Rheum

Question 1

Heberden’s Nodes

Answer 1

DIPs (OA)

Question 2

Brouchard’s Nodes

Answer 2

PIPs (OA)

Question 3

Anti Jo-1, Anti DS DNA, Anti SS DNA

Answer 3

Inflammatory Myopathies (dermatomyositis, polymyositis)

Question 4

Anti DS DNA, Anti SS DNA, Anti Smith

Answer 4

SLE

Question 5

Anti-SSB/Anti-LA

Answer 5

SLE, Sjogrens

Question 6

Anti SSA/Anti-Ro

Answer 6

SLE, Sjogrens

Question 7

Anticentromere

Answer 7

CREST, Scleroderma

Question 8

ANCA

Answer 8

Vasculitis

Question 9

Gout Info

Answer 9

Monosodium Urate

• *Needle shaped cyrstales, Negative biefringence**
• monoarticular
• tophi

Question 10

Pseudogrout Info

Answer 10

Calcium pyrophosphate

• *prism shaped crystals, Positive birefringent**
• large joints (knees, wrists)

Question 11

SE of Colchicine

Answer 11

LFT changes, cramping, N, V, D, bone marrow suppression

Question 12

Meds that make gout worse

Answer 12

HCTZ & loop diuretics
low does aspirin
NIACIN

Question 13

Probencid MOA

Answer 13

increases Uric acid excretion

Question 14

Allopurinol MOA

Answer 14

blocks uric acid production

-nausea, diarrhea, rash, LFTs, 2% = TEN

Question 15

CCP antibody

Answer 15

Rheumatoid Arthritis
(80% RF +)
(if ANA positive may indicate comorbid condition)

Question 16

Tx of RA

Answer 16

Acute = NSAIDS, corticosteroids
DMARDS = MTX, hydrochloroquine

Question 17

Methotrexate SE

Answer 17

• gastritis, liver toxicity, bone marrow suppression
• **severe life threatening interstitial lung dz
• need to use folic acid supplement*

Question 18

Plaquinil/Hydroxycholoquine sulfate SE

Answer 18

Need regular eye exams 2 to retinal toxicity

Question 19

When to use Biologic DMARDs

Answer 19

Ex: mumabs

After failure of MTX

Question 20

Biologic DMARD warning

Answer 20

Serious infection/malignant
Reactivation of latent TB
Lymphoma

Question 21

Lupus Features

Answer 21

MD SOAP BRAIN (need 4 or more)

• Malar rash
• discoid rash
• serositis
• oral ulcers
• arthritis
• photosensitivity, pulmonary fibrosis
• blood disorders
• renal disease
• ANA +
• Immunolgic abn
• neuro dz

Question 22

CREST syndrome

Answer 22

calcinosis, raynaud phenom, esophageal dysmot, sclerodactyly, telangiectasias

Question 23

Positive HLA-B27 (RF negative, ANA negative) List them

Answer 23

• ankylosing spondylitis
• reactive arthritis
• psoriatic arthritis
• GI colitic arthritis

Question 24

? is 17x more common in pts w/ temporal arteritis

Answer 24

Thoracic aneurysm

Question 25

Takayasus Arteritis

Answer 25

-Adolescent grils and young women
-aortic arch and branches
-pulses routinely absent
Tx: steroids

Question 26

Kawasaki Dz

Answer 26

Typically <5y/o
-preceded by viral infection
-strawberry tongue, swollen perioral area, high fever, conjunctivitis, cervial lymphadenopathy
Tx: IV IG, ASA

Question 27

Wegeners Granulomatosis/Granulomatosis w/ polyangitis

Answer 27

Triad = upper resp symp, lower resp symp, focal segmental glomerulonephritis
ANCA

Question 28

Behcets Dz

Answer 28

recurrent oral and genital ulcers, iritis, polyarthralgias

Question 29

Polymyosisits

Answer 29

Proximal symmetric msucle weakness
**elevated CK
Tx: steroids

Question 30

Dermatomyositis

Answer 30

Dx = clinical = heliotrope rash, gotton’s paules, shawl sign/V-sign, clacinosis cutis
Tx: glucocrticoids