Dermatology/rheum Flashcards
knee pain, DIP involvement no swelling or warmth, worse @ the end of the day, crepetence
Osteoarthritis
PIP and wrist bilaterally, worse in the AM, low-grade fever
Rheumatoid arthritis
DIP joint involvement, rash w/ silverly scale on elbows, and knees, pitting nails and swollen fingers
psoriatic arthritis
symmetric, bilateral arthritis, malar rash, oral ulcers, proteinuria, thrombocytopenia. arthritis is not erosive or have lasting sequellae
SLE
a patient comes in w/ acute swollen painful joint…. 1st best test?
tap it!
a patient comes in w/ acute swollen painful joint…. tap: WBC>50k
- 30 yo who travels a lot for work
- 70 yo nun
septic arthritis
- 30 yo who travels a lot for work- gonococcal. cx may be negative. look also for tenosynovitis and arm pustules. Tx. w/ ceftriaxone
- 70 yo nun- staph aureus. Tx w/ nafcillin or vanco
a patient comes in w/ acute swollen painful joint…. tap: WBCs 5-50k
inflammatory, if no crystals think RA, ank spo, SLE, reiter’s
a patient comes in w/ acute swollen painful joint…. tap: WBCs 200-5k
OA, hypertrophic osteoarthropathy, trauma
a patient comes in w/ acute swollen painful joint…. tap: WBCs<200
normal
needle shaped, negatively birefringent crystals? acute tx? chronic tx?
Gout. monosodium urate.
acute tx- indomethacin + colchicine
chronic tx- probenecid if undersecreter. allupurinol of overproduc
rhomboid shaped, positively birefringent crystals
pseudogout. calcium pyrophosphate
Anti-dsDNA/Anti-smith
sensitive for SLE
anti-histone
drug induced lupus
anti-Ro (SSA) or Anti-La (SSB)
sjorgen’s syndrome
anti-centomere
crest syndrome
