Master the Boards: Rheumatology 4 Flashcards
Complex regional pain syndrome features 4
- severe excruciating pain in limb with allodynia
- vasomotor sx w intermittent edema skin color changes
- previous hx of trauma damaging myelin or peripheral nerves
- nuclear bone scan/MRI can be abnormal
Complex regional pain syndrome tx
NSAIDS, TCA’s, gabapentin/pregabalin
5 common clinical features of all vasculitis types
- fatigue/malasie/weight loss
- Fever
- palpable purpura/rash
- neuropathy
- joint pain
3 common lab findings all vasculitis
- normocytic anemia
- Elevated ESR
- Thrombocytosis
Most accurate test for vasculitis
biopsy
vasculitis tx
prednisone
refractory ritux or cyclophosphamide
next azathioprine/6-mercaptopurine and methotrexate
5 specific features of poly arthritis nodosa
- Abdominal pain 65%
- Renal involvement 65%
-Testicular involvement 35% - pericarditis 35%
- HTN. 50%
(NO lung involvement )
What antigen is found in 30% of PAN patients
Hep B
Best first test and most accurate test for PAN
angiogram first
biopsy most accurate
poly arthritis nodosa tx
prednisone and cyclophosphamide or ritux
acute life threatening dz may respond to plasma exchange
specific features of Granulomatosis w polyangitis
upper AND lower respiratory findings
c-ANCA (anti-proteinase 3)
Granulomatosis w polyangitis tx
prednisone and cyclophosphamide
Vasculitis + Eosinophillia + Asthma =
Churg Strauss (Eiosinophilc Granulomatosis w polyangitis)
Churg Strauss (Eiosinophilc Granulomatosis w polyangitis) sero marker sometimes
p-ANCA
Churg Strauss (Eiosinophilc Granulomatosis w polyangitis) tx
steroids + immunosuppressive (cyclophosphamide, azathioprine, or methotrexate) to help reduce steroid dose
IL-5 inhib like mepolizumab can induce remission in like 50% of cases
what meds can cause Churg Strauss (Eiosinophilc Granulomatosis w polyangitis)?
Leukitriene modifiers (zafirlukast, montelukast, or zileuton)
patient presents w HA, Jaw claudication, vison changes, and tenderness of scalp. ESR is elevated. step to dx and tx
biopsy
steroids for Giant cell temporal arteritis
Temporal arteritis med besides steroids
Tocilizumab (IL-6 inhibitors)
Young asian women + diminished pulses =
Takayasu Arteritis
most acurate test for Takayasu
Aortic Angiography or MRA
NOT biopsy!
Cryoglobulinemia tx
For Hep c sofosbuvir/ledipasvir or any of the other combos
for cryoglobulinemia - ritux
vasculitis- cyclophosphamide is alternative to ritux
What ancestory has Behcet
Middle Eastern/ Asia
Behcet sx
- oral and genital ulcers
- ocular involvement ( uveitis/optic neuritis)
- skin lesions (pathergy-hyperreactivity to needle stick = sterile abscesses
- CNS disease 10% can have serious brain injury or spinal cord involvement
- pulmonary artery aneurysm
Behcet tx
prednisone and colchicine
sever dz may need cyclophosphamide
