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MSK 2 Final DF > CIS RA johnston > Flashcards

CIS RA johnston Flashcards

1
Q

diagnosis RA, active signs of inflammation for at least ____ weeks

A

6

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2
Q

what deviation in RA

A

radial deviation of wrist
ulnar deviation of fingers

think Radial (w)Rist RA

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3
Q

36 hr old with history of dry mouth, decreased tearing and sandy gritty feeling under eyelids. complains of bright light sensitivity and has history of RA what is DD

A

extra articular RA due to secondary sjogrens
-seen in 35% of RA pts, 90% women

R/O SLE
R/O AIDS assocaited keratoconjunctivitis
R/O vitamins A deficiency

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4
Q

caplan syndrome

A

coal workers pneumocon with backround of RA, so multiple nodules on lung

nodular densities after exoposure to coal or silica

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5
Q

pencil in cup appearance

A

psoriatic arthritis

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6
Q

enteropathic arthritis

A 
arthritis associatred swith crohns or UC
axial involvement
peripheral arthritis
large joints LE
small joints UE
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7
Q

tests for sjogren

A

Ro/SSa and La/SSB
schirmers test
slit lamp exam

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8
Q

seronegative spondyloarthropathies

A

predilection for spine and SI joints

new bone formation at sites of inflammation

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9
Q

tests for ankylosing and imaging

A 
HLAB27
CRP, sed rate
xray pelvis (si joint)
xray lubar vert
CT of both if xrays non diagnostic
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10
Q

late complications of AS

A

restrictive lung disease
compression fractures
cauda equina syndrome

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11
Q

odontoid and RA

A

atlantoaxial subluxation due to erosoin of odontoid proces

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12
Q

DD RA

A 
sle 
viral arthritis
endocarditis
sarcoid
sjogren
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13
Q

tests to order with coal workers pneumoconniosis

A 
CT of cehst
bronchoscopy with cytology and biopsy
sputum cytology, gram stain, culture
TB skin test
PFTs
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14
Q

reactive arthritis

A

autoimune disease, asymmetric mono arth or oligo arth in LE

may be associated with infection like blood diarr bugs or chlamydia

young men get it

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15
Q

C1 and C2 in RA

A

may sublux

don’t force into flexion or hyperextension (when intubating)

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16
Q

labs with AS

A

increasesd ESR and CRP
hla b27 potisitve
anemia of chornic disesae

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17
Q

treatment of sjogren

A

lubrication with artificial tears
encourage water

anti inflammatory and immunosuppressive

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18
Q

PE AS

A

restricted forward flexion (shober test) restricted chest expansion
loss spinal mobility

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19
Q

why is RA important

A

significant mortality
CAD, HF due to endothelial damage from chronic inflamation

frequently disables pts

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20
Q

hyperlucent lungs

A

look dark, cannot get air out

think obstructive pulmonary disesase

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21
Q

imaging for RA

A

x rays of hands and feet

CT for erosions

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22
Q

vertebrae in AS

A

squaring
shiny corners, sclerosis at edge of vertebral bodies
bamboo spine or syndesmophytes

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23
Q

wrist RA compression

A

median nerve, carpal tunnel syndrome

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24
Q

iritis seen in what

A

SLE and AS

not in RA

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25
Q

clinical manifestations AS

A 
low back pain over 3 months
morning stiffness, improved with exercise
fatigue, weight loss
symmetric SI joint pain
tendonitis, planter fasciitis
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26
Q

extra articular manifestations of AS

A 
iritis
photophobia
aortic insuff
pulmonary fibrosis
IBD
psoriasis
27
Q

enthesitis

A

inflammed tendon insertion into bone

immune susceptibiity to allele B27

28
Q

methotrexate labs to monitor and toxicity

A

CBC, LFTs, creat
tox = hepatic, myelosupp, pulmonary
dont give during pregnancy

29
Q

spondylolisthesis

A

anterior displacement of vertebral body

30
Q

clinical manifestations of reactive arth

A 
asymm oligo arth LE
enthesitis- achilles or plantar fasciitis
dactylitis
SI pain
reiters syndrome
circunate balanitis
keratoderma blennorrhagicum on palms/soles
---- painless eruptions
eyes- conjunctivitis
31
Q

FELTY syndrome

A

SANTA FELTY through the roof

splenomegaly
arthritis (Rhemuaetoid)
neutropenia
thrombocytopenia
anemia
32
Q

spondylosolysis

A

defect of portion of bone btwn inferior and superior articular process of vertebrae

33
Q

extra articular manifestations enteropathic arth

A 
skin- pyoderma gangrenosum, erythema nodosum
uveitis
GI 
nephrolithiasis
thromboemolism
bones
34
Q

treatment of psoriatic arth

A

nsaids
DMARDs
tnf inhibitors

35
Q

monitor what with sulfasalzine

pregnancy?

A

WBC,

safe in preg

36
Q

articular manifestations of RA

increase risk of what

A

diarthrodial synovial joints
small joints first, large ones later
C1-C2
increase risk osteoporosis

37
Q

treatment for ReA

A

usually self limited
nsaid and steroids
dmards if chronic
antibiotics for urethritis

38
Q

ankylosing spond and reactive arthritis more prevelant in __

A

men

39
Q

what is the gel time

A

the time it takes for joints to loosen up throughout the day

longer the time, the worse the prognosis

40
Q

classification of RA, what are you looking at and what score means RA

A 
is synovitis there 
look at number of joints
serology
acute phase reactants
duration of symptoms

if 6/10 then def RA

41
Q

mortality associated with RA

A

heart disease > malignancy > infcetion > renal disease> GI

42
Q

AS and SI joint

A

erosions

43
Q

hydroxychloroquine for RA

A

fu with ophthalmologist bc can casue retinal damage

safe in pregancy

44
Q

labs for react arth

A

same as AS

45
Q

peak of RA

A

30-60 yrs old

46
Q

anti TNF agents in RA

A

catch the TNF in the AIRE

adalimumab
infliximab
rituximab
etanercept

47
Q

rheumatoid vasculitis

A

purpura, petechial, splinter hemorrhages, digital infacrt

48
Q

HLA for RA

A

HLA DRB4 or DRB1

49
Q

pathogenesis of AS

A

immune mediated
t cells
TNF a level high
enteric bacteria

50
Q

spondylitis

A

inflammation of vertebrae

51
Q

leflunomide for RA

A

dont use when pregnant!!!!

GI/hepatic/teratogenic

52
Q

pyroderma gangrenosum in RA

A

tender reddish purple papule, leads to necrotic non healing ulcer

poor prognosis

53
Q

treatment of enteropathic arthritis

A

nsaids
steroids
methotrex
tnf alpha inhibtor

54
Q

treatment of RA

A

general with PT and OT
NSAIDs
Corticosteroids (long term use AEs)
DMARDS: immunosupp = increase risk infection

55
Q

treatment for AS

A

exercise PT
NSAIDs
TNF inhib

56
Q

treatment of RA

A

NSAID for pain
DMARD: methotrexate
low dose steroid for few weeks

57
Q

most common inflamation problem with the axial spine

A

ankylosing spondylitis

58
Q

psoriatic arthritis

A 
40-60
SI and axial involvment
pitting nails
soft tissue swelling
small and large joints
59
Q

keratoconjuctivitis sicca (dry eyes)

A

2ndary to sjogrens syndrome or SLE

60
Q

systemic features RA

A

fatigue, fever, anemia
elevated ESR, CRP
malaise, myalgia, depression

61
Q

enthesis

A

site of ligamentous attachment to bone

62
Q

knee and RA

A

bakers cyst in popliteal fossa

63
Q

DD of AS

A

DISH
calcification
osteitis condensans Ilii- normal SI jt but xray shows sclerosis on iliac side of SI joint

64
Q

imaging for AS

A

CT for erosions

MRI detects inflammation before changes seen on x rays or CT

MSK 2 Final DF (10 decks)

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