Ortho Flashcards
Initial txt for Fibromyalgia?
conservative (multi disp approach)
Medical Txt for fibromyalgia?
Amitriptyline, SSRNI
The FDA approved txt for fibromyalgia?
Pregabalin
What is polymyalgia rheumatica closely associated with?
giant cell arteritits
What is polymyalgia rheumatica?
inflammation of the joints, bursae, and tendons
Worsening pain in the shoulder, neck, hips, pelvic girdle especially in the morning?
Polymyalgia rheumatica
What is seen on PE for polymyaglia rheumatica?
normal muscle strength with decreased active and passive ROM
Dx of polymyaglia rheumatica?
increased ESR & CRp
Txt for polymyaglgia rheumatica?
low dose corticosteroids
What drugs causes gout?
Thiazide, loop diuretics, ACEi, Pyrazinamide, Ethambutol, Aspirin
MC location of gout?
1st MTP joint of the great toe (podagra)
DOC for gout?
arthocentesis
What is seen on arthrocentesis for gout?
neg birefringent needle shaped crystals
Initial txt for gout?
NSAIDs (Indomethacin)
Txt for gout when NSAIDs are contraindicated?
Corticosteriods
Txt for gout when NSAIDs and steroids are contraindicated?
Colchicine
Prophylaxis txt for gout?
allopurinol
Who is NSAIDs contraindicated in?
renal insuffiency
Who is corticosteroids contraindicated in?
glucose intolerance, heart failure, poorly controlled hypertension
What gout medication can be used in both acute and chronic attacks?
colchicine
Calcium pyrophosphate dihydrate deposition in joints & soft tissue?
pseudogout
Sx of pseudogout?
severe pain, erythema, warmth, swelling & tenderness
DOC for pseudogout?
arthrocentesis
What is seen on arthrocentesis for pseudogout?
post birefringent or rhomboid shaped calcium
Txt for pseudogout?
corticosteroids if 1 - 2 joints
Txt for pseudogout if >2 joints?
NSAIDs
Prophylaxis and txt of acute and chronic pseudogout?
colchicine
What is polyarteritis nodosa?
vasculitis of medium sized vessels
What distinguishes polyarteritis nodosa from other vasculitides?
doesn’t involve pulmonary vessels
What is polyarteritis nodosa commonly associated with?
increased association w/ chronic Hep B and C
What is seen on renal or mesenteric angiography for polyarteritis nodosa?
microaneuryms
Txt for polyarteritis nodosa?
steriods
What is sjogren syndrome
a autoimmune dx affecting the exocrine glands
What sx are seen in Sjogren syndrome?
dry mouth, dry eyes, dyspareunia, bilateral partoid gland enlargement
What two antibodies are seen in Sjogren syndrome?
antiSS-A (Ro) and antiSS- B (La)
What test can be use to dx Sjogren syndrome?
positive schirmer test (wetting <5mm)
Txt for Sjogren syndrome?
artificial tears, increased intake
Med txt for sjogren syndrome?
cholinergic drugs- Pilocarpine or Cevimeline
What are complications related to Sjogren syndrome?
increased risk of Non-Hodgkin lymphoma
What is scleroderma?
autoimmune connective tissue disorder
What sx are seen in scleroderma?
tight, shiny thickened skin
What abx are associated with scleroderma?
anti centromere
Txt for scleroderma?
organ specific
