OA, RA, Gout, Lupus, Sleep Apnea, Dizziness Flashcards
Common sites for OA?
DIP, PIP, CMJ, great toe, hips, knees
Vertebral sites for OA?
C5, T8, and L3
Physical examination of fingers?
Huberden’s Nodes (DIP) and Bouchard’s Nodes (PIP)
Physical findings for hand OA?
No welling over joint, minimal tenderness, reduced passive and active ROM
Diagnosis of OA?
Largely clinical, but x-ray may show thinning of of the internal joint space
Complimentary treatment for OA?
Physical therapy, exercise, weight loss
Treatment for hand OA?
Topical capcasin, topical NSAID, oral NSAID, tramadol
Treatment for Knee OA?
Oral NSAID, topical NsAID, Tramadol, IA injection
Treatment for hip OA?
APAP, oral NSAID, tramadol, IA injection
Consitutional symptoms of RA?
Alaise, wieght loss, low grade fever
Symptoms of RA?
Peripheral symmetric polyarthritis >1 hour, warm, tender to palpation
What is a Boutonniere Deformity?
PIP is in a state of continuous flexion
Labs for RA?
Anti-CCP, ESR, C-reactive protein, RA, ANA antibodies, antiphospholipd antibodies, consider parvovirus, lyme disease, and hepatitis
-X-rays to monitor progress of disease
What shouldn’t you do for RA?
Start corticosteroid right before seeing rheumatologist.
What do patient’s need who take methotrexate?
Folic acid supplementation
Who manages RA?
Rheumatologists
Precpitating factors of gout?
Metabolic syndrome, alchol intake, lots of protein intacke
Drugs that cause gout?
Diuretics, salicylate, niacin, cyclosporine, levodopa
PE for gout?
Tophi in pinnae, olecranon tips, distal joints of hands and feet, helix and antihelix
What’s the only way to make a definitive diagnosis of gout?
Joint aspirate with sodium rate crystal
What’s the usual serum concentration for gout?
7.5 or greater
What should you consider with acute gout?
Acute septic arthritis
Mediations for gout?
Indomethacin 50 mg q 8 hours until pain decreases
- Colchicine 1.2 mg and then .6 mg every hour
- Steroids
Medications to prevent gout?
Probenecid and allopurinol
What food should you avoid with gout?
Meats, seafood, gravies, yeast, ETOH, lentils, asparagus, cauliflower, mushroom
4/11 signs that must be present for Lupus
- Arthritis
- Photosensitivity
- Oral or nasal ulcers
- Malar Rash
- Discoid rash
- Serositis of pleura or pericardia
- Renal Disease
- hematological disorders
- Neurological disease
- Positive ANA
- Positive other test
Subjective findings of lupus?
Malaise, fever, anorexia, blurred vision, joint problems, vague abdominal pains, multiple miscarrages
Objective findings for lupus
Rash, alopecia, slinter hemorrages, fingertpi lesions, adenopathy, reaynauds, joint pains, perasthesias, diminished DTRs, systolic mumur, oral ulcer, RUQ pain, RLQ pain from vasculitis
Common labs for lupus?
CBC, CMP, serum albumin, ANA, UA, antibody screen for anti ds DNA, antiphospholipid antibodies, antismith antibodies
Other labs and tests to order?
Anti ro, anti La, anti RNP, complement, VDRL, EKG, Echo
Differential diagnosis with lupus?
Vasculitis, RA
Common drugs causing lupus?
Procainamide, hydralzine, minocycline, andti TNF immunomodulators
What antibiotics to avoid with lupus?
Bactrim and tetracycline because they cause light sensitivity
Other drugs to treat lupus?
Hydroxychloroquine, coriosteroids, DHEA
