Romato Flashcards
(31 cards)
Gout ttt
Acute: 1.NSAID 2.colchicin
Main: Allopurinol
Child, palpable red rash leg and arm, arthritis, abdominal pain, stool + blood
Henoch-Schonlein purpura (HSP) is a disease involving inflammation of small blood vessels. It most commonly occurs in children (2-6). The inflammation causes blood vessels in the skin, intestines, kidneys, and joints to start leaking.
There is no specific treatment for HSP other than rest and recuperation, and symptoms usually go away within several weeks. Paracetamol or ibuprofen can be given to relieve any joint pains. Steroids may be used in children with severe symptoms, particularly bad tummy pain or kidney damage.
Gower’s sign What is? In which dis?
Gowers’s sign is a medical sign that indicates weakness of the proximal muscles, namely those of the lower limb. The sign describes a patient that has to use their hands and arms to “walk” up their own body from a squatting position due to lack of hip and thigh muscle strength.
Classically seen in Duchenne muscular dystrophy
Duchenne muscular dystrophy diagnose?
Diagnosis of DMD is based on the symptoms, clinical exam, and the result of a biopsy to remove a small piece of muscle for examination under a microscope. The result of genetic testing may also help confirm the diagnosis.
SLE
diagnostic criteria
soap brain md
Serositis (pleuritis, precarditis)
Oral ulcers
Arthritis
Photosensivity
Blood disorders
Renal involvement
ANA +
Imunologic(anti-sm,anti-dsDNA)
Neurologic disorders
Malar rash
Discoid rash
HSP defnition
Henoch-Schonlein purpura (also known as IgA vasculitis) is a disorder that causes the small blood vessels in your skin, joints, intestines and kidneys to become inflamed and bleed. The most striking feature of this form of vasculitis is a purplish rash, typically on the lower legs and buttocks
Sjogern’s synd
a disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouth. The condition often accompanies other immune system disorders, such as rheumatoid arthritis and lupus
There’s currently no cure for Sjögren’s syndrome, but there are several treatments that can help, such as: eye drops that keep your eyes wet (artificial tears) sprays, lozenges (medicated sweets) and gels that keep your mouth wet (saliva substitutes) medicine that helps your body produce more tears and saliva
Tupe 4 hypersensivity
Type four hypersensitivity reaction is a cell-mediated reaction that can occur in response to contact with certain allergens resulting in what is called contact dermatitis or in response to some diagnostic procedures as in the tuberculin skin test. Certain allergens must be avoided to treat this condition
The fourth type is considered a delayed hypersensitivity reaction because it usually occurs more than 12 hours after exposure to the allergen, with a maximal reaction time between 48 and 72 hours
Ocular examples of type IV hypersensitivity include phlyctenular keratoconjunctivitis, corneal allograft rejection, contact dermatitis, and drug allergies, although drug sensitivities can lead to all four types of hypersensitivity reaction
Middle aged woman with osteoarthritis best advice
Decrease weight
Osgood-schlatter dis
Osgood-Schlatter disease is a condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the shinbone (tibia), a spot called the tibial tuberosity. There may also be inflammation of the patellar tendon, which stretches over the kneecap
Osgood Schlatters will not cause permanent damage and will usually resolve when the child has reduced activity and stopped growing. It can, however, cause a bump to form on the shin bone underneath the tendon insertion
RA pathophysio
Although the pathophysiology of RA is not completely understood, the process generally involves dysregulated inflammation, with antigen presentation, T-cell activation, and autoantibody production all serving as mediators in the inflammatory process
prevent permanent joints loss in RA
In many cases, it is now possible to prevent these deformities by using disease-modifying anti-rheumatic drugs (DMARDs) and biologic drugs before the loss of bone (bony erosions) occurs.
What are Bouchard’s Nodes?
Bouchard’s nodes are bumps on the joints in the middle of your fingers (the proximal interphalangeal joint, or PIP), and are a sign of advanced finger osteoarthritis (OA), which is a degenerative joint disease
Heberden’s nodes
Heberden’s nodes are small bony growths that appear on the joint closest to the tip of your finger. Along with Bouchard’s nodes, Heberden’s nodes are a symptom of osteoarthritis of the hands. They can cause pain and limited motion in your hands
Boutonniere deformity
Boutonnière deformity is a condition that affects your ability to straighten the middle joint of a finger or — less commonly — a toe. Your joint is stuck in a bent position and won’t straighten. At the same time, the joint toward the tip of your finger or toe (extremity) is flexed upward
PIP flexion with DIP hyperextention
Polymyalgia rhumatica dif
An inflammatory disorder causing muscle pain and stiffness around the shoulders and hips.
Most people develop polymyalgia rheumatica after age 50. Sometimes this condition occurs with temporal arteritis, a more serious condition that causes inflammation of the lining of the arteries.
The most common symptom of polymyalgia rheumatica (PMR) is pain and stiffness in the shoulder muscles, which develops quickly over a few days or weeks. You may also have pain in your neck and hips. Both sides of the body are usually affected. The stiffness is often worse first thing in the morning after you wake up.
Polymyalgia rhumatica ttt
Treatment consists of steroids
Treatment is usually a low dose of an oral corticosteroid, such as prednisone. Although treatment often lasts two to three years, most people start to feel better within a day or two.
Juvenile arthritis
The most common type of childhood arthritis is juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis. Childhood arthritis can cause permanent physical damage to joints. This damage can make it hard for the child to do everyday things like walking or dressing and can result in disability
Symptoms:
Swollen, stiff, and painful joints in the knees, hands, feet, ankles, shoulders, elbows, or other joints, often in the morning or after a nap
Eye inflammation
Warmth and redness in a joint
Less ability to use one or more joints
Fatigue
Decreased appetite, poor weight gain, and slow growth
High fever and rash (in systemic JIA)
Swollen lymph nodes (in systemic JIA)
Lupus criteria
The EULAR/ACR classification requires an 💯antinuclear antibody (ANA) titer of at least 1:80 on HEp-2 cells or an equivalent positive test at least once; otherwise, the patient is considered not to have SLE💯. If it is present, 22 “additive weighted” classification criteria are considered, comprising seven clinical domains and three immunologic domains. Each criterion is assigned points, ranging from 2 to 10. Patients with at least one clinical criterion and 10 or more points are classified as having SLE.
Table 1. EULAR/ACR Clinical Domains and Criteria for SLE
1️⃣Constitutional:
(1)Fever *2
2️⃣Hematologic:
(1)Leukopenia *3
(2)Thrombocytopenia *4
(3)Autoimmune hemolysis *4
3️⃣Neuropsychiatric:
(1)Delirium *2
(2)Psychosis *3
(3)Seizure *5
4️⃣Mucocutaneous:
(1)Non-scarring alopecia *2
(2)Oral ulcers *2
(3)Subacute cutaneous or discoid lupus *4
(4)Acute cutaneous lupus *6
5️⃣Serosal:
(1)Pleural/pericardial effusion *5
(2)Acute pericarditis *6
6️⃣Musculoskeletal:
(1)Joint involvement *6
7️⃣Renal
(1)Proteinuria > 0.5 g/24 h *4
(2)Renal biopsy class II or V lupus nephritis *8
(3)Renal biopsy class III or IV lupus nephritis *10
Table 2. EULAR/ACR Immunologic Domains and Criteria for SLE (Open Table in a new window)
Domain
Criteria
Points
Antiphospholipid antibodies
Anti-cardiolipin antibodies or
Anti-β2GP1 antibodies or
Lupus anticoagulant
2
Complement proteins
Low C3 or low C4
Low C3 and low C4
3
4
SLE-specific antibodies
Anti-dsDNA antibody or
Anti-Smith antibody
6
Note the following [5, 6] :
A criterion should not be counted if there is a more likely explanation for it than SLE
Occurrence of a criterion on at least one occasion is sufficient
Criteria need not occur simultaneously
Within each domain, only the highest-weighted criterion is counted toward the total score
Kawasaki disease
is a condition that mainly affects children under the age of 5. It’s also known as mucocutaneous lymph node syndrome. A child with Kawasaki disease has a high temperature that lasts for 5 days or longer, and possibly 1 or more of the following symptoms: a rash. swollen glands in the neck.
Most kids with Kawasaki disease recover completely, especially when they are diagnosed and treated early. Some, especially those who develop heart problems from Kawasaki disease, might need more testing and to see a cardiologist (a doctor who specializes in conditions that affect the heart)
There’s no specific test available to diagnose Kawasaki disease. Diagnosis involves ruling out other diseases that cause similar signs and symptoms, including: Scarlet fever, which is caused by streptococcal bacteria and results in fever, rash, chills and sore throat. Juvenile rheumatoid arthritis
Clinical signs include fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips, and throat. Kawasaki disease primarily affects children younger than 5 years of age.
What is the first line treatment for lupus?
Hydroxychloroquine is first-line treatment unless contraindicated and is useful in almost all manifestations of lupus. Other treatments are titrated against type and severity of organ involvement. Monoclonal antibodies have a limited role in the management of lupus
Nowadays, antimalarials are the basic treatment for every patient with SLE, whereas glucocorticoids should only be used when acutely indicated. If reduction or tapering of glucocorticoids proves impossible, extended immunosuppression with azathioprine, methotrexate, or mycophenolate mofetil is recommended
ra swelling hand ttt
Apply an ice pack to inflamed joints to help ease swelling. Cold can also help to numb pain and relax muscle spasms. A 2013 research review suggested that cryotherapy, or cold therapy, may reduce pain in people with RA
Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain. These may be combined with biological treatments.
…
The DMARDs that may be used include:
methotrexate.
leflunomide.
hydroxychloroquine.
sulfasalazine
Reiter’s syndrome
Reactive arthritis, also known as Reiter’s syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. is usually preceded by an infection caused by bacteria, such as Chlamydia trachomatis (a sexually transmitted disease) or Salmonella (a bacteria that can contaminate foods).
Symp:
Joint pain and inflammation that often affect the knees, feet, and ankles.
Inflammation of a tendon that is attached to bone. …
Bony growths in the heel (heel spurs) that can cause chronic pain.
Inflammation of the spine (spondylitis)
Ankylosing spondylitis
Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the bones in the spine (vertebrae) to fuse. This fusing makes the spine less flexible and can result in a hunched posture. If ribs are affected, it can be difficult to breathe deeply.Azar 4, 1400 AP
Symptoms: Uveitis; Joint stiffness; Inflammation
Early signs of AS
pain in the lower back, hips, and buttocks.
stiffness in the lower back, hips, and buttocks.
neck pain.
ligament and tendon pain where these structures attach to the bones.
tiredness.
night sweats.
mild fever.
appetite loss
