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Rheumatology > Awesome Review > Flashcards

Awesome Review Flashcards

1
Q

Patient with Rheumatoid Arthritis for preoperative clearance

A

Check flexion/extension of cervical spine

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2
Q

Name 2 poor prognostic factors for RA

A

Elevated ESR
Elevated Rh factor (= nodules!)
Joint space loss/erosions
Progressive synovitis

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3
Q

Name 3 side effects of MTX

A 
Hypersensitivity Pneumonitis! 
Pancytopenia 
Hepatotoxicity
Nephrotoxicity 
Neurotoxicity/Seizures 
Pulmonary Fibrosis

Follow up labs every 3 months

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4
Q

Treat MTX induced Acute Renal Failure

A

Glucarpidase

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5
Q

Name the 5 TNF Alpha Inhibitors

A 
Adalimumab 
Etanercept 
Infliximab 
Golimumab
Certolizomab
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6
Q

If your rheumatoid patient on leflunomide, surprisingly gets pregnant, what can you give?

A

Cholestyramine to accelerate metabolism

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7
Q

If your patient has been taking 5 mg prednisone for 3 months, what diagnostic do you need to order?

A

DXA scan

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8
Q

Diagnose this:
Triad is fever, joint pain, salmon bumpy Rash
Associated with leukocytosis and increased ferritin, LAD

A

Still’s disease

Tx- steroids and Anakinra (IL1 receptor inhibitor)

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9
Q

Sjögren’s syndrome has increased risk of… (2) and associated with which NAGMA

A

Lymphoma including B cell and MALT
And
Celiac sprue

And distal Type 1 RTA

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10
Q

What is Schober Test and what disease is it associated with?

A

Ankylosing Spndylitis

While bending forward, there is no intervertebral space when there is normally 5 cm
Due to bamboo spine

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11
Q

What is Keratoderma Blenorrhagica and what disease is it associated with?

A

Hyperkeratotic rash on soles and palms, associated with reactive arthritis

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12
Q

Diagnose this:
Recurrent painful aphthous stomatitis, genital aphthous ulcers, joint pain, erythema nodosum
HLA B5
Pathergy

A

Behçet’s disease
If only mucocutaneous disease, use colchicine
If moderate to severe disease, use steroids

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13
Q

Diagnose this:
Xray of T spine shows:
Flowing ossification of anterior longitudinal ligaments

A

DISH

Diffuse Idiopathic Skeletal Hyperostosis

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14
Q

Diagnose this:

MRI showing double line sign

A

Avascular Necrosis or Bone Infarct

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15
Q

Type of crystals in Gout

A

Mono sodium urate

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16
Q

2 causes of Pseudo gout

A

Hyperparathyroidism and Hemochromatosis

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17
Q 
Diagnose this: 
Shoulder pain 
XRAY- calcification of peri-articular cartilage/ligaments 
Blood tinged effusion 
Crystals on alizarin red stain
A

Milwaukee shoulder

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18
Q

Most commonly affected muscle in lateral epicondylitis

A

Extensor Carpi Radialis Brevis

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19
Q

Treat Dupuytren’s contracture

A

Collagenase injection

Otherwise surgery

20
Q

Polymyalgia Rheumatica is also associated with which vasculitis?

A

Temporal arteritis

Tx PMR with low dose prednisone
Tx Temporal Arteritis with high dose prednisone

21
Q

What is Crowned Dens Syndrome?

A

Neck pain, elevated inflammatory markers
XRAY showing calcification of cervical ligaments (eg- transverse of atlas and calcium deposits surrounding odontoid)
Made of hydroxyapatite or calcium pyrophosphate dihydrate

22
Q

How to diagnose Takayasu disease?

A

Aortography which shows stenosis

23
Q

What’s the diagnosis and treatment?
Fever, polyserositis, arthritis, erysipeloid rash around ankles
MEFV1 gene

A

Familial Mediterranean Fever

Colchicine to decrease cytokines

24
Q

Long term complication of Familial Mediterranean Fever

A

AA amylodosis

25
Q

Which Vasculitis?
Saddle Nose Deformity
Subglottic stenosis
Pulmonary Hemorrhage

Hint- affects sinus, lung and kidney

A

Granulomatosis with Polyangiitis/Wegners

26
Q

pANCA

Also known as

A

Anti-myeloperioxidase

Seen in Churg Strauss/eosinophilia granulomatosis with polyangiitis & ulcerative colitis

27
Q

c-ANCA

Also known as

A

Antiproteinase 3

Seen in Wegners/granulomatosis with polyangiitis

28
Q 
Which vasculitis? 
Migratory Pulmonary infiltrate 
Mononeuritis Multiplex
Purpuric skin rash
Seen with asthma, eosinophilia, allergic rhinitis
A

Eosinophilia granulomatosis with polyangiitis/Churg Strauss

29
Q

Describe complement levels in SLE

A

Everything decreased
But C3 is more decreased than C4
CH50 is decreased

30
Q

What serology test correlates with disease activity in SLE?

A

Anti double stranded DNA

31
Q

Patient on Cyclosporine, develops HA, AMS, Seizures, Visual Loss

MRI shows enhancement in occipital lobes

Diagnosis and Treatment?

A

Posterior Reversible Encephalopathy Syndrome

Control BP

32
Q

Serology in Generalized Systemic Sclerosis

A

ANA
Scl 70
Anti-topoisomerase
Antipolymerase III antibody

33
Q

Anti Polymerase III antibodies predict increased risk for…? (3)

A

Diffuse thickening of skin
Cancer
Renal crisis

34
Q

Serology and MHC for Polymyositis

Major Histocompatibility Complex

A

Anti Jo

HLA DR3

35
Q

Serology for Dermatomyositis

A

Anti Mi2

36
Q

If only ONE joint involved in acute gouty attack, what’s the treatment?

A

Intra-articular glucocorticoids

37
Q

IgA deposition in skin is?

A

Henoch Schlonein- small vessel vasculitis

38
Q

Polymyositis is associated with what lung disorder?

A

Interstitial Lung Disease

Must check CXR especially if (+) transfer RNA synthetase, anti Jo-1 Abs

39
Q

Goal urate level in gout

A

Less than 6

However if you have tophaceous gout, keep your urate lowering agent despite the serum urate level

40
Q

In giant cell arteritis aka temporal arteritis, what else can you give (in addition to prednisone) to decrease risk of visual loss?

A

Low Dose ASA

41
Q

Diagnose this:
Lymphoplasmacytic infiltration and enlargement of pancreas, lymph nodes, salivary glands, periaortic region causing retroperitoneal fibrosis, kidneys and skin

A

IgG4 related disease

42
Q

Patient with SLE

Presents with triad- hypoxemia, new pulmonary infiltrates, and decreasing hematocrit is what?

A

Diffuse Alveloar Hemorrhage

Dx via Bronch and Lavage

43
Q

Dermatomyositis have increased risk of…?

Cancer!

A

Solid malignancies and NHL

44
Q

If you have gout and HTN, what antihypertensive do you recommend?

A

ARB (Losartan) and CCB, lowers urate levels

45
Q

Patient with diffuse cutaneous systemic sclerosis is at risk for malabsorption from what?

A

Bacterial overgrowth due to impaired peristalsis from underlying fibrosis

Rheumatology (1 decks)

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