RA and Lupus and other autoimmune

Question 1

Crescent formation in glomeruli?

Answer 1

Rapidly progressive or crescentic GN

Question 2

Joints feel like this on physical exam in RA?

Answer 2

Boggy, due to Pannus formation and synovial hypertrophy. Vs hard in OA

Question 3

Serology in rheum arthritis?

Answer 3

Rheumatoid factor and ACPA

Question 4

RA tx?

Answer 4

DMARDs: disease modifying drugs

Hydroxychloroquine
Sulfalazine
Methotrexate
TNF-alpha inhib: Etanercept or adalimumab or infliximab
Anikinra
Leflunoamide

NSAID or steroid is just adjunct

Question 5

Drug induced lupus mnemonic?

Answer 5

SHIPP anti-histone antibodies
Sulfa
Hydralazine
INH
Phenytoin
Procainamide

Question 6

Painless oral ulcers?

Answer 6

happen in Lupus

Discoid rash is Seal’s face

Question 7

False positive tests from lupus?

Answer 7

False positve RPR or VDRL

Question 8

Tests for lupus?

Answer 8

ANA
DsDNA
Anti-Smith
Anti-histones for drug induced
Antiphospholipid (is associated)
LOW COMPLEMENT!

Question 9

Tx of lupus?

Answer 9

Hydroxychloroquin
Steroids
Anticoag

Question 10

Polymyositis and dermatomyositis markers?

Answer 10

ANA and Anti-Jo-1 antibodies

Question 11

CREST syndrome marker?

Answer 11

anti-centromere

Question 12

Polymyositis symptoms?

Answer 12

Symmetric proximal weakness

Question 13

Labs in polymyosiits and dermatomyositis?

Answer 13

CK, aldolase, AST, ALT and LDH

Can all be elevated

Question 14

Findings for polymyositis for specific rheumatic marker?

Answer 14

ANA and Anti-Jo (grandpa Jim had it, so J and J)

Question 15

Tx for polymyo and dermato?

Answer 15

CORTICOSTEROIDS or method or azthioprene, IVIG

Question 16

Polymyalgia rhematica is associated with what?

Answer 16

Temporal arteritis

Question 17

Difference between polymyalgia rheumatica and polymyositis?

Answer 17

POM is weakness, polymyalgia rheumatica is painful (name makes sense)

Question 18

Tx of polymyalgia rheumatic?

Answer 18

Steroids, (makes sense since it is associated with temporal arteritis)

Question 19

Tx of fibromyalgia?

Answer 19

Reassurance, relaxation stuff all the other behavioral stuff

Amitryptilnne or nortryptiline
Neuropathic pain med (duloxetine, pregabaline)

Question 20

pain in back and hip worst in morning and painful kyphosis relieved by bending forward WITH POSSIBLE UVEITIS?

Answer 20

Ankylosisng spondylitis

Question 21

Pencil in cup deformity?

Answer 21

Psoriatic arthritis

Question 22

Tx of psoriatic arthritis?

Answer 22

NSAID, methotrexate, sulfasalazine, anti TNF drugs depending on severity

Question 23

HLA B27 arthritidis?

Answer 23

PEAR

Psoriatic
Enteropathic (IBD)
Ankylosing Spondylitis
Reactive arthritis

Question 24

Old person with no wrinkles, think what?

Answer 24

Scleroderma b/c skin thickening

Question 25

Scleroderma lab?

Answer 25

anti-scl70

Question 26

CREST?

Answer 26

``` calcinosis Reaynauds Esophageal Sclerodactyliy (skin fibrosis) Telangiectasia ``` Labs show anti-dcl-70, anti-centromere

Question 27

Scleroderma tx?

Answer 27

ACEi for hypertension CCI for raynaud Methotrexate or steroids help skin and pulm symptoms

Question 28

Scleroderma can cause dyspnea and stuff

Answer 28

oh ok

Question 29

Complications of scleroderma?

Answer 29

Pulm fibrosis, heart failure, acute renal failure from malignant renal HTN

Question 30

Positive RNP means what? mnemonic?

Answer 30

mixed connective tissue Thank stands for rheumatologically non-particular otherwise the disease in not testible

Question 31

Sjogren symptoms?

Answer 31

Can't spit, can't see can't climb a tree Ro and La Supportive and steroids