Orthopedics/Rheumatology High Yield Flashcards
What is Gout
Uric Acid Deposition in soft tissue, joints, bones
What is a common cause of Gout
Purine rich foods like alcohol, liver, oily fish, yeast
Sx of Gout
Podagra: 1st MTP joint is red and painful
Tophi Deposition: Collection of solid uric acid in soft tissue
Dx of Gout
Arthrocentesis: Negative Bifringent Needle Shape Urate Crystals
Xrays: Rat Bite, Punched out Erosions
Tx of Gout
NSAIDS (indomethacin)
Colchicine 2nd line
For chronic: Allopurinol
What is Pseudogout
Calcium Pyrophosphate deposition in joints
Knee is red, swollen and tender
See Cartilage Calcifications (Chondrocalcinosis)
Dx of Pseudogout
Arthrocentesis: Positively birefringenet, Rhomboid Shaped CPP Crystals
Tx of Pseudogout
Corticosteroids are 1st line
NSAIDS
Colchicine for prophylaxis
What is Sjogren’s Syndrome
Autoimmune disorder attacking exocring glands
Sx of Sjogren’s Syndrome
Salivary: Xerostoma (dry mouth)
Lacrimal: Keratoconjunctivitis sicca (dry eyes)
Parotid Enlargement
Dx of Sjogren’s Syndrome
ANA AntiSS-A AntiSS-B Positive RF Shirmer Test (decreased tear production) Biopsy of gland
Tx of Sjogren’s Syndrome
Artificial Tears, Pilocarpine
Cevimeline stimulates muscarinic cholinergic receptors
What is Polymyositis
Idiopathic inflammatory muscle disease of proximal limbs, neck, pharynx
Sx of Polymyositis
Progressive symmetrical proximal muscle weakness (not painful)
Dysphagia, Skin Rash, Polyarthrlagias, Muscle Atrophy (difficulty combing hair, climbing stairs)
Dx of Polymyositis
Aldolase
Anti-SRP antibody
Muscle Biopsy: See inflammation around the individual muscle fiber (endomysial involvement)
Tx of Polymyositis
High dose steroids
Methotrexate
What is Reactive Arthritis (Reiter’s Syndrome)
Autoimmune response to infection
Sx of Reactive Arthritis
Can’t see, can’t pee, can’t climb a tree
Conjunctivitis/Uveitis, Urethritis, Asymmetric inflammatory arthritis
Sausage toes/fingers
What infections preceded Reactive Arthritis
Chlamydia, Gonoarrhea, GI (Salmonella, Shigella)
Dx of Reactive Arthritis
HLA-B27
Synovial Flud WBC will be
Tx of Reactive Arthritis
NSAIDS
What is Scleroderma
Systemic connective tissue disorder
Thickened skin, lung, heart, kidney, GI tract
Sx of Scleroderma
Tight, Shiny, Thickened skin due to fibrous collagen buildup
CREST syndrome
Calcinosis cutis, Raynaud’s Phenomenon, Esophageal MOtility disorder, Sclerodactyly, Telangectasis
Pulmonary HTN
Dx of Scleroderma
Anti-Centromere AB
Anti-SCL-70 antibodies
Positive-ANA
Tx of Scleroderma
DMARDS, Steroids
Vasodilators for Raynaud’s: CCB, Prostacyclin
