Week 9 - Rheumatology And Connective Tissue Disorders

Question 1

Sx of ankylosising spondylitis

Answer 1

Constant Pain and Stiffness in the low back >3 months

Morning stiffness >30 minutes improved with exercise, not with rest. Alternating buttock pain. Awakening in 2nd half of the night d/t pain

Age <40 yo
Insidious onset

Question 2

What gene is associated with ankylosising spondylitis?

Answer 2

HLA-B27

Question 3

Dx of Ankylosing spondilytis

Answer 3

Physical exam including Schober’s test and Respiratory excursion (normal for both is at least 5 cm)

X-rays
HLA B27

Question 4

What is a CT disorder characterized by recurring mouth and genital ulcers, uveitis and arthritis?

Answer 4

Behçet’s disease

Question 5

Sx of Behçet’s disease

Answer 5

Mouth ulcers
Skin lesions
Sores on genitals
Uveitis
Joint swelling
Inflammation

Question 6

What tests make Dx of Behçet’s disease

Answer 6

None.

Signs and symptoms

Question 7

An inflammatory CT disorder that affects skin, muscles, joints, esophagus, lungs, and heart

Purple or dark red rash may occur anywhere

Calcinosis

Answer 7

Dermatomyositis

Question 8

Dermatomyositis Sx

Answer 8

Dark red or purple skin rash
Dysphagia
Fatigue
Fever
Muscle pain, weakness
Unintentional weight loss

Question 9

Dx of Dermatomyositis

Answer 9

None. Signs and symptoms.

Question 10

Causes of fibromyalgia

Answer 10

Not known, but possibly:

Serotonin deficiency
Hypometabolism

Question 11

Sx of fibromyalgia

Answer 11

Fatigue 
Stiffness
Headache
Sleep disturbance
Anxiety
Coldness
Exercise intolerance
Dysmenorrhea

Question 12

How to Dx fibromyalgia

Answer 12

Symptoms and Abnormal tenderness at 11 or more of 18 specific anatomical tender point sites

Question 13

Increased ____ can cause gout

Answer 13

Uric acid

Question 14

Elevated uric acid levels due to

Answer 14

Increased uric acid
Not eliminating uric acid
Or both: overproduction and underexcretion of uric acid

Question 15

Primary gout is __% of all cases of gout

Answer 15

90%

Question 16

Causes of secondary gout

Answer 16

Diuretics

Low-dose aspirin

Question 17

Sx of gout

Answer 17

Pain and inflammation in one joint, fever and chills

50% big toe

Question 18

Causes of juvenile rheumatoid arthritis

Answer 18

Not known. Thought to be autoimmune

Question 19

Sx of juvenile rheumatoid arthritis

Answer 19

Inflammation in joint
Limping
Sudden high fever
Rash that comes and goes with fever

Question 20

Dx for juvenile rheumatoid arthritis

Answer 20

Physical exam
Blood tests:
- rH factor
- ESR
- ANA
- CBC
- HLA B27

Question 21

Primary vs secondary osteoarthritis

Answer 21

Primary - old age

Secondary - obesity, trauma, surgery, congenital malformations in joint structure/function, etc.

Question 22

What is a persistent inflammatory muscle disease that causes weakness of muscles

Answer 22

Polymyositis

Question 23

Causes of polymyositis

Answer 23

Unknown, possibly autoimmune

Question 24

Sx of polymyositis

Answer 24

Progressive mm weakness
Dysphagia
Difficulty speaking
Mild joint or mm tenderness
Fatigue
Shortness of breath

Question 25

Dx of polymyositis

Answer 25

MRI Electromyography Muscle biopsy Blood tests - increased CK and aldolase suggest muscle damage

Question 26

Chronic inflammatory condition affecting the entire body, esp synovial membranes of joints

Answer 26

Rheumatoid arthritis

Question 27

What deformities are named in the hand with Rheumatoid arthritis?

Answer 27

Boutonnière deformity | Swan neck deformity

Question 28

Dx of Rheumatoid arthritis

Answer 28

RF factor in serum | Radiograph

Question 29

Buildup of scarlike tissue int he skin

Answer 29

Scleroderma

Question 30

Causes of scleroderma

Answer 30

Unknown. Autoimmune? Build up of collagen in the skin

Question 31

Sx of scleroderma

Answer 31

Skin hardening and tightening Raynaud’s phenomenon Acid reflux

Question 32

Dx scleroderma

Answer 32

Blood tests Biopsies of skin Breathing tests, CT lungs, echocardiogram of the heart

Question 33

An autoimmune disorder in which the glands that produce tears and saliva are destroyed

Answer 33

Sjogren syndrome | - dry mouth, dry eyes

Question 34

Primary vs secondary sjogren syndrome

Answer 34

1˚ is without other AI disorder | 2˚ is with other AI disorder e.g. Rheumatoid arthritis, lupus, etc.

Question 35

Sx for sjogren syndrome

Answer 35

Dry eyes, mouth Itching eyes Dysphagia, loss of sense of taste, problems speaking Fatigue

Question 36

Dx sjogren syndrome

Answer 36

Physical exam ANA test RH factor

Question 37

AI disease that leads to long-term inflammation that affects skin, joints, kidneys, brain, other organs

Answer 37

Systemic lupus erythematosus

Question 38

Characteristic sign of SLE

Answer 38

Butterfly rash on the face

Question 39

Sx of SLE

Answer 39

``` Chest pain with deep breath Fatigue Hair loss Mouth sores *butterfly rash* ```

Question 40

Dx SLE

Answer 40

Antibody tests, ANA panel CBC Chest xray

Question 41

General term for inflammation of blood vessels

Answer 41

Vasculitis

Question 42

Dx vasculitis

Answer 42

Biopsy of involved tissue