Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*Pance Re-Up * > MSK Re-Up #2 > Flashcards

MSK Re-Up #2 Flashcards

1
Q

Eosinophilic Granulomatosis with Polyangiitis (EGPA - Churg-Strauss) is systemic small and medium sized granulomatous necrotizing vasculitis.

What is this a rare side effect of?

A

Montelukast and Zafirlukast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What triad of symptoms is associated with EGPA?

What labs (there is a specific lab)

A

Asthma + Eosinophilia + Chronic Rhinosinusitis

Eosinophilia + P-ANCA HALLMARK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What diagnostic is most accurate for EGPA?

Treatment?

A

Biopsy

Glucocorticoids (may add Cyclophosphamide if severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

On the other hand, granulomatosis with polyangiitis is inflammation and necrosis of what three things?

What are symptoms?

A

-Nose, lungs, kidneys

-Triad: upper respiratory tract involvement + lower respiratory tract involvement + glomerulonephritis
–Nasal congestion, saddle nose deformity, otitis media, stridor, refractory sinusitis
–cough, dyspnea, wheezing, hemoptysis, pulmonary infiltrates
–rapidly progressive glomerulonephritis (crescent on biopsy), hematuria, RBC casts, proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Best initial test for GPA - Wegener’s

A

C-ANCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for GPA - Wegener’s

A

Glucocorticoids PLUS Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Microscopic Polyangiits (MPA) is small and medium vessel vasculitis that is NOT associated with _________.

It’s symptoms include…

A

Nasopharyngeal symptoms, necrosis, or granulomatous inflammation (like in GPA)

Palpable purpura, cough, dyspnea, hemoptysis, acute rapidly progressive glomerulonephritis (crescentic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lab and treatment for MPA

A

-P-ANCA

Glucocorticoids PLUS Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Immunoglobulin A Vasculitis (Henoch-Schoenlein-Purpura) MC occurs in ________.

It often occurs after __________

What are the four cardinal symptoms (HSPA)

A

-MC occurs in children (3-15 years old)

After infection (URI, GABHS, Parvovirus B19)

Hematuria
Synovial (arthritis or arthralgia)
Palpable Purpura (on LE)
Abdominal Pain (may present with GI bleeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Usually a clinical diagnosis, Henoch-Schonlein Purpura has what lab studies?

What is seen on kidney biopsy?

A

-Normal PT, PTT, and platelets

-Mesangial IgA deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for HSPA?

A

-Supportive: NSAIDs, hydration, bed rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anti-GBM Antibody (Goodpasture’s) Disease is a Type II hypersensitivity reaction where IgG antibodies are against…..

Symptoms are limited to which systems? What are the symptoms?

A

Against Type IV collagen of alveoli and glomerular basement membrane of the kidney

Limited to lungs and kidneys
-Hemoptysis, dyspnea, dry cough, hematuria, oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the best initial test for Goodpasture’s?

Next diagnostic (specific antibody)

What is seen on biopsy of the kidney?

A

UA: Increased BUN/Cr, hematuria, proteinuria, dysmorphic RBC’s, RBC casts
-Anti-glomerular basement membrane antibodies

-Linear IgG deposits. Crescentic glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment for Goodpasture’s

A

-Glucocorticoids + Cyclophosphamide + Plasmapheresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Psoriatic Arthritis is inflammatory arthritis in patients with psoriasis. What are risk factors associated with this, along with other seronegative spondyloarthropathies?

A

Young males, < 40 years old, HLA-B27 positivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of psoriatic arthritis

What is seen on radiographs (it has a unique description)

A

-Arthritis (may involve the DIP joint)
-Dactylitis, Sacroilitis, Uveitis
-Psoriasis (thick silvery white scales and nail pitting)

Pencil in a cup deformities: thin end of one bone is being inserted into a thicker bone

17
Q

Treatment for Psoriatic Arthritis
-Mild
-Severe

A

Mild: NSAIDs
Severe: Methotrexate (> 5 joints, severe damage on XR, no response to NSAIDs)

18
Q

Ankylosing Spondylitis, another seronegative condition, with chronic inflammatory arthropathy of the axial skeleton. What are some symptoms of this condition?

A

-Back pain, stiffness, and decreased ROM worse in the morning with rest and decreases with exercise and activity
-Sacroilitis, large joint arthritis
-Dactylitis, uveitis
-AV cardiac blocks

19
Q

What labs would show for ALS?

A

-Increased ESR
-Negative RF and ANA

20
Q

What is seen on radiographs for ALS?

Most accurate diagnostic?

A

-Sacroilitis (narrowing of the SI joint)
-Bamboo spine: straightening of the spine, loss of normal lumbar curvature and squaring and fusion of the vertebrae.

MRI

21
Q

First-line treatment for ALS?

What if there is no response to the first option?

A

NSAIDs, exercise program, and PT

Anti-TNF drugs (Etanercept, Adalimumab, Infliximab)

22
Q

Reactive Arthritis, with is inflammatory arthritis in response to an infection or inflammation in another part of the body. Formerly known as Reiter Syndrome, this may be seen 1-4 weeks after _________ or ____________. It is also associated with ________ positivity.

A

Chlamydia Trachomatis

GI infection (Salmonella, Shigella, Yersinia)

HLA-B27 positivity

23
Q

Symptoms of Reactive Arthritis

A

-Arthritis + Ocular (Conjunctivitis, Uveitis) + Genital (Urethritis, Cervicitis, Balanitis)
–Can’t see, can’t pee, can’t climb a tree

-Keratoderma blennorrhagicum (hyperkeratotic lesions on palms and soles)

24
Q

What diagnostic should you do first and why for reactive arthritis?

A

Arthrocentesis: to rule out septic arthritis

25
Q

What is the first-line treatment for Reactive arthritis?

A

NSAIDs

26
Q

What is gout?

Who is it MC in?

What cause triggers of gout?

A

Uric acid deposition in soft tissues, joints, bones

MC in men (90%)

Purine-rich foods (alcohol, liver, seafood, yeasts).
Meds: Thiazides and Loop Diuretics, ACEi, Pyrazinamide, Ethambutol, Aspirin, ARBs

27
Q

What is the only ARB that decreases uric acid levels?

A

Losartan

28
Q

Symptoms of gout

A

-First MTP joint of the great toe MC (podagra)
-Severe joint pain, erythema, warmth, swelling, and tenderness, and fever

29
Q

What is the diagnostic of choice for gout?

What is seen on this?

A

-Athrocentesis: negatively birefringent, needle-shaped crystals

30
Q

What is also seen on radiographs for gout?

A

Mouse or rat bite lesions (punched out erosions with sclerotic and overhanging margins)

31
Q

Acute management (attacks) of gout

Chronic Management (Prophylaxis) of gout

A

-Acute Attacks: NSAIDs initially. Corticosteroids if refractory or if renal disease. Colchicine if unable to use NSAIDs or Corticosteroids.

-Chronic: Lifestyle (decrease alcohol, weight loss, high purine foods). Allopurinol first line. Colchicine.

32
Q

Calcium pyrophosphate dehydrate deposition disease AKA ________, involves what joints most commonly?

What is the initial diagnostic of choice and what is seen?

A

Pseudogout

Arthrocentesis: positively birefringent, rhomboid-shaped calcium pyrophosphate crystals

33
Q

What are symptoms of pseudo gout?

A

-Majority asymptomatic
-Acute CPP crystal arthritis: severe joint pain, erythema, warmth, swelling, tenderness (MUCH like gout)

34
Q

Treatment for pseudogout

A

-Corticosteroids IJ: if 1 or 2 joints
-NSAIDs if > 2 joints
Colchicine as prophylaxis if 3 or more attacks annually

35
Q

Juvenile Idiopathic (Rheumatoid) Arthritis is autoimmune arthritis in children <16 years for > 6 weeks. There are three types. Explain the following:
-Systemic (Still’s Disease)
-Oligoarticular
-Polyarticular

A

-Systemic: daily or diurnal high fever, daily arthritis. Salmon-colored pink migratory rash. NO iridocyclitis.

-Oligo: < 5 joints involved. Iridiocyclitis (anterior uveitis)

-Polyarticular: 5 or more small joints, morning stiffness (like adult RA), iridocyclitis.

36
Q

JRA is primarily a clinical diagnosis. What is the treatment?

A

NSAIDs first line
-Glucocorticoids second line
-PT
-Routine eye exam every 3 months if ANA positivity

*Pance Re-Up * (76 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions