Rhem Qs Flashcards
Henoch-Schönlein purpura - affects? Caused by? Lab findings? What comfirms the diagnosis?
skin, joints, kidneys, and gastrointestinal tract
Immune complex disease
Active Urine sedimentl C4 low, IgA elevated
Deposition of IgA on a skin
biopsy
Hemochromatosis - affect on joints?
OA-like arthropathy BUT affects second and third metacarpophalangeal (MCP) or wrist joints.
Anti-synthase syndrome?
If suspected on PE, should get what imaging test?
anti–Jo-1 plus two of the following clinical features:
myositis, interstitial lung disease, Raynaud phenomenon, nonerosive inflammatory arthritis, and mechanic’s hands.
CXR
Tofacitinib - used to treat? Will cause what lab abnormality?
RA; elevation of all components of lipid panel
Patients with Sjögren syndrome are at risk of developing what cancer?
Lymphoma (B-cell and MALT)
Long term consequence of FMF?
AA amylodosis
Pt with interstitial lung disease from diffuse cutaneous systemic sclerosis - start this medication?
cyclophosphamide
Eosinophilic granulomatosis with polyangiitis is characterized by? (4)
eosinophilia,
migratory pulmonary infiltrates,
purpuric skin rash,
mononeuritis multiplex in the setting of antecedent atopy.
immunosuppressant agent that preferentially targets T cells?
Cyclosporine
Diffuse idiopathic skeletal hyperostosis?
noninflammatory condition defined by the presence of flowing osteophytes involving the anterolateral aspect of the thoracic spine at four or more contiguous vertebre
prodromal stage of hepatitis B virus infection?
rapid-onset symmetric polyarthritis, (present before frank jaundice)
inclusion body myositis - age of onset? muscles involved? symmetry?
Usual CK level?
> 50, distal and proximal, mostly symmetric
<1000
This improves the symptoms of dry eyes in patients with primary Sjögren syndrome?
Topical cyclosporine
used to treat allergic conjunctivitis?
Olopatadine drops
Hydroxycloroquine - benefit in SLE? (4)
Reduces disease activity
improves survival
reduces risk of SLE-related thrombosis
Reduses risk of MI
When to start urate lowering therapy for you? (4)
- 2+ attacks within a year
- An attack + CKD
- An attack tophi
- An attack with a history of urolithiasis
Treatment of polymyalgia rheumatica?
Low dose (10-20mg) prednisone
Anyone with reactive athritis should be tested for?
Chlamydia
Milwaukee shoulder syndrome - age/sex? caused by? Charaterized by? Historical clues?
Women 70+
calcium phosphate deposition
pain, stiffness, and swelling that occurs gradually.
preceding trauma or history of overuse on the affected side
IgG4-related disease is characterized by (histologically)?
lymphoplasmacytic infiltration
Eosinophilia myalgia syndrome - presents with? Caused by?
- fasciitis and dermal induration
- neuropathy
- myopathy
linked to consuming contaminated L-tryptophan
Morphea is characterized by ?
ocalized area of skin thickening
initial treatment of choice for patients with new-onset, rapidly progressive, or erosive rheumatoid arthritis?
For non-erosive disease?
Methotrexate
Hydroxychloroquine
anti-U1-RNP antibodies suggest?
Also must have 3/5?
- Raynaud phenomenon,
- edema of the hands,
- sclerodactyly,
- synovitis, and
- myositis
Triad for DAH?
hypoxemia, new infiltrates found on chest radiograph, and decreasing hematocrit
Löfgren syndrome?
Characterized by?
Treat with?
self-limited sarcoidosis
acute arthritis, bilateral hilar lymphadenopathy, and erythema nodosum
NSAIDs or low-dose prednisone
Nonbiologic disease-modifying antirheumatic drugs (DMARDs) such as methotrexate and sulfasalazine - role in axial disease? in peripheral arthritis?
Not efficacious
may be considered
Women with dermatomyositis may have an increased risk of?
Ovarian cancer
Strong risk factor for PAN?
HBV
Diagnosis of PAN is best established by demonstrating what on biopsy? Or this on imaging findings?
necrotizing arteritis
characteristic medium-sized artery aneurysms and stenoses on imaging studies of the mesenteric or renal arteries
People with gout should eat MORE of this?
Low-fat dairy
Study that could be appropriate if thromboangiitis obliterans (“Buerger disease”) were suspected?
Digital arteriography
U1-ribonucleoprotein antibodies are associated with?
Mixed Connective tissue disease
primary angiitis of the central nervous system (PACNS). Diagnosis and treatment?
Brain biopsy; glucocorticoids and cyclophosphamide
Test to confirm Takayasu arteritis?
arteriography of the aorta and its branches
SLE treatment that needs to be stopped during pregnancy?
That do not need to be stopped?
Mycophenolate mofetil
Prednisone and hydroxychloroquine
The presence of these antibodies is sufficient to establish a diagnosis of granulomatosis with polyangiitis in patients with these 3 findings?
antiproteinase 3 antibodies
classic upper airway manifestations, pulmonary infiltrates/nodules, and glomerulonephritis
Antimyeloperoxidase antibodies are associated with? (3)
microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome), and rapidly progressive glomerulonephritis.
Blood pressure medications that lower uric acid levels?
losartan and calcium channel blockers
Pt with severe tophaceous gout and persistent hyperuricemia and has not responded to oral urate-lowering therapy, including the xanthine oxidase inhibitors allopurinol and febuxostat. Next Med?
pegloticase
Scleroderma renal crisis presents with? (organ affected, vitals, labs)
Treatment?
Acute onset of oliguric kidney disease and severe hypertension, mild proteinuria, urinalysis with few cells or casts, microangiopathic hemolytic anemia, and thrombocytopenia.
ACE inhibitor
In patients with systemic sclerosis, malabsorption is often due to? Test?
bacterial overgrowth. glucose hydrogen breath test.
Treatment for high-risk polymyalgia rheumatica?
Methotrexate+ prednisone
