Orthopedic exams + rheumatology Flashcards
How does Colchicine work?
Inhibits the cytoskeleton of neutrophils and impairs urate crystal formation in gout flares.
However it doesn’t reverse what has already been produced!
What do 3 things do we use to classify the severity of Gout?
- Gouty tophi
- bone erosion
- Renal stones
What medications can we use to control gout
- Allopurinol: xanthine oxidase inhibitor
- Rasburicase
- Increased excretion: Probenecid or benzbromarone
- don’t take if the patient has kidney stones as this will exacerbate!
4.
- don’t take if the patient has kidney stones as this will exacerbate!
What symptomatically indicates Connective Tissue disease over RA?
- Sicca symptoms
- Photosensitivity
- Raynauds phenomenon
- alopecia
- Mouth ulcers
also ILD and skin involvement
What is the first test to diagnose CTD?
ANA
95% sensitive but not specific
Once you’ve got ANA, what do you then want?
- ENA
- dsDNA
- ANCA
What are the different ENA antibodies and what disease do they correlate to?
- Jo1 polymyositis
- Ro lupus
- La Sjogrens
- u1RNP CTD
- Scl-70 systemic scleroderma
- Sm lupus
What does the dsDNA antibody indicate
lupus
What is the most specific antibody test for lupus?
Sm
also dsDNA and Ro
What are the two ANCA types and what do they indicate?
- pANCA: binds to myeloperoxidase
- indicates microscopic polyangitis
- cANCA: binds to protein kinase 3
- Wegners Granulomatosis with polyangiitis
Why does CRP rise?
in response to IL-6 during inflammation
Why does ESR rise?
increased fibrinogen and increased globulins cause increase erythrocyte sedementation rate
What do you see on blood tests with inflammation?
- increase CRP and ESR
- decr iron and Hb
- Increased platelets and WBC
in what do you see HLA B27
ankylosing spondyloarthritis in 90-95%, specific to 100%
on locus of Ch6
