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Flashcards in Rheumatology Deck (44)
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1

What are the differential diagnoses for a single joint pain?

Septic, crystals

2

What are the differential diagnoses for a multiple joint pain?

Osteoarthritis, rheumatoid arthritis, Seronegatives, lupus, scleroderma, myositis

3

What are the differential diagnoses for a Acute joint pain?

Septic, crystals, reactive, trauma

4

What are the differential diagnoses for a Chronic joint pain?

Osteoarthritis, rheumatoid arthritis, Lupus, scleroderma, myositis, seronegative

5

What are the differential diagnoses for joint pain with systemic manifestations?

Seronegative (IBD), lupus (Face, CNS, Renal, heart lung), rheumatoid (nodules, Serositis), reactive (oral, genital ulcer)

6

What describes non-inflammatory joint pain?

Osteoarthritis

7

What are the percentage of poly that is present in arthrocentesis in down flag Tori as opposed to inflammatory? Sepsis? Normal?

Less than 20% in normal and noninflammatory. Greater and 50% in inflammatory and greater than 75% Sepsis

8

What is considered inflammatory?

Everything that is not osteoarthritis or infection

9

In arthrocentesis what is the of white blood cell count and inflammatory as opposed to noninflammatory?

Great and 50,000, less than 50,000 but greater than 2000

10

What is the antibiotics for lupus? Lupus plus Renal involvement?

Anti-nuclear antibodies, anti-ds DNA antibodies,

11

Antibiotic for autoimmune hepatitis?

Anti-smooth muscle antibody

12

Antibiotics for primary biliary cirrhosis?

Anti-mitochondrial antibodies

13

Antibody for rheumatoid arthritis?

Anti-CCP, anti-RF antibodies

14

Antibiotics for systemic scleroderma? Crest scleroderma?

Anti-topoisomerase Antibodies, anticentromere antibodies

15

What does MD SOAP BRAIN stand for?

Malar rash, Discoid Rash, Serositis, Oral Ulcers, Arthritis, Photosensitive, Blood, Renal failure, ANA, Immunologic, Neuro

16

What happened to that complement levels in a lupus flare? In a lupus infection?

Complement levels decrease in flare and increase in infection

17

What is given to lupus patient that is refractory to other medications, severe case?

Mycophenolate Mofetil

18

How do you patients present that are infected with drug induced lupus?

Skin and joint symptoms only, no visceral involvement

19

What is the pathophysiology for antiphospholipid antibody syndrome?

Lupus anticoagulant causes coagulation in the body.

20

How do you do patience with anti-phospholipid antibody syndrome present?

Arterial and venous clots. Patient will have lupus. False positives RPR

21

How are antiphospholipid antibody syndrome diagnosed?

PPT increased, normal INR, mixing study fails to correct, Russell viper venom test

22

What is the treatment for anti-phospholipid antibody syndrome?

Warfarin plus aspirin

23

Symmetric stiffness of hands describes what disease? What joints are spared? What does the x-ray show?

Rheumatoid arthritis, DIP, erosions

24

What two diseases are given NSAIDs for symptoms and steroids for flares?

Lupus and rheumatoid arthritis

25

We should be given to rheumatoid arthritis if refractory to other medication, severe cases? Severe Lupus?

Biologics: Etanercept, infliximab
Mycophenolate Mofetil

26

What is the spinal involvement for Rheumatoid arthritis?

C1 and C2

27

What non arthritis symptoms can be an early sign of rheumatoid arthritis?

Bilateral carpal tunnel

28

What is Felty syndrome?

Rheumatoid arthritis plus neutropenia plus splenomegaly

29

What is the pathophysiology for giant cell arteritis?

Multi nucleated Giant cells in large blood vessels like the temporal artery

30

How does a patient with giant cell arteritis present?

Jaw Claudication, vision loss, unilateral head pain and tenderness. Greater than 50 in age

31

What is the treatment for Giant cell arteritis?

Treat first with steroids then temporal artery biopsy

32

How does a patient present that has polymyalgia rheumatica?

Symmetric pain and stiffness of neck, shoulder, hip girdle.

33

How is polymyalgia rheumatica diagnosed? Proximal muscle weakness is indicative of what elevated biomarkers?

Normal CK, inflammatory myopathy elevated ESR, CRP. Diagnosed clinically

34

What is the treatment for polymyalgia rheumatica?

Steroids

35

Polymyalgia rheumatica is diagnosed clinically however what should be done to rule out other diseases?

Angiogram

36

What is the pathophysiology for Takayasu Arteritis?

Giant cell arteritis of the aorta, subclavian, and axillary artery.

37

How do patients with Takayasu Arteritis present?

Asymmetric pulselessness, discordant blood pressure from left to right arm

38

What is the age difference between patients who have giant cell arteritis and Takayasu Arteritis⁉️

Giant cell arteritis greater than 50, less than 40

39

Takayasu Arteritis Diagnosed?

Angiogram CT, MRI, direct

40

Takayasu Arteritis Treated?

High dose prednisone

41

How does the patient presents with polyarteritis nodosa?

Infarction of multiple organs without a common vascular distribution. Purpura, Mesenteric ischemia, Renal failure.

42

How is polyarteritis nodosa diagnosed?

Angiogram microaneurysms and stenosis

43

How is polyarteritis nodosa treated?

High dose steroids and cyclophosphamide

44

What viral hepatitis is associated with poly arthritis nodosa? Cryoglobulinemia?

Hepatitis B, hepatitis C