Ortho/Rheum Flashcards
what presents as widespread muscular pain, fatigue, muscle tenderness, headaches, poor sleep and memory problems
fibromyalgia
how is fibromyalgia diagnosed
process of elimination
what is the treatment of fibromyalgia
stress reduction
sleep/exercise
antidepressants and anticonvusants
what are FDA approved medications for the treatment of Fibromyalgia
Duloxetine (cymbalta)
Milnacipran (Savella)
Pregabalin (Lyrica)
what causes gout
altered purine metabolism and sodium urate crystal precipitation into the synovial fluid
what is podagra
Gout of MTP
how is gout diagnosed
arthrocentesis
- rod-shaped negatively birefringent
- serum uric acid levels >8
what is the medication of choice for gout treatment
indomethacin
colchicine
what is pseudogout
usually >60yo, large joints, LE, No tophi
how is pseudo gout diagnosed
rhomboid-shaped calcium pyrophosphate
positively birefringent
what is the treatment of pseudogout
NSAIDs, colchicine, intra-articular steroid injection
what is used for prophylaxis of pseudogout
colchicine
what is the treatment for acute attacks of pseudogout
NSAIDs
what is the T score for osteoporosis
< -2.5
what is the t score for osteopenia
(-1 to -2.4)
what AE is associated with bisphosphonates
osteonecrosis of the jaw
what is another name for Reiter Syndrome
reactive arthritis
what is reactive arthritis
autoimmune response to infection in another part of the body (chlamydia +/- gonorrhea MC)
what is the presentation of reactive arthritis
asymmetric inflammatory arthritis
Conjunctivitis, uveitis, urethritis, and arthritis (cant see, cant pee, cant climb a tree)
what are the treatment options for reactive arthritis
NSAIDS = mainstay
abx to treat infection that triggered disease
what presents wtih morning joint stiffness that improves later in the day
Rheumatoid arthritis
what are diagnostic studies for rheumatoid arthritis
(+) Rheumatoid arthritis
(+) Anti-cirullinated Peptide antibodies
what is the treatment for rheumatoid arthritis
DMARDS
- methotrexate
- hydroxychloroquine
- sulfasalazine
- leflunomide
what presents with the triad of joint pain + fever + malar rash
systemic lupus erythematosus (SLE)
what diagnostics tests are positive with SLE
(+) ANA and (+) anti-double-stranded DNA and Anti-Smith Ab
what is the treatment of SLE
manage with sun protection, hydroxychloroquine (for skin lesions), NSAIDs or tylenol for arthritus
