Rheum 2 Flashcards
what rash is associated with antiphospholipid syndrome
livedo reticularis
what type of endocarditis is associated with antiphospholipid syndrome and SLE
libmann sacks endocarditis
what happens to platelets in antiphospholipid syndrome
low
anticoagulation in antiphospholipid syndrome
warfarin
target INR antiphospholipid syndrome
2-3 on warfarin
anticoagulation in antiphospholipid syndrome when pregnant
LMWH and aspirin
sjogrens syndrome antibodies
anti ro and anti la
what test is done on examination for sjogrens syndrome
schrimer test
schrimer test method and results
place a piece of filter paper on the lower eyelid for 5 mins
distance travelled <10mm is significant for sjorgens
pilocarpine is used for and moa
stimulating tears and salivary gland secretion
stimulates muscarinic receptors and the parasympathetic nerves
what is polyarteritis nodosa
a medium vessel vasculitis
sx include
renal impairment
htn
tender skin nodules
what is kawasaki disease
a medium vessel vascultiis
sx
higher fever for 5 days
bilateral conjunctivitis
rash
adenopathy
strawberry tongue
hands and feet peeling
what is takayasu arteritis
large vessel vasculitis
sx include
aortic arch affected
pulseless
how to remember what antibody is associated with microscopic polyangitis
p-anca
p for petite like microscopic
what antibody is associated with HSP
IgA
what do patients with HSP need monitored
urine dipstick for renal involvement
blood pressure for hypertension
granulomatosis with polyangitis is also known as
wegners
wegners granulomatosis sx
nosebleeds
hearing loss
sinusitis
saddle shaped nose
glomerulonephritis
eosinophilic granulomatosis with polyangitis
severe asthma
sinusitis
allergic rhinitis
what infection is polyartertitis nodosa associated with
hep b
key complication of kawasaki disease
coronary artery aneurysm
kawasaki disease mx
aspirin and IVIG
how is takayasus arteritis diagnosed
CT or MRI angiography
takayasus arteritis sx
claudication
fever
malaise
muscle ache
lack of pulse
sx bechets disease
oral ulcers- painful, sharply circumscribed and have a red halo
genital ulcers
bechets disease is associated with what gene
HLA B51
what test can be done to aid diagnosis of bechets disease
pathergy test
how is bechets disease managed
steroids
colchicine
bechets disease pattern
relapsing remitting
types of ehlers danlos syndrome
classic
hypermobile
vascular
autonomic dysfunction in ehlers danlos causes what
pots syndrome
tachycardia on sitting/standing
syncope
what score is used to assess patients in ehlers danlos
beighton
ehlers danlos is defect in
collagen
features of marfans syndrome
high arch palate
long fingers- arachnodactyly
increased arm span
what diet increases risk of gout
high purine (meat and seafood)
what is seen on x ray in gout
maintained joint space
lytic lesions
punched out erosions
allopurinol moa
xanthine oxidase inhibitor
gout mx
nsaid (not in renal impairment)
colchicine
steroids 3rd line
if a patient is on allopurinol or feburoxstat and gets active gout what happens to their prophylactic medications
continued
gout prophylactic medications
allopurinol
febuxostat
what is chondrocalcinosis
deposits of calcium in the joint cartilage
how is pseudogout managed
it resolves by itself
symptomatic relief:
nsaids
colchicine
intra articular steroid injections
oral steroids
t score osteopenia
-1 to -2.5
t score osteoporosis
< -2.5
what is osteopenia
a less severe form of osteoporosis
what do qfracture and frax tools calculate
10 year risk of a major osteoporotic fracture and hip fracture
what q fracture score indicated need for dexa scan
> 10%
when do you not have to calculate qfracture score before doing dexa
patients over 50 with a fragility fracture
osteoporosis mx
1st line= bisphosphonates
lifestyle adivce= increase exercise, reduce alcohol and smoking, weight loss
make sure calcium and vitamin D levels are normal and if not supplement them
bisphosphonate side effects
reflux
atypical fractures
osteonecrosis of the jaw or external auditory canal
advice given on how to take bisphosphonates
take on an empty stomach with a full glass of water
remain upright for 30 mins after taking them
when should you reassess someone on bisphosphonates
after 3-5 years
if t score > -2.5 stop medication
strontium ranelate moa
stimulates osteoblasts and blocks osteoclasts
strontium ralenate side effects
increases risk of VTE and MI
raloxifene moa
SERM
targets bone receptors not uterus or breast
raloxifene side effect
increases risk of VTE
what are looser zones
fragility fractures that go partially through bone
how is osteomalacia treated
vitamin d supplementation
when should serum calcium be checked after starting vitamin D supplementation in osteomalacia
within a month
what causes osteomalacia
vitamin d insufficiency
x ray findings in paegts disease
bone enlargement and deformity
osteoporosis circumscripta
cotton wool appearance of skull
v shaped osteolytic defects of long bones
pagets disease mx
bisphosphonates
calcitonin when not suitable
what cancer can those with pagets disease get
osteosarcoma
