MSK- OA, Rheum Flashcards
narrowing of intervertebral disc spaces with formation of osteophytes
OA of spine = Spondylosis
RF assessment of osteoporosis
B: background- age, fhx, habits O: ongoing medical N: nutrition E: exercise S: surgical hx
Who should get bone mineral density screenings?
ALL WOMEN >65
postmenopausal with 1+ RF or with fx
what score dx osteoporosis
Z score
negative bifringence
gout
+ bifringence
rhomboid crystals
pseudogout
acute attack of gout tx
prevention tx
acute- colchicine, indomethacin, ~prednisone
prevention- allopurinol
RA associated with what genetic component
HLA-DR4
Heberdens is changes at
Bouchard is changes at
Heberdens= DIP
Bouchard= PIP
goes with OA mostly
bone changes seen in OA
osteophytes, joint space narrowing
bone changes seen in RA
periarticular erosion
When (OA vs RA) has inflammation and lab changes
RA has inflammation and (+) labs
-RF, ESR, anti-CCP, anemia
Most specific lab for RA
anti-CCP
which (OA vs RA) has morning stiffness and MC affects the wrist
RA
DVT patient that has hx of thrombosis and 2 spontaneous abortions (both 2nd trimester)
w/o
dx
tx
Antiphospholipid Antibody Syndrome
ELISA for antiphospholipic atb
tx anticoagulation (Heparin not warfarin)
jaw claudication and vision change
GCA
start prednisone, get bx within 48 hrs
GCA associated with what other Rheum disorder
Polymyalgia Rheumatica
aching and stiffness of shoulders, neck, and hip-girdle areas that is worse in the morning
dx
tx
PR
prednisone-should show rapid response
necrotizing inflamm of muscular arterioles and medium sized arteries that spares the capillaries and has no venous involvement or lung involvement
Polyarteritis Nodosa
60 y/o F who owns a daycare presents with myalgias. On exam you note tachycardia, a mild fever, and a lace-like purple mottled skin that doesn’t blanch (livedo racemosa)
w/o
tx
Polyarteritis Nodosa
check for Hep B
can do tissue bx or angio that demonstrates microaneurysms
tx- steroids (prednisone, methylpred)
proximal progressive and symmetric muscle weakness
pt has difficulty rising from chair
only other PMH is Raynauds
muscle bx is nl
Polymyositis
anti-DNA and anti-Smith
SLE
anti-centromere
antitoposiomerase/ anti-scl-70 atbs
Systemic sclerosis (scleroderma)
anti-Ro/SS-A
anti- La/SS-B
Elevated ESR, nl CRP, +ANA
Sjogren Syndrome
lab most specific for Sjorgren’s
anti-La
