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Internal Medicine > Allergy And Rheumatology > Flashcards

Allergy And Rheumatology Flashcards

1
Q

B cell surface marker and EBV receptor

A

CD21

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2
Q

Most potent and effective APCs in the body

A

Dendritic cells

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3
Q

Antibody secreted in mucosal surfaces as dimer; most produced antibody overall

A

IgA

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4
Q

Protein molecules capable of activating up to 20% of T cell pool resulting in widespread immune response

A

Superantigen

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5
Q

Binding of an opsonized target cell to a FC receptor bearing effector cell resulting in lysis of the target

A

Antibody dependent cellular cytotoxicity

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6
Q

Opsonin complement

A

C3b

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7
Q

5 acute phase reactants that are increased during inflammation

A 
Serum amyloid A
CRP
Ferritin
Fibrinogen
Hepcidin
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8
Q

2 proteins that are decreased during inflammation

A

Albumin and transferrin

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9
Q

3 complement proteins involved in anaphylaxis

A

C3a, 4a, 5a

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10
Q

Complement that induces neutrophol chemotaxis

A

C5a

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11
Q

Leukotriene involved in neutrophil chemotaxis

A

LTB4

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12
Q

3 components of slow reacting substances of anaphylaxis (SRS-A)

A

LTC4, D4, E4

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13
Q

Cytokine involve in fever and activates osteoclast

A

IL1

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14
Q

Cytokine that stimulates all types of T cell

A

IL2

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15
Q

Cytokine that activates mcrophages and increases antigen presentation

A

IFN gamma

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16
Q

Cytokine that stimulates septic shock, vascular leakage, recruitment of leukocytes

A

TNF alpha

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17
Q

Cytokine that differentiates T cells into TH1 and activates NK cells

A

IL12

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18
Q

Cytokine that stimulates bone marrow stem cells

A

IL3

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19
Q

Cytokine that modulates inflammatory response togethef with TGF-B

A

IL10

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20
Q

Cytokine that induces B cell growth and IgE production

A

IL 4

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21
Q

Major neutrophil chemotactic factor or cytokine

A

IL8

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22
Q

Cytokine that induces eosinophil growth and IgA production

A

IL-5

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23
Q

Cytokine involved in fever and stimulates acute phase proteins

A

IL6

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24
Q

Anti Ach receptor

A

Myasthenia gravis

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25
Q

Anti basement membrane

A

Goodpasture syndrome

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26
Q

Anti glutamate decarboxylase

A

T1 DM

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27
Q

Anti Jo, anti SRP, anti Mi-2

A

Dermatomyositis, polymyositis

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28
Q

Anti microsomal, anti thyroglobulin, anti- TPO

A

Hashimoto thyroiditis

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29
Q

Anti mitochondrial

A

Primary biliary cirrhosis

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30
Q

Anti smooth muscle

A

Autoimmune hepatitis

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31
Q

TSH-receptor stimulating immunoglobulin and anti-TPO

A

Grave’s disease

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32
Q

Anti centromere

A

Limited scleroderma, CREST syndrome

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33
Q

Anti Scl-70, anti topoisomerase 1

A

Diffuse scleroderma

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34
Q

Female, joint pains, pleural or pericardial effusions, photosensitive rash, hematuria or proteinuria, oral ulcers, anemia, leukopenia or thrombocytopenia, seizures or psychosis, headache, fever, myalgias, autoantibodies

A

SLE

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35
Q

Best screening and most sensitive test for SLE

A

ANA

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36
Q

SLE-specific antibodies that correlate with level of disease activity nephritis and vasculitis

A

Anti-dsDNA

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37
Q

SLE-specific antibodies with no clinical correlations

A

Anti-Sm

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38
Q

Antibodies associated with Sicca syndrome, subacute cutaneous lupus, neonatal lupus with congenital heart block and decreased risk for nephritis

A

Anti-Ro (SS-A)

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39
Q

Anti-bodies in drug-induced lupus

A

Anti-histone

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40
Q

Antibodies predisposing to recurrent fetal loss, thrombosis, detected by ELISA fir Cardiolipin and B2G1 and DRVVT

A

Anti-phospholipid antibody

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41
Q

Most serious manifestation of SLE

A

Nephritis

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42
Q

Immunosuppressive therapy for Class 3-5 lupus nephritis

A

Steroids + cyclophosphamide/mycophenolate mofetil

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43
Q

Most common pulmonary manifestation of SLE

A

Pleuritis with or without effusion

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44
Q

Most frequenf cardiac manifestation of SLE

A

Pericarditis

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45
Q

Fibrinous vegetations and endocarditis in SLE

A

Libman-Sacks endocarditis

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46
Q

Most frequent hematologic manifestation of SLE

A

Normocytic, normochromic anemia

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47
Q

Most common manifestation of diffuse CNS lupus

A

Cogniyive dysfunction

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48
Q

Most common chronic dermatitis in SLE

A

Discoid lupus erythematosus

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49
Q

Most common form of chronic inflammatory arthritis

A

RA

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50
Q

Most common cardiac and valvular manifestations of RA

A

Pericarditis and mitral regurgitation

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51
Q

Most commob cause of death in patients with RA

A

Cardiovascular disease

52
Q

Environmental factor most implicated in RA

A

Smoking

53
Q

Triad of neutropenia, splenomegaly, and nodular RA

A

Felty’s syndrome

54
Q

Triad of keratoconjunctivitis sicca, xerostomia and RA

A

Sjogren’s syndrome

55
Q

Length of time for joint symptoms tobe suggestive of RA

A

6 weeks or more

56
Q

Synovial inflammation and proliferation, focal bone erosions, thinning of the articulat cartilage and pannus formation are pathological hallmark s of

A

RA

57
Q

IgM against the Fc portion of IgG

A

Rheumatoid factor

58
Q

Serum marker with higher specificity for RA than RF

A

Anti-CCP

59
Q

Initial radiological finding in RA

A

Juxta-articular osteopenia

Other findings:
Soft tissue swelling
Symmetric joint space loss abf subchonral erosions

60
Q

Test with greatest sensitivity for detecting synovitis, joint effusions and early bone and marrow changes in RA

A

MRI

61
Q

DMARD of choice for RA

A

Methotrexate

62
Q

Most common type of arthritis

A

OA

63
Q

2 major factors contributing to the developmeng of OA

A

Joiny loading and joint vulnerability

64
Q

Most potenf risk factor for OA

A

Age

65
Q

Nodes found on the proximal interphalangeal joint in OA

A

Bouchard’s nodes

66
Q

Nodes found on the distal interphalangeal joint in OA

A

Heberden’s nodes

67
Q

Fulcrum of the longest lever arm in the body

A

Knee

68
Q

Asymmetric joint space narrowing, subchondral sclerosis and osteophytes are radiological hallmarks of

A

OA

69
Q

Initial analgesic of choice for OA

A

Acetaminophen or paracetamol

70
Q

50 year old alcoholic male complaining of severe joint pain starting last night with noted swelling and redness on his right first metatarsophalangeal joint

A

Gouty arthritis

71
Q

Inflammation of the first metatarsophalangeal joinf in gout

A

Podagra

72
Q

Needle-shaped crystals that are negatively birefringent

A

Gouty arthritis

73
Q

Rhomboid-shaped crystals that are weakly-positive birefringent

A

Psuedogout

74
Q

Mainstay of treatmenf during acute attacks of gout

A

NSAIDs (indomethacin)

75
Q

Indication for uricosuric agents

A

Under excretors of uric acid

76
Q

Most commonlg used hypouricemic and best drug to use in urate overproducers, urate stone formers, and renal disease

A

Allopurinol

77
Q

Target therapeutic blood uric acid level for gout

A

Less than or equal to 6 mg/dl

78
Q

Joint most frequently affected in CPPD or pseudogout

A

Knee

79
Q

Radiograph findings of punctate or linear radiodense deposits in fibrocartilaginous joint menisci or articular hyaline cartilage suggestive of CPPD

A

Chondrocalcinosis

80
Q

Arthritis presenting with predominant DIP involvement, asymmetric or symmetric, involving one or more joints, dactylitis, shortening of digits and nail changes with or without silvery scaly skin lesions

A

Psoriatic arthritis

81
Q

Nail pitting, horizontal ridging, onycholysis, yellowish discoloration of margins (oil spots), dystrophic thick subungal hyperkeratosis, salmon patches are nail changes of

A

Psoriasis or psoriatic arthritis

82
Q

Uveitis in psoriatic arthritis

A

Bilateral chronic posterior uveitis

83
Q

Pencil-in-cup deformity, “whiskering”, small joint ankylosis, osteolysis, periostitis, new bone formation, and telescoping of digits are radiologic characteristics of

A

Psoriatic arthritis

84
Q

Ideal treatment for psoriatic arthritis

A

Anti-TNF alpha agents (infliximab, adalimumab, golimumab)

85
Q

Acute nonpurulent arthritis complicating an infection elsewhere in the body

A

Reactive arthritis

86
Q

Triad of arthritis, urethritis, and conjunctivitis

A

Reiter’s syndrome

87
Q

6 common organisms implicated in reactive arthritis

A

Shigella, salmonella, yersinia, campylobacter, chlamydia, HIV

88
Q

Initial treatment of choice for reactive arthritis

A

Indomethacin and other NSAIDs

89
Q

Young adult male, insidious onset of dull pain in the lower lumbar or gluteal region, lumbar morning stiffness lasting a few hours that improves with activity and returns after inactivity with nocturnl exacerbation

A

Ankylosing spondylitis

90
Q

Genetic marker prominent in ankylosinf spondylitis and other spondyloarthropathies

A

HLA-B27

91
Q

Earliest manifestation of ankylosing spondylitis

A

Sacroiliitis

92
Q

Inflammation in the fibrocartilaginous regions where a tendon, ligament or joint capsul attaches to bone characteristic of spondyloarthropathies

A

Enthesitis

93
Q

Most common extra articulat manifestation of ankylosing spondylitis

A

Acute anterior uveitis

94
Q

First line pharmacologic management of ankylosing spondylitis

A

NSAIDs

95
Q

Patient with pneumonia presenting with sudden onset moderate to severe pain on the right knee with muscle spasm, decreased range of motion, swelling and redness, high fever, leukocytosis

A

Infectious or septic arthritis

96
Q

Most common site of infectious arthritis

A

Knee

97
Q

Most common route of infection for infectious arthritis in all age groups

A

Hematogenous

98
Q

Most common etiologic agent for infectious arthritis among young adults and adolescents

A

Neisseria gonorrhea

99
Q

Most common nongonococcal cause of infectious arthritis in adults of all ages

A

Staphylococcus aureus

100
Q

Most common etiologic agent for infectious arthritis afer surgery or penetrating injuries

A

Staphylococcys aureus

101
Q

Subset of patients with highest incidence of inectious arthritis

A

RA patients

102
Q

Most common presentation of infectious arthritis

A

Monoarthritis

103
Q

Sites of infectious arthritis most common among IV drug abusers

A

Vertebral, sacroiliac, and sternoclavicular joints

104
Q

Other than antibiotics, essential treatment needed for a favorable outcome on joint function in infectious arthritis

A

Timely drainage of pus and necrotic debris

105
Q

Late manifestation of congenital syphilis manifesting as chonic painless synovitis with effusion of large joints, particularly the knees and elbows

A

Clutton’s joint

106
Q

Reactive symmetric form of polyarthritis that affects persons with visceral or disseminated tuberculosis

A

Poncet’s disease

107
Q

Antibodies directed against proteinase-3 detected as diffuse granular cytopladmic staining pattern in neutrophils

A

c ANCA (cytoplasmic anti-neutrophil cytoplasmic antibodies)

108
Q

Antibodies direced against myeloperoxidase with perinuclear or nuclear stainin in neutrophils

A

p ANCA

109
Q

First step in the workup of a patient witb suspected vasculitis

A

Exclude other diseases

110
Q

Granulomatous necrotizing vasculitis of the triad of upper and lower respiratory tract and kidney (sinusitis, lung involvement, glomerulonephritis, (+) cANCA

A

Wegener’s granulomatosis

111
Q

Non-granulomatous inflammation of the small arteries and veins including venules, glomerulonephritis, usually with no upper airway involvement and no pulmonary nodules, (+) pANCA

A

Microscopic polyangiitis

112
Q

Asthma, peripheral and tissue eosinophilia, extravascular granuloma, and vasculitis of multiple organ systems (predominant pulmonary findings)

A

Churg-Strauss

113
Q

Necrotizing vasculitis, renal and visceral artery involvement witb aneurysmal dilatations, no pulmonary artery involvement, associated with Hepatitis B

A

Polyarteritis nodosa

114
Q

Elderly female presenting with fever, anemia, headaches, temporal tenderness, jaw claudication, higb ESR, and accompanying stiffness, and muscle pains of the neck, shoulders, hips and thighs

A

Giant cell/temporal arteritis

115
Q

Syndrome characterized by stiffness aching and pain in the muscles of the neck, shoulders, lower back, hips and thighs associated with giant cell arteritis

A

Polymyalgia rheumatica

116
Q

Dreaded complication of giant cell arteritis

A

Ischemic optic neuropathy

117
Q

Young female, systemic symptoms, arm claudication, diminished pulses on one arm, vasculitis of medium to large arteries involving the aortic arch and branches

A

Takayasu’s arteritis

118
Q

Aka aortic arch syndrome or pulseless disease

A

Takayasu’s arteritis

119
Q

Child with glumerolonephritis, palpable purpura over the buttocks and lower extremities, gastrointestinal symptoms, arthralgias, and history of recent respiratory infection

A

Henoch schonlein purpura

120
Q

Most commonly encountered vasculitis in clinical practice

A

Cutaneous vasculitis

121
Q

So far, the most effectice treatment for the systemic vasculitides

A

Cyclophosphamide

122
Q

Cutaneous vasculitis, arthritis, peripheral neuropathy, membranoproliferative glomerulonephritis, hepatitis C, cold-precipitated agglutinins or immunoglobulins

A

Cryglobulinemic vasculitis

123
Q

8 drugs implicated in vasculitis syndromes

A 
Allopurinol
Thiazides
Gold
Sulfonamides
Phenytoin
Penicillin
Hydralazine
PTU
124
Q

Malar rash, Gottron’s papules, erythematous periorbital rash (heliotrope rash), shawl and face rash, mechanic’s hands, high creatinine kinase, (+) ANA, (+) Anti Jo-1, anti-SRP, and anti-Mi2

A

Dermatomyositis

125
Q

CREST syndrome

A 
Calcinosis
Reynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia

Internal Medicine (8 decks)

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