Musc step 3 Flashcards
medications that predispose to gout
diuretics, low dose aspirin, immune suppressants
treatment of gout
Nsaid –> if contra –> Colchicine (Like high cR) –> if contra –> systemic steroids in more than 2 joints, systemic or intaarticular steroids if 1 or 2 joints
most accurate test to diagnose Achilles tendon
Thompson test: sqeezing of the calf and observe plantar flexion (patient lying prone) –> absence of flexion
hemochromatosis arhtropathy
2nd and 3rd metacarpophalangeal joints, knees ankles and shoulders
- calcium pyrophosphate dihydrate crystals in 50%
- not improved by phlebotomy
disease modifying antirhematic drugs
- methotrexate
- leflunamide
- hydroxyckoroquine
- sulfasalazine
- TNF inhibitors
Reactive arthritis treatment
antibiotics and nsaid
how to decrease chances of lung complication in surgery
stop smoking 4 weeks before
scleradeorma renal crisis - treatment
ACEi inh (captopril) \+ nitropr if papilledema
myotonic dystrophy - presentation
classic (adult): myotonia and weakness (face, hands, ankles)
childhood: cognitive and behavioral
infants: hypotonia, resp failure, inverted V shapped upper lip
myotonic dystrophy: non muscle symptos
DM, hypogonadism, catarhact, frontal balding, daytime sleeping
common causes of shoulder pain
- rotator cuff impingement or tendinopathy
- rotator cuff tear
- adhensive capsulitis (frozen shoulder)
- biceps tendinopathy or rupture
- glenohumeral osteoarthritis
rotator cuff impingement or tendinopathy
- pain with abd and ext rotation
- subacromial tenderness
- normal motion with positive tests
rotator cuff tear
similar to rotator cuff impingement
adhensive capsulitis (frozen shoulder)
decreased passive and active motion
stiffness +/- pain
biceps tendinopathy or rupture
anterior shoulder pain
pain with lifting or carring
glenohumeral osteoarthritis
uncommon, trauma
gradual anterior and deep pain
decreased active and passive motions
adhensive capsulitis (frozen shoulder) - treatment
range of motion exercises
steroid injections if severe
raynold + systemic symptoms
ANA, RF, CBC, complement, urinalysis
when to start osteoporosis screening
65 if no RFs
chronic stroid use: osteoporosis?
baseline and annual test
calcium and vit d
3 criteria of ankylosing spondylitis
- low back pain and stiffness for mor than 3 months diration that improves with exerecise
- limit range of motion
- limit chest expansion
monitor ankylosing spondylitis - f/u
- anteroposterior and lateral views of the lumbar spine
- lateral view of the cervical spine
- pelvic radiograph including sacroiliac joint
Dupuyrten contracture
progressive fibrosis of the palmar fascia. Thickening and nodule formation along flexor tendons distal palmar crease, (decreased extension
Dupuyrten - associated with
DM
correlates with SLE activity
anti-DS
sle initial treatment
low prednisone and hydroxychloroquine
Complex regional pain syndrome
recent joint injury presented with local burning pain, edema, skin changes and decreased range of motion
sjogren - cancer
B cell lymph
giant cell arteritis - diagnosis
3/5
- more than 50
- new onset of headache with fever and visual stiurb
- esr more than 50
- tenderness or decrease pulse of temporal artery
- temporal artery biopsy with necrotizing arteritis
