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Flashcards in Rheumatology Deck (259)
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1

Osteoarthritis

DIP(heberden's), PIP (bouchard's)

2

Rheumatoid arthritis

PIP, MCP

3

Psoriasis

DIP

4

Scleroderma

PIP, MCP

5

Heartburn + dysphasia + thickened skin=

scleroderma

6

Poor prognositc factors for Rheum Arthritis

Progressive synovitis
Joit space loss/erosiions
Inc Rh factor >1:80
Inc ESR

7

70yo F early morning stiffness >45min & symmetric small joint pain in 2nd-4th MCP and 2-5th MCP and PIP in L hand - jnt pain in R knee for 6 wks and ESR 48 - swelling of MCP and PIP RH neg wtd?

Start tx
Anti-CCP +

8

Antlanto odontoid subluxation

compress vertibrobasilar artery-> lightheadedness, sncope
screen for subluxation with lat xray before anesthesia
Compress cord - snsory motor quadriplegia
8mm asyx - surgical correction
Sx any size sx corretion

9

Pt with rheum arthritis can present with what?

carpel tunnel tarsal tunnel

10

Extra articular manifestations of RA

spill over of active disease from synovium
Rheumatoid nodules (inc'd RH factor (- in 15%))
Vasculitis/DR4
RF leaves joint thru capillaries-> inflamm, ulcers
Heart
Effusion
Constrictive pericarditis
Myocarditis
Lung
Rheum nodules (Caplan's syndrome)
Pleural effusion (low glucose, high LDH, exudative)
BO
Interstitial fibrosis
Hypersenitive pneumonitis (methotrexate)
Blood anemia of inflammation
Vasculitis - nexrosis ulceration at tip of fingers
Nerve - Mononeuritis multiplex->foot/hand drop
Skin - rheumatoid nodules (commonest extra artiuular manifestation - RH factor inc'd - AgAb complex depostion)
Renal - usually lsate stage with amyloid nephropathy
Drug induced NSAID, Peniclliamine, nephrotic syndorme
Eye - scleritis - deeper - r/o globe rupture
episleritis - superficial both autoimmune

11

Fx vs sprain

4 steps without sx

12

HCV with mixed cryoglobuinemia

vasulitis and LE ulcers

13

Tx for RA

Mild - NSAIDS+- hydroxychoroquine (need yearly retinal exam)/sulfasalazine(reactive arthritsi)/Minocycle (leading cause drug induced lupus and hepatitis)

Mod to severe - Add methotrexate(25mg/wk, check folate level) +- low dose steroid+- Leflunomide

Severe Add etanercept (check PPD)/infliximab/adalimumab or anakinra (IL inhib)
Abatacept, Rituximab, Tocilizumab

14

Egg shell Ca+

siliciosis

15

Salmon pink rash

still's dz/inc'd ferritin

16

Schools of fish or boxcar

chance - haemaphilis ducre
Tx: azithro orceftriaxone

17

Methotrexate contraindicated in?

Pt on bactrim, Hep B/C, Etoh liver dz

18

Macular degeneration

lose central vision

19

Reflexes

L5 lesion - no dorsiflex, no evert, no invert
Peroneal lesion - No dorsiflex, no evert, +invert

20

45yo p/w joint tiffness>1hr in AM, pain in MCP, PIP and pain while climbing stairs x 6wks Rh+, on tylenol no rlief - started on naproxen no relief Rh still high wtd?

Add methotrexate

21

Fastest acting DMARD (Disease modifying anti rheum drug) is?

Methotrexate

22

Which drug decreases mortality in RA

Methotrexate

23

Floppy iris syndrome

d/c tamsulosin before cataract surgery

24

What is preictor for CVS dz in Rheumatoid arthritis

Inc'd homocysteine levels

25

Pt with rheumatoid arthritis on NSAIDs with persistent synovitis, methotreaxate was added and pain improved, 3 months later pt p/w fatigue, Hg low, MCV high best tx would be?

folic acid def (from methotrexate use) - tx with folic acid

26

S/e NSAIDs

nephrotic syndrome, PUD, int nephritis

27

S/e hydroxychloroquine

Macular damage loss of accommodation

28

S/E Methotrexate

Heptox, hyper Pneum, athous ulcer

29

S/E Lefluonmide

Teratogenic

30

s/e Corticosteroid

Osteoporoiss, HTN, cataract, avasc necrosis