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Flashcards in Rheumatology and Orthopedics Deck (98):
1

Charcot Disease

Decreased sensation secondary to (diabetes, peripheral nerve damage, syringomyleia, spinal cord injury, B12 deficeincyor tabes dorsalis) causes patients to traumatically injure their feet

X rays reveal loss cartilage, osteophyte development and loose bodies

2

Management of charcot joint

Treat underlying disease and provide mechanical support to prevent injury

3

Risk Factors for Avascular necrosis

corticosteroid use
Trauma
SLE
Sickle Cell

4

Diffuse narrowing of all joint spaces in hand do to degenerative changes

Osteoarthritis

5

squared-off bone ends
hook-like osteophytes
Lesions of second and third MCP

hemochromatosis related arthropathy

6

Telangiectasia
Sclerodactyly
Raynauds
Dysphagia, dyspepsia, angiodysplasia (watermelon stomach)
Pulmonary fibrosis and hypertension
Renal Crisis
Myocarditis, pericarditis

Systemic sclerosis

7

Treatment of myositis or dermatomyositus

Corticosteroids

8

Treatment for ALS

Riluzole

9

Treatment of acute gouty arthritis

Colchicine

10

negative bifiringent urate crystals

gout

11

Rhomboid shaped positively bifiringent cells

calcium pyrophsophate

12

Age >50
Weakness in shoulders and hip
Morning stiffness >1hr
Elevated ESR

Polymyalgia rheumatica

13

Treatment of polymyalgia rheumatic

low dose glucocorticoids

14

Painful subcutaneous nodules

Erythema nodosum

15

Causes of erythema nodosum

Streptococcal infection (most common)
Sarcoidosis
Histoplasma TB
IBS

16

Treatment of SLE

Glucocorticoids for acute flare
Hydroxychloroquine to prevent progression
Belimumab to kill lymphocytes
Cyclophosphamide or mycophenolate for lupus nephritis

17

DMards

For RA
Methotrexate
Rituxumab
Etanercept: anti TNF
Adalimumab: anti TNF
Anakinra: IL 2 inhibitor of neutrophil activation
Abatacept: stops T cells

18

Management of cord Compression

Glucocorticoids first
Stat MRI
STAT neuro consult
STAT surgery consult

19

Treatment of osteomyelitis

If MRI positive empiric Vanc and Zosyn
Gram neg bacilli oral cipro
Ertapenem or ceftriaxone otherwise

20

Flexion of the 4th and 5th digits

Dupuytren Contracture

21

Treatment of Dupuytren Contracture

Early: inject collagenase
Advancing Disease: injection triamcinolone

22

Conditions leading to pseudogout

hyperparathyroidism
hemachromatosis
recent surgery
osteoarthritis
hypomagnesium

23

Treatment of rotator cuff injury

Complete tear (acute)-immediate surgery
Chronic tear- physical therapy and steroid injections

24

severe pain in bottom of foot near heel
Worse in the morning

Plantar Fasciitis

25

What condition is associated with Giant Cell arteritis

Polymyalgia Rheumatica

26

Pathophysiology of Pagets

accelerated and disorder osteoclastic bone resorption with disorganized formation of lamellar bone in affected site most common in femur, axial skeleton and skull
Deafness may also occur

27

Lab findings in Pagets

Calcium normal
Phosphate Normal
Alk Phos high
Urine hydroxyproline high

28

Side effect of hydroxychloroquine

Occular concerns-retinopathy or corneal damage

29

Heberden Nodes

Found in the DIP joints in osteoarthritis.
Formed from calcified, cartilaginous spurs

30

Treatment of Fibromyalgia

Amytriptaline or SSRI

31

Side Effects of methotrexate

hepatotoxicity
stomatitis
cytopenias

32

subacute-chronic pain in the knee in a young female

patellofemoral syndrome

33

Patellofemoral compression test

extend knee while pushing on patella to see if pain is illicted
Diagnostic for patellofemoral syndrome

34

Episodic pain of the inferior patella in atheletes

patellar tendonitis

35

Tenderness and swelling of the tibial tubercle

Osgood Schlatter disease

36

Diagnosis of Bechet syndrome

Recurrent oral ulcer with 2 following:
genital ulcers
uveitis
retinal vascularization
Skin findings

37

Treatment of Bechet

colchicine and corticosteroids

38

Patient with difficulty abducting the arm, pushing and pulling

Rotator Cuff tear

39

Diagnostic test for a rotator cuff tear

MRI

40

Infections related to hemachromatosis

Listeria
Vibrio vulnificus
Yersinia enterocolitica

41

hepatomegaly
hyperpigmentation with diabetes
arthropathy
cardiomyopathy
hypogonadism

hemachromatosis

42

chronic malabsorptive diarrhea
protein losing enteropathy
migrating non-deformingarthritis
lymphadenopathy
fever

Whipple's Disease

43

biopsy of small intestine showing PAS positive organisms

Whipple's disease

44

Infectious organism in whipple
s

Tropheryma whippelii

45

Treatment of Whipple's disease

6-12 months ceftriaxone, doxycycline, TMP/SMZ

46

Treatment of Raynaud's

Avoid aggravating factors
CCB: nifedipine or amlodipine

47

Hepatomegaly
Nephrotic syndrome- facial swelling, leg edema
Cardiomyopathy

Amyloidosis

48

Treatment of amyloidosis

Colchicine

49

CREST

Calcinosis
Raynauds
Esophageal dysmotility
Sclerodactyl
Telangiectasia

50

Skin changes
GERD
Dyspnea
Finger ulcers

CREST

51

Treatment of CREST

CCB for Raynauds
PPI for GERD
Bosentan and ambrisentan (endothelin antagonist) Sildenafil for pulmonary HTN along with prostacyclin analogs epoprostenol, treprostinil and iloprost

52

repeated wrist extension and supination
lateral arm pain

lateral epicondylitis

53

pathophysiology of lateral epicondylitis

degeneration of the extensor carpi radialis brevis tendon near the lateral epicondyle

54

Chemical composition of crystal found in gout and pseudogout

Gout Monosodium urate
Pseudogout calcium pyrophosphate

55

Pain with active range of motion of shoulder
Pain with internal rotation of shoulder
Pain with forward flexion

subacromial bursitis

56

Most common extra-articular finding in ankylosing spondylitis

anterior uveitis

57

Described characteristics of SLE arthritis

Usually not permanent deformity
Migratory arthritis
lower incidence of erosion and joint deformity

58

>50% decrease ROM of the arm

Adhesive capsilitis (frozen shoulder syndrome)

59

Treatment for osteoporosis in RA

bisphosphonates

60

anti SSA (Ro)/anti SSB (La) autoantibodies

Sjogren's Syndrome

61

Most dire complication of Sjogren's

Lymphoma

62

Schirmer Test

inability to wet filter paper placed into the eye. Diagnostic in sjogren's

63

Rose Bengal

abnormal staining of the eye seen in Sjogren's.

64

Rapid deceleration or direction changes
Rapid onset of pain in the leg
Popping sensation
Joint instability

ACL tear

65

Lower abdominal pain with bloody diarrhea
Tenesmus
erythema nudism
arthritis
cholangitis
pANCA

Ulcerative colitis

66

Pulmonary manifestations of systemic sclerosis

Interstitial lung disease (most common)
Pulmonary artery hypertension

67

Management of acute presentation of SLE

If renal symptoms must get a kidney biopsy to differentiate

68

anterior hip pain
worsened by exercise and improved with rest
Progressive
Eventual pain at rest and joint instability

osteronecrosis
Secondary to prolonged cortico steroid use, alcohol abuse etc

69

expanding ulcer with purlulent base and violacious surround

pyoderma gangrenosum

70

treatment of pyoderma gangrenosum

corticosteroids

71

hemorrhagic pustules with surrounding erythema that evolve into necrotic ulcers

ecthyma gangrenosum

72

acute back pain
activity
point tenderness

compression fracture of vertebrate

73

Complications of cyclophosphamide use

hemorrhagic cystitis
bladder carcinoma
myelosuppression
sterility

74

Drugs cause cochlear dysfunction

Cisplatin
Carboplatin
Aminoglycosides

75

Drugs causing optic neuritis

Ethambutol
hydroxychloroquine

76

Drugs causing peripheral neuropathy

isoniazid
phenytoin
vincristine
heavy metals

77

Drugs cause Raynaud's

Beta-blockers
ergotamine

78

Drugs causing thyroid dysfunction

Lithium
Amiodorone

79

Risk factors for osteoperosis

Post menopausal most significant
low calcium intake
smoking
corticosteroid use
Low BMI
heavy alcohol use
lack weight bearing exercise

80

Colonoscopy protocol

Start at 50 and every ten year
If polyps then every 3-5 years

81

Involvement of the DIP joints
dactylitis
morning stiffness
Nail involvement

psoriatic arthritis

82

Chronic neck pain
Bony spurs
sensory deficits

cervical spondylosis

83

pain and stiffness of shoulders and pelvic girdle
No muscle tednerness

Polymyalgia rheumatica

84

symmetric proximal muscle weakness
mild pain
elevated CK

polymyositis

85

Elevated alkaline phosphatase is seen in

Hepatobiliary disease
Increased bone turnover
Leukemoid reaction

86

anti-topoisomerase 1 antibodies

systemic sclerosis

87

passively grasping the flexed thumb into the palm with the fingers

Dequervain Tenosynovitis
abductor policis longus
extensor policis brevis

88

Heliotrope rash of the face

dermatomyositis

89

Rashes in dermatomyositis

Heliotrope rash of face
Gottron's Sign of hands
Shawl sign of chest and shoulers

90

anti-Jo Antibodies

Dermatomyositis

91

anti Mi 2 antibodies

dermatomyositis

92

Diseases appearing with dermatmyositis

Neoplasms: colon, ovarian, lung, pancreatic, stomach

93

Inflammatory disease associated with aortic aneurysm

Bechet
Takaysu
Giant Cell arteritis
AS
RA
psoriatic arthritis
IgG4
Reactive Arthritis

94

Numbness and pain between the 3rd/4th toe
Clicking sensation when palpating the third and fourth toe

Morton Neuroma

95

Pain in the foot that hurts more with the first few steps of the day

Plantar fasciitis

96

burning pain or stiffness 2-6cm above the posterior calcaenous

Achillies tendonopathy (fluoroquinolone use)

97

burning, numbness and aching of the distal plantar portion of the foot and toes

Tarsal Tunnel syndrome (compression of the tibial nerve of the ankle)

98

Pain with Neer test

rotator cuff tendonitis with impingement.
(arm cannot be passively raised above the head without pain)