Internal Med Orthopedics Flashcards
presentation of fibromyalgia
- chronic fatigue
- generalized aching pain
etiology of fibromyalgia
presence of central sensitization to pain and deficits in endogenous pain inhibitory mechanism
diagnostic criteria of fibromyalgia
- pain index over 7
- sx for at least 3 months
- no other condition that can explain patient’s sx
management of fibromyalgia
- reassurance
- exercise
- cyclobenzaprine or amitriptyline
- Cymbalta
etiology of gout
hyperuricemia
s/s of gout
red, swollen, painful, hot joint
diagnosis of gout
- negatively birefringent joint fluid analysis
- rat bite on xray
treatment of gout
- low purine diet
- NSAIDs, colchicine, corticosteroids
- allopurinol to prevent
etiology of polyarteritis nodosa
arteritis of small and medium arteries
s/s of polyarteritis nodosa
- nonspecific sx (fever, malaise, fatigue, HA)
- extremity pain
- livedo reticularis
- digital gangrene
- abdominal pain
diagnosis of polyarteritis nodosa
- ANCA negative
- test for hep b
- tissue biopsy to confirm (shows evidence of arterial necrosis)
Treatment of polyarteritis nodosa
high dose steroids
S/s of polymyalgia rheumatica
- pain and stiffness in neck, shoulders, and pelvis
- fever, malaise, and weight loss
- difficulty with ADLs
Treatment of polymyalgia rheumatica
Low dose prednisone
s/s of polymyositis/dermatomyositis
- symmetric, progressive, painless, proximal muscle weakness
- gottrons papules
- heliotrope eruption
- hyperkeratotic hands
- shawl sign
diagnosis of polymyositis/dermatomyositis
- anti-Mi2
- anti-Jo1
- anti-SRP
treatment of polymyositis/dermatomyositis
steroids
s/s of reactive arthritis
- urethritis
- uveitis
- arthritis
- mucocutaneous lesions
- lesions of palms and soles
etiology of reactive arthritis
GI infection or STD
Diagnosis of reactive arthritis
HLA-B27
treatment of reactive arthritis
NSAIDs
s/s of rheumatoid arthritis
- symmetrical swelling of multiple joints with tenderness
- stiffness persisting for >30 minutes to hours in prominent in the AM
- finger deformities
- rheumatoid nodules
diagnosis of rheumatoid arthritis
- anti-CCP
- rheumatoid factor
- hypochromic normocytic anemia
treatment of rheumatoid arthritis
- DMARDs (methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide)
- steroids
s/s of sjogren’s
dry eyes and dry mouth
diagnosis of sjogren’s
- anti-SSA
- anti-SSB
- salivary gland biopsy
- schirmer test
treatment of sjogren’s
- symptomatic
- pilocarpine
precipitating factors of lupus
- sun exposure
- stress
- infection
- pregnancy
- stress
s/s of lupus
- low grade fever
- joint pain
- malar rash
diagnosis of lupus
- 4/11 symptoms
- anti-dsDNA
- anti-Smith
treatment of lupus
hydroxychloroquine + NSAIDs + prednisone
s/s of scleroderma
- C: calcium skin deposits
- R: raynaud’s
- E: esophageal dysfunction
- S: sclerodactyly
- T: telengiectasias
diagnosis of scleroderma
- anti-DNA top
- anti-centromere
- anti-RNA polym
treatment of scleroderma
treat each symptom as they come
