First Aid Rheum Flashcards
Joint findings in osteoarthritis
subchondral cysts, sclerosis, osteophytes, eburnation, Heberden nodes (DIP) and Bouchard notes (PIP)
Joints findings in rheumatoid arthritis
Pannus formation (MCP, PIP), subcutaneous rheumatoid nodules (fibrinoid necrosis), ulnar deviation of fingers, subluxation, baker cyst
Classic presentation of osteoarthritis
pain in weight-bearing joints after use, improves with rest, bowlegged, non-inflammatory, no systemic symptoms
Classic presentation of rheumatoid arthritis
morning stiffness lasting more than 30 minutes, improves with use, symmetric joint involvement, systemic symptoms
treatment of osteoarthritis
NSAIDs, intra-articular glucocorticoids
treatment of rheumatoid arthritis
NSAIDs, glucocorticoids, disease-modifying agents
disease modifying agents
methotrexate, sulfasalazine, TNF-alpha inhibitors
predisposing factors to osteoarthritis
age, obesity, joint deformity, trauma
predisposing factors for rheumatoid arthritis
female, +RF, anti-cyclic citrullinated peptide antibody more specific, HLA-DR4
Findings in Sjogren’s syndrome
xerophthalmia (decreased tear production/corneal damage)
xerostomia (decreased saliva production
SS-A (anti-Ro) and SS-B (anti-La) antinuclear antibodies
bilateral parotid enlargement
definition of sjogren’s syndrome
autoimmune disorder characterized by destruction of exocrine glands
Treatment of gout
Acute: NSAIDs, glucocorticoids, colchicine
Chronic: xanthine oxidase inhibitors (allopurinol, febuxostat)
overproduction of uric acid can be caused by
Lesch-Nyhan syndrome, PRPP excess, increased cellular turnover (cancer), von Gierke disease
diseases that may be associated with pseudogout
hemochromatosis, hyperparthyroidism, hypoparathyroidism
treatment of pseudogout
NSAIDs for sudden severe attacks; steroids; and colchicine
common causes of infectious arthritis
S. aureus, Streptococcus, and Neisseria gonorrhoeae
Gonococcal arthritis presents as
migratory arthritis with an asymmetric pattern
synovitis, tenosynovitis, and dermatitis
Seronegative spondyloarthropathies
HLA-B27: more often in males psoriatic arthritis ankylosing spondylitis IBS Reactive arthritis (Reiter syndrome)
findings in psoriatic arthritis
asymmetric and patchy involvement, dactylitis (sausage fingers), pencil in cup deformity
findings in ankylosing spondylitis
stiff spine due to fusion of joints, uveitis, aortic regurgitation, bamboo spine
classic triage with reactive arthritis
conjunctivitis and anterior uveitis
urethritis
arthritis
“can’t see, can’t pee, can’t bend my knee”
classic presentation of SLE
rash, joint pain, fever in females of reproductive age and of african descent
treatment of SLE
NSAIDs, steroids, immunosuppressants, hydroxychloroquine
sarcoidosis is characterized by
immune-mediated, widespread noncaseating granulomas and elevated serum ACE levels
sarcoidosis is associated with
restrictive lung disease, erythema nodosum, lupus pernio, bell palsy, epithelioid granulomas containing micrscopic SChaumann and asteroid bodies, uveitis and hypercalcemia
treatment of sarcoidosis
steroids
polymyositis
progressive symmetric proximal muscle weakness, characterized by endomysial inflammation with CD8+T cells (most often involves shoulders)
dermatomyositis
similar to polymyositis but also invovles malar rash, Gotron papules, heliotrope (erythematous periorbital) rash, perimysial inflammation and atropy with CD4+ T cells
Lab findings in polymyositis/dermatomyositis
increased CK, +ANA, +anti-Jo-1, +anti-SRP, + anti-Mi-2 antibodies
treatment of polymyositis/dermatomyositis
steroids
pathophysiology of myasthenia gravis
autoantibodies to postsynaptic ACh receptor
Scleroderma
excessive fibrosis and collagen deposition throughout the body
manifestations of scleroderma
sclerosis of skin, manifesting as puffy and taut skin with absence of wrinkles
diffuse scleroderma
widespread skin involvement, rapid progression, early visceral involvement
anti-Scl-70 antibody (anti-DNA topoisomerase I antibody)
limited scleroderma
Calcinosis Raynaud phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia (associated with antiCentromere antibody)
