more rheumatology Flashcards
What is CREST syndrome?
limited type of scleroderma with calcinosis (anti-centromere antibodies), raynaud’s, esophogeal dysmotility, sclerodactyly, and telangiectasias
skin thickening only seen on face and fingers
What are the typical findings/complications of disseminated scleroderma?
involves the skin, pluse any visceral organ. GI tract, lungs, and kidneys are commonly involved
What are treatments for scleroderma?
- supportive
- for renal HTN: ACE-Is,
- CCBs, reduce caffeine
- methotrexate or corticosteroids may help with skin thickening and pulmonary sx
What are complications of scleroderma?
pulmonary fibrosis, heart failure, renal failure due to malignant renal hypertension
What are complications of psoriatic arthrits?
anterior uveitis, nail pitting
What are the fadiographic and lab findings of psoriatic arthritis?
- negative RF and ANA
- highly destructive DIP and PIP joint lesions
What is mixed connective tissue disease?
disease with features that overlap between SLE, scleroderma, and polymyositis. pts typically have a hx of Raynaud’s disease, polyarthralgias, arthritis, swollen hands, proximal muscle weakness, esophageal dysmotility, pulm sx, and NO renal or neuro sx
What is sjogren’s sydnrome? (what kind of inflammation and where)? What conditions is it linked to?
lymphocytic infiltration of exocrine ducts; may be linked to RA, SLE or primary biliary cirrhosis
What are key findings in fibromyalgia?
myalgias and weakness without inflammation; trigger points, depression/sleep problems, dizziness and HA
What is polymyalgia rheumatica?
rheumatic disease with mulitple sites of joint pain and associated with temoporal arteritis. pts have pain and stiffness in the shoulder and pelvic girdle and difficulty raising arms and getting out of bed due to pain. may have weight loss. strength should be normal
What are labs and radiology of polymyalgia rheumatica? treatment?
- labs: incr. ESR, negative RF
- radiology: MRI shows incr. signal at tendon sheaths and synovial tissue outside of joints. PET shows incr. uptake at large vessels
- tx: low dose corticosteroids, taper
What internal organ system is often involved iwht polymyositis or dermatomyositis?
lung
What are the muscle biopsy findings in polymyositis vs. dermatomyositis?
- polymyosiitis: infammation within muscle fascicles in polymyositis
- dermatomyosis: inflammation surrounding muscle fascicles
What is a key joint finding in rheumatoid arthrits?
pannus formation (synovial hypertrophy with granulation tissue formaiton on articular cartilage
What are labs for RA?
positive RF in 75% but not specific; many ANA positive. incr ESR, incr anticitrulline contianing protein IgM antibodies