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2 > Rheum 2 > Flashcards

Rheum 2 Flashcards

1
Q

OA is what
symptoms
XR
treatment

A

non -inflam. degen. wear and tear
pain and worse on activity. relieved by rest. morning stiffness <30 mins

LOSS

physio. weight loss. analgesia. NSAIDs

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2
Q

RA is what
where is it not
symp

A

inflam seropositive. synovium (pannus)
Not in DIPs
stiffness and swelling, pain, morning stiffness >30 mins

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3
Q

RA treatment

A

NSAIDs and analgesia short term for immediate relief and to cover the lag phase of DMARDS
1st line methotrexate, sulfasalzine, hydro
biologics - if two DMARDs tried in comb
influximab and metho
other anti TNFs - toclizumab, rituximab

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4
Q

large vessel vasculitis takayas A who

symptoms /signs

A

young women, asian, 20-30s

claudication, vascular stenosis and aneurysms, carotid bruits

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5
Q

large vessel vasculitis GCA symptoms
investigation
treatment

A

claudication of jaw, low of vision
temporal artery biopsy - skip lesions
40mg pred 60mg if loss of vision
metho/azithro

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6
Q

kwaasaki disease is what
who
what can occur

A

vasculitis of medium vessels
children under 5
coronary artery aneurysms

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7
Q

GPA (wegners) is what
signs
treatment

A

ANCA pos, CANCA, PR3
sinusitis, rhinitis, saddle nose
IV steroids and cyclophosphamide

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8
Q

ECGPA charge strauss
symp
treatment

A

pANCA, ANCA pos
same as GPA with late onset asthma and high esosinophil count
IV steroids and cyclophosphamide

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9
Q 
HSP is what 
who
symp/signs 
ix
rx
A

acute IgA mediated disorder
children aged 2-11
<75% have had URTI, pharangyeal infection, GI infection
purpuric rash over buttocks and lower limbs, abdom pain, joint pain, vom, bloody diarrhoea

urinalysis - 50% have renal impairment

self listing within 8 weeks - relapses may occur

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10
Q

gout is what
settles how
ix
rx

A

hot painful swollen joint
settles in 7-10 days without treatment

serum urate may be be raised in an acute attack
needle shaped negative birefringent

NSAIDs (colchaamen), analgesics, steroids

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11
Q

chronic gout treatment

A

allopurinol (febixstat)

start 2-4 hours after acute attack - cover with NSAIDs

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12
Q

pseudo gout
what is it and what does it affect
ix
rx

A

calcium pyrophosphate crystals
affectes fibrocartilage
rhomboid positive birefringent crystals
NSAIDs (colchicine), steroids, rehydration

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13
Q 
hydroxy patite  what is another name for it 
what is it 
what is released 
who 
treatment
A

milwouke shoulder
hydroxylate crystals deposition around a joint
release of collagenous, IL1, serum phosphate
F>M 50-60s
NSAIDs, intra articular steroid injection

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14
Q

reactive arthrirtis triad
when
treatment

A

ureters triad - urethritis, arthritis, conductivititis
1-3 weeks after infection in another part of the body
self limiting
if chronic - NSAIDs, intra articular steroid, oral steroids, ABs, DMARDs

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15
Q

enteropathic arthritis is what
ix
treatment

A

worsening of symptoms during flare up of IBD
HLA-B27, increased CRP, increased ESR, XR/MRI - sacroilitis
treat IBD, no steroids - can exacerbate IBD, analgesia, steroids, DMARDs, anti TNF

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16
Q 
psoriatic arthritis 
do all the px have psoriasis 
ix
XR
treatment
A

10-15% of px don’t have psoriasis
HLBA27, increased ESR, increased inflam markers
XR - marginal erosions and whisking, pencil in cup
physio, OT, orthotics, NSAIDs, steroid injections, DMARDs, anti - TNF
DIP fusion for stage 1 where disease confined to just DIPs

17
Q 
ankolysing spondolysis hallmark
symp
A disease
ix
rx
A

sacroilitis
back pain improved with exercise not relieved by rest, decreased chest expansion
ant uveitis, aortic regurg, apical fibrosis, amyloidosis/IgA nephropathy, achilles tendonitis/plantar fasciitis
HLAB27, XR - bamboo spine
physio, OT, NSAIDs, DMARDs if peripheral joint involvement

18
Q

polymyalgia rheumatica
symp
dx and treatment
assoc with what

A

ache in shoulders and hip girdle. symp improve as day goes on and with movement
dx test 15 md pred daily - decrease dose over 18m
assoc with temporal arteritis/GCA

19
Q

GCA symp
ix
treatment

A

headache in temples. jaw claudication - pain comes on from muscle use. tender enlarged non pulsatile temporal arteries
TAB - skip lesions
40mg pred 60 is visual impairment
reduce dose over 2 years

20
Q

soft tissue rheumatica is what

A

pain caused by inflammation/damage to ligaments, tendons, muscles of nerves near a joint

21
Q

poly/dermatomyositis
symp
treatment

A

symm proximal weakness, difficulty brushing hair/going up stairs
derm - v shaped rash on chest, hallitrope rash
pred 40mg and immunosuppression
IV Immunglobulin if no response

22
Q

fibromyalgia

A

trigger points

23
Q

inclusion body myositis symp
ix
rx

A

distal assym muscle weakness
biopsy - inclusion bodies
poor response to treatment

24
Q

systemic sclerosis is what
limited
diffuse
treatment

A

excessive deposition of collagen in skin and internal organs. AI

limited - anti centromere hands, face, for arms, feet
diffuse - anti SC 70, can involve trunk, early organ involvement

raynauds - CCB, GI - PPS, Renal - ACEI, ILD - cyclophosphamide

25
Q

sjorgens is what
symp
ix
rx

A

lymphocyte infiltration in exocrine organs
ocular dryness - Schirmes test for it
dry mouth. salivary gland involvement
anti La/Ro, biopsy - lymphocytic infiltrate
eye drops, steroids, immune suppressants, saliva replacement, pilocarpine

26
Q

anti phospholipid syndrome is what
ix
rx
1-5% what have what

A

recurrent venous thrombosis or arterial thrombosis, fetal loss in young women

anti cardiolupin ABs, anti coag antibodies, anti beta 2 glycoproteins

life long anti coag

of healthy population have anti card ABs

27
Q

SLE is what
ix
moniter

A

defect in apoptosis - increased cell death - loss of immune regulation

ANA (not specific) A ds DNA (specific) decreased complement levels C3 C4. Anti SM (specific but low sensitivity), Anti La anti Ro

Anti ds DNA, comp levels (low means active disease), urinalysis, CVS risk - bp, cholesterol, FBC

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