Rapid Style Questions Flashcards
What is Complex Regional Pain Syndrome
Complex Regional Pain Syndrome
- History of previous extremity injury, fracture, or surgery
- More common in women, mean age of 40yrs
- Pain > 6 months
- Sx and findings: light touch causes extreme pain, allodynia, autonomic changes, alterations in skin appearance, motor symptoms
- Tx options include physical therapy, NSAIDs, amitriptyline, gabapentin, nerve blocks
Describe the clinical manifestations of fibromyalgia?
Clinical manifestations include
* diffuse pain that is worse in the morning,
* extreme fatigue
* stiffness
* painful and tender joints
* SLEEP DISTURBANCES
Symptoms often worsened with physical and psychological stress
What medication class is typically used to treat fibromyalgia?
Anticonvulsants (pregabalin/gabapentin)
The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica)
What is the most commonly affected joint in gout?
The first metatarsophalangeal joint (big toe), also known as podagra
Which type of crystals are found in synovial fluid analysis of a gout patient?
Needle-shaped, negatively birefringent monosodium urate crystals
What lifestyle modification can help reduce gout attacks?
Reducing intake of purine-rich foods (e.g., red meat, seafood) and alcohol
Which medication inhibits xanthine oxidase to reduce uric acid production in gout?
What patient education must be done prior to prescribing?
Allopurinol
It may make gout worse at first. Rash is the m/c side effect.
What type of crystals are associated with pseudogout?
Which joint is most commonly affected by pseudogout?
Rhomboid-shaped, positively birefringent calcium pyrophosphate dihydrate (CPPD) crystals
Knee
Name a common risk factor for developing pseudogout
Advanced age or metabolic disorders like hyperparathyroidism or hypothyroidism
What is the radiographic finding characteristic of pseudogout?
Chondrocalcinosis (cartilage calcification)
What is the initial treatment for an acute pseudogout flare?
NSAIDs
What is the most commonly affected joint pattern in rheumatoid arthritis?
Symmetrical involvement of small joints (wrist, MCP, PIP, MTP).
Spares the DIP
What is the hallmark laboratory test for diagnosing rheumatoid arthritis?
What imaging finding is characteristic of long standing RA?
Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies
**Anti-CCP most specific **
Symmetric joint space narrowing and erosions
What is the first-line disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis?
What is the MOA? And what supplement needs to be initiated with its use?
Methotrexate
Folic antagonist - must initiate supplementation of folic acid
What type of blood vessels are primarily affected in polyarteritis nodosa?
Medium-sized arteries
What is a common infectious association with polyarteritis nodosa?
Which organ systems are most commonly involved?
Hepatitis B virus (HBV) infection
The kidney’s, skin, peripheral nerves and GI system
What is the gold standard diagnostic tool for confirming polyarteritis nodosa?
Tissue biopsy or angiography
What are the typical symptoms of polymyalgia rheumatica?
What age group is most commonly affected?
Bilateral pain and stiffness in the shoulders, neck, and hips, especially in the morning.
Adults over 50
Which laboratory marker is typically elevated in polymyalgia rheumatica?
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
What is the primary clinical feature of polymyositis?
Which laboratory marker is usually elevated in polymyositis?
Symmetrical proximal muscle weakness
Creatine Kinase (CK)
What diagnostic test is definitive for confirming polymyositis?
Which autoantibody is often associated with polymyositis?
Muscle Biopsy
Anti-Jo-1 Antibody
What is the first line treatment for polymyositis?
Corticosteroids (prednisone)
What is the classic triad of symptoms in reactive arthritis?
- Arthritis
- Urethritis
- Conjunctivitis
What infections are commonly associated with triggering reactive arthritis?
What genetic marker is often associated with reactive arthritis?
- Gastrointestinal (Shigella, Salmonella, Campylocator)
- Genitourinary (Chlamydia)
HLA-B27
What is the first line treatment for arthritis in reactive arthritis?
NSAIDs
What is the typical joint involvement pattern in reactive arthritis?
Asymmetric involvement of large joints, especially the lower extremities (knee’s, ankles)
What is the most common joint pattern affected by rheumatoid arthritis?
Symmetrical involvement of small joints, especially the hands (metacarpophalangeal and proximal interphalangeal joints).
What is the hallmark lab test for diagnosing rheumatoid arthritis?
Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP)
What are the two most common clinical symptoms of Sjögren’s syndrome?
- Dry Eyes (xerophthalmia)
- Dry Mouth (xerostomia)
Which autoantibodies are commonly associated with Sjogren’s Syndrome?
Anti-Ro/SSA and Anti-La/SSB antibodies
What test is commonly used to evaluate tear production in suspected Sjogren’s syndrome?
Schirmer’s Test
What is a common extra-glandular manifestation of Sjögren’s syndrome?
- Arthralgias
- Interstitial Lung Disease
- Vasculitis
What is the first-line treatment for dry eyes and dry mouth in Sjogren’s Syndrome?
Artificial Tears and Saliva Substitutes
What is the most common cause of acute compartment syndrome?
Fractures, particularly of the tibia or forearm
Acute compartment syndrome commonly results from trauma, with fractures being the leading cause due to increased pressure from bleeding or swelling.
What is the critical threshold of intracompartmental pressure that typically suggests the need for surgical intervention?
Greater than 30 mmHg
Compartment pressures above this level can compromise perfusion and tissue viability, necessitating fasciotomy.
What is the most reliable clinical finding for diagnosing acute compartment syndrome?
Pain out of proportion to the injury
What is the definitive treatment for acute compartment syndrome?
Fasciotomy
Which nerve is most commonly affected in anterior compartment syndrome of the lower leg?
Deep peroneal nerve
This nerve runs through the anterior compartment and can be affected, leading to sensory and motor deficits
