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#DOOS MSK > MSK and CT dos > Flashcards

MSK and CT dos Flashcards

1
Q

*Define SLE

A

multisyst auto immune CT do characterized by numerous autoantibodies, circ immune complexes, with widespread immunologically determined tissue damage

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2
Q

______ decent is most common afflicted by LSE

A

african american descent

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3
Q

90% of SLE cases are ______gender of _____(age)

A

female; child bearing

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4
Q

age reange of SLE diagnosis?

A

15-45 (after menarche and before menopause)

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5
Q

what are enviro triggers for SLE (4)

A

UV light, smoking,microrganisms, and likely estrogen

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6
Q

what are the two ways SLE causes tissue damage?

A

1) formation/deposition of immune complexes at dermal/epidermal jxn and at renal tissue
2) damage of specific cells resulting inflammation activated PMNs, and release of lysozymes and ROS – t lymphocyte dominant

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7
Q

exacerbations of SLE are common with _____ or when taking _____; in addition there is an inc incidence in males with _________

A

pregnancy or taking OCP

inc incidence in males with kleinfelters

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8
Q

SLE can be induced by various _____; these pts still have positive _____ tests

A

drugs

pos ANAs

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9
Q

*Name the 3 primary clinical features of SLE

A

arthritis, arthralgia(polyarthralgia), and fever(fever and rash) (raynauds is also common)

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10
Q

*_______ is the most common constitutional sx in SLE

A

fatigue(>90%)

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11
Q

SLE arthritis is often _____ and _________

A

transitory and migratory

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12
Q

SLE pts present with vasculitis, purpura, malar butterfly rash and _____ lesions

A

discoid (and painful oral ulcers)

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13
Q

_______ involvement can affect up to 60% of SLE pts and can include: chorea, depression, epilepsy and peripheral neuropathy.

A

CNS

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14
Q

females with SLE often have a normal rate of conception but a 1.5-3x higher rate of ________

A

miscarriage

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15
Q

_______ is positive in 98% of SLE cases but low titer has a low predictive value… conversely high titer….

A

ANA

higher titer =SLE more liekly

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16
Q

Tx for SLE includes NSAIDs, sun protection, exercise and smoking cessation
________ is the mainstay drug treatment -moniter for retinal toxcicity
________ is prescribed if the above drug is inneffective

A

antimalarials

corticosteroids– very bad side effects

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17
Q

If SLE pt is pregnant perscribe _______/_______

A

prednisone/prednisolone

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18
Q

what are the 5 critical comorbidities for SLE

A 
accel atherosclerosis
Pul HTN
antiphospholipid syndrome
osteopenia/porosis
non-hodgkins lymphoma
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19
Q

Name the 6 ways to prevent SLE

A 
sun protection
vaccination
caution with live attenuated vaccine and immunosupp
supress reccurent UTIs
prevent osteoporosis
prevent/control obesity and CVD risk
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20
Q

what’s the difference between SLE and sjogren’s dz?

A

SLE- widespread destruction

Sjo-focal/specific destruction

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21
Q

what is sjogren’s syndrome?

A

autoimm do where the salivary and lacrimal glands are destroyed(exocrine glands)

22
Q

Sjogren’s is most common in _______(age) _______(gender)

A

middle-aged females(9-1)

related to other autoimmune dos, can be a 2ry complication

23
Q

_______ cells infiltrate glands in sjogren’s

A

b lymphocytes — hyperreactive

24
Q

exocrine malfxn(sjogrens’) can lead to _____, _________, and ________

A 
dry mouth(xerostomia)
dry eyes(xeropthalmia)
enlargement of parotid gland
25
Q

name the 4 constitutional sx of sjogren’s

A

fever, wt loss, fatigue, lymphadenopathy

26
Q

name 2 critical diagnostic criteria for sjogrens

A

histopath of salivary glands(biopsy)

reactive autobodies for RO/SS-A or LA/SS-b

27
Q

how do you treat sjogrens

A

treat sx, often with lubricants for eyes, mouth, vagina, etc also try to inc PO intake

28
Q

2 drugs used to treat sjogrens

A

NSAIDS for arthralgia

antimalarials/methotrexate (also corticosteroids for sx relief)

29
Q

what is scleroderma

A

multi-syst autoimmune do with vasculopathy and excess collagen deposits leading to fibrosis and degen skin changes and organ damage - presents with high circ autoantibodies

30
Q

name 2 early manifestations of scleroderma

A

raynaud’s phenomenon and skin calcinosis

31
Q

scleroderma is 4.6:1 ___ to___(gender) with onset b/w _____and _____yo

A

f:m

30-50

32
Q

______ damage occurs in scleroderma as a result of _____ activation and vasoconstrictors such as_____ – this leads to ulcerations, ischemia, and gangrene of digits and skin

A

endothelial
platelet activation
endothelin

33
Q

what are the 2 types of scleroderma

A

diffuse -affects the organs and skin (arthralgias more prononced(crepetis present)
limited cutaneous - CREST syndrome (skin of face neck and elbows; pulm htn, and raynaouds/gangrene of fingers)

34
Q

name 4 cardinal features of scleroderma

A

skin involvement(95%)
Raynauds(85%)
arthralgias, and esoph dysfxn
tendon/bursal friction rubs often seen prior to thickening of skin

35
Q

Systemic and bilat skin changes result in scleroderma, name 5

A 
non-pitting edema sausage fingers
shiny skin(atrophy)
dec facial pigment, face becomes taut
beaking of nose and tight mouth
loss of adipose tissue
36
Q

In limited cutaneous scleroderma, what does CREST stand for\?

A 
calcinosis
raynauds
esophageal dysfxn
sclerodactyly -tight skin over fingers
telangiectasia
37
Q

scleroderma can result in _____ and ______ failure

A

cardiac(restrictive pericarditis)

renal

38
Q

sclerodermal dx is mainly ____; but labs reveal pos _____, and anti-______ antibody in limited type

A

ANA

anti-centromere

39
Q

treatment for scleroderma?

A

no curative tx

treat organ-specific sx

40
Q

what is kawasaki’s dz?

A

acute systemic do of childhood that resembles viral exanthem

41
Q

who is more suceptible to kawasaki? name the 4 complications

A

boys 3x more likely

coronary anuerysms, MI, Pericarditis, and effusions

42
Q

whta is polymyalgia rheumatica

A

PMR is an inflam rheumatic condition with aching and a.m. stiffness in shoulders, hip girdle, neck and torso.

43
Q

_________ may be assoc with PMR in 15% of pts

A

temporal arteritis (aka giant cell arteritis) which presents with jaw pain anemia, elvated ESR, headache and visual sx

44
Q

PMR is typically seen in those +_____yo; and is assoc with the HLA-_____ type

A

50

DR4

45
Q

In PMR pain/stiffness is most common in the _______(time), and after ______. stiffness may last more than 30 minutes

A

morning

after rest

46
Q

In PMR swelling and tendnosynovitis can be seen in apendages. Swelling is typically ____(UL or BL), ______(prox vs dist), and _____(symet vs asymmet)

A

BL
proximal
symmetrical

47
Q

________ are usually used to treat PMR which is dosed for 2 yrs and must be tapered. _____not freq used as 1ry tx.

A

corticosteroids

NSAIDs not used typically

48
Q

what is fibromyalgia

A

controvesial chronic pain syndrome with widespread pain and tenderness to palpation at defined soft tissue structures/points — can be associated with mood disorders

49
Q

pain of fibromyalgia is…(3)

A

non-articular, diffuse, and poorly localized “pain all over”

50
Q

with fibromyalgia you must r/o _________and _________

A

inflamm condition and articular pathology

51
Q

where are the 7 trigger points for fibromyalgia? what constitutes a diagnosis(# and duration of pain)

A

the neck, along the lev scapulae, central ant chest, near lat epicondyle of arm, hips, lowerback/butt, medial knee
need at least 11 points of pian for >3months

52
Q

tx for fibromyalgia(4)

A

NARCOTICS ARE NOT INDICATED
amytriptyline - sedating for sleep
SSRIs
and Exercise

#DOOS MSK (4 decks)

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