcal urethritis (chlamydia, ureaplasma). These patients have distinct mucocutaneous manifestations: keratoderma blennorrhagica, circinate balanitis, oral or genital ulcers, conjunctivitis, and arthritis.
43
causes of ReA
1. Post veneral -Urethritis | 2. Post enteric -Diarrhoea caused by invasive org.( camp , shigella , salmonella)
44
Circinate balanitis
comprising a serpiginous annular dermatitis of the glans penis. Circinate balanitis is the most common cutaneous manifestation of reactive arthritis
45
Keratoderma blennorrhagica
Keratoderma blennorrhagicum  meaning keratinized (kerato-) skin (derma-) mucousy (blenno-) discharge (-rrhagia) (also called keratoderma blennorrhagica) are skin lesions commonly found on the palmsand soles. One of the manifestation of Re A
46
Psoritic arthritis hand changes
``` Typical skin rash Pencil in cup deformity Mouse ear appearance Nail pitting Sausage shaped finger ```
47
What is mc joint involved in osteoarthritis
Weight bearing joint(Knee,hip) Small joints of fingers(PIP , DIP , base of thumb) Monoarthritis/ assymetric oligarticular
48
Osteophytes in PIP and DIP
Bouchard Herbeden nodes
49
Why serum uric acid level is not app for dx of gout?
The serum uric acid during the acute attack may be normal or low. On the other hand, many people have elevated serum uric acid levels and never develop gout. Thus, the serum uric acid level is of no value in the diagnosis of acute urate arthropathy. This is why the diagnosis is made by the analysis of synovial fluid.
50
Fish like scales seen in
Icthyoses 3 types Icthyoses vulgaris AD X linked icthyoses Lamellar icthyosis
51
Icthyosis vegaris
AD Deficiency in filagggrin Both males and females Small, branny , except on shins where large. Pasted in centre with upturned edge. Extensors of limbs, lower back. Associated with- hyperlinear palms and soles, keratosis pilaris , atopic diathesis
52
X linked icyhyoses
``` Only males Deficiecy in steroid sulfate Large dark , tightly adherent Sites: generalised, flexures enctoached Ass: corneal opacities , cryptorchidism ```

Internal Medicine (9 decks)

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