PANCE - rheum review

Question 1

only med that can be used both in acute and chronic gout

Answer 1

colchicine

AE: diarrhea

Question 2

list 2 xanthine oxidase inhibitors

Answer 2

allopurinol

febuxostat

MOA:
- inhibits purines fr being broken down into uric acid

Question 3

probenecid

Answer 3

used to tx chronic gout

promotes renal uric acid clearance
- inhibits proximal tubule that mediates uric acid reabsorption

avoid in pts w hx of nephrolithiasis

Question 4

XR findings in gout

Answer 4

punched out erosions w overhanging edges
- “rat bite”

Question 5

XR findings in pseudogout

Answer 5

chondrocalcinosis
- punctate / linear radiodensities in cartilage of joint spaces

Question 6

why is long term steroid therapy a RF for osteoporosis

Answer 6

steroids decrease Ca absorption fr the GI tract
- this causes osteoclast activation and inhibits osteoblasts

Question 7

MOA of bisphosphonates

Answer 7

inhibit osteoclastic bone reabsorption

Question 8

anabolic agents (teriparatide) for osteoporosis indications

Answer 8

reserved for SEVERE osteoporosis (T-score: -3.5 or less) because they rebuild new bone

MOA:
- synthetic form of PTH that stimulates osteoblasts to rebuild new bone

med can only be taken for 2 years MAX

Question 9

patho of polymyositis

Answer 9

CD8 T cells destroys muscle fibers

Question 10

patho of dermatomyositis

Answer 10

CD4 w perimysial inflammation

Question 11

polymyositis presentation

Answer 11

symmetric muscle WEAKNESS and NO pain

Question 12

dermatomyositis presentation

Answer 12

heliotrope rash
- rash over periorbital skin
- MC on upper eyelids

gottron papules
- violaceous, scaly, & ulcerated papules over bony prominences (MC knuckles)

photodistributed poikiloderma (shawl sign)

Question 13

how to dx polymyositis / dermatomyositis

Answer 13

creatine kinase

muscle biopsy confirms

Question 14

antibodies assoc w polymyositis

Answer 14

anti-Jo-1

Question 15

antibodies assoc w dermatomyositis

Answer 15

anti-Mi 2

Question 16

polymyalgia rheumatica presentation

Answer 16

PAIN, no weakness

Question 17

antibodies assoc w RA

Answer 17

anti-CCP

Question 18

patho of sjogren’s

Answer 18

lymphocytic infiltration of exocrine glands
- esp lacrimal & salivary glands

Question 19

sjogren’s is assoc with increased risk of

Answer 19

lymphoma

Question 20

antibodies assoc w sjogren’s

Answer 20

anti-Ro (SSA) and anti-La (SSB)

Question 21

dx of sjogren

Answer 21

shermir test

salivary gland biopsy
- confirms

Question 22

tx of sjogrens

Answer 22

artificial tears
- cyclosporine eye drops

oral cholinergic agonists
- pilocarpine
- cevimeline

Question 23

antibodies assoc w CREST (limited)

Answer 23

anti-centromere

Question 24

antibodies assoc w diffuse scleroderma

Answer 24

anti-topoisomerase (anti-SCL-70)