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2step > Rheum > Flashcards

Rheum Flashcards

1
Q

HLA-DR3

A

a/w DM-1, systemic lupus erythematosus and Graves’ disease.

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2
Q

HLA-B27

A

a/w ankylosing spondylitis, Reiter’s syndrome (arthritis, urethritis, and conjunctivitis).

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3
Q

HLA-B51

A

a/w Behçet’s syndrome.

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4
Q

HLA-D11

A

a/w Hashimoto’s disease

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5
Q

HLA-DR2

A

a/w Goodpasture’s syndrome and multiple sclerosis.

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6
Q

Pancreatic tumors, hyperparathyroidism, and pituitary tumors (prolactinoma/ ACTH/GH-secreting adenomas)

A

Type I multiple endocrine neoplasia (MEN-I), AD

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7
Q

Recurrent peptic ulcers due to excessive gastrin secretion by a gastrinoma, either in the pancreas or elsewhere in the gastrointestinal tract

A

Zollinger-Ellison syndrome causes

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8
Q

Hypercalcemia, hypophosphatemia, and elevated levels of serum parathyroid hormone

A

Hyperparathyroidism

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9
Q

Medullary thyroid cancer, pheochromocytoma, and hyperparathyroidism

A

MEN 2A: type IIA multiple endocrine neoplasia

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10
Q

Medullary thyroid cancer, pheochromocytoma, and mucosal neuromas

A

MEN 2B: type IIB multiple endocrine neoplasia

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11
Q

Depressed mental status and hypothermia, and can also involve bradycardia, hypotension, hypoglycemia, and hyponatremia

A

Myxedema coma: hypothyroid emergency

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12
Q

CREST Sx? Rx?

A

Calcinosis (IVF), Raynaud’s (CCB), Esophageal dysmotility (PPI), Sclerodactyly, and Telangiectasias

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13
Q

AL Amyloidosis a/w?

A

Multiple Myeloma, Waldenstroms Macroglobullinemia

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14
Q

AA Amyloidosis a/w?

A

Chronic infl dz/inf- Rheumatoid arthritis, IBD, TB, Osteomyelitis

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15
Q

Antimitochondrial

A

1° biliary cirrhosis

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16
Q

Anti-smooth muscle

A

Autoimmune hepatitis

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17
Q

Anti-U1 RNP (ribonucleoprotein)

A

Mixed connective tissue disease

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18
Q

CREST syndrome sx? Elevated ab?

A

Calcinosis, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasias. Elevated anti-centromere and/or anti-nucleolar autoantibodies.

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19
Q

Cytoplasmic Anti-Neutrophil cytoplasmic autoantibody

A

Wegener’s granulomatosis, sinusitis, lungs and kidneys

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20
Q

anti-Scl-70 antibody (anti-DNA topoisomerase I)

A

diffuse cutaneous systemic sclerosis (DCSS); widespread skin involvement, rapid progression, early visceral involvemen; death from pulmonary fibrosis

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21
Q

AntiCentromere antibody

A

Limited scleroderma—limited skin involvement confined to fingers and face. Also with CREST involvement

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22
Q

Anti-Smith autoantibodies, anti–double-stranded DNA autoantibodies, ANA

A

Systemic lupus erythematosus (SLE)

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23
Q

Anti-SSA, anti-SSB (anti-Ro, anti-La)

A

Sjögren’s sx w dry eyes, dry mouth, and enlarged salivary glands

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24
Q

p-ANCA (MPO-ANCA)

A

Microscopic polyangiitis, Churg-Strauss syndrome

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25
Q

Antimicrosomal, antithyroglobulin

A

Hashimoto thyroiditis

26
Q

Anti-glutamate decarboxylase

A

Type 1 diabetes mellitus

27
Q

Antihistone

A

Drug-induced lupus

28
Q

Anti-Jo-1, anti-SRP, anti-Mi-2, +ANA

A

Polymyositis, dermatomyositis

29
Q

Anti-desmoglein

A

Pemphigus vulgaris

30
Q

Anti-hemidesmosome

A

Bullous pemphigoid

31
Q

Anti-cardiolipin, lupus anticoagulant

A

SLE, antiphospholipid syndrome

32
Q

Anti-dsDNA, anti-Smith, ANA (not specific)

A

SLE

33
Q

Rheumatoid factor (antibody, most commonly IgM, specific to IgG Fc region), anti-CCP (anti- cyclic citrullinated peptide)

A

Rheumatoid Arthritis; sx>6months, morning joint stiffness >1hr, joint swelling, involes PIP/MCP, spares DIP

34
Q

Daycare/school teacher p/w 10days of b/l arthalgia/arthritis of PIP/MCP/wrists/knee/ankle, fatigue, intermittent diarrhea, mild itchy skin patches; dx?

A

Parvovirus B19 (B19 IgM), self resolves in 2-3 weeks

35
Q

Drugs that cause lupus-like sx w/ malar rash, fevers, arthritis, positive ANA

A

Procainamide, hydralazine, isoniazid, minocycline, propylthiouracil, lithium, carbamazepine, and phenytoin.

36
Q

2 wks Post BM transplant maculopapular rash on hands, feet, face, bloody diarrhea, elevated ALT/AST; rx?

A

GVHD Graft vs Host Dz w/ donor T-cell activation

37
Q

Rhabdomyolysis labs?

A

Elevated K, Cr, BUN (BUN:Cr

38
Q

F >50yo p/w Pain and stiffness in shoulders hips w morning stiffness, mild fever, malaise, and wt loss, fatigue; elevated ESR, CRP, normal CK.

A

Polymyalgia rheumatica (PMR) a/w temporal (giant cell) arteritis; Rapid response to low-dose corticosteroids (prednisone 10-20mg).

39
Q

F 20–50 YO. Chronic, widespread msk pain a/w stiffness (improves w use), paresthesias, poor sleep, and fatigue.

A

Fibromyalgia; rx regular exercise, antidepressants (TCAs, SNRIs), and anticonvulsants. (amitriptyline 1st, fluoxetine, chlorpromazine, cyclobenzaprine.)

40
Q

F p/w progressive symmetric proximal muscle weakness, “can’t comb hair” (involves shoulders), Elevated CK; dx? ab? Rx?

A

Polymyositis, characterized by endomysial inflammation with CD8+ T cells,􏰆 positive ANA, anti-Jo-1, anti-SRP, anti-Mi-2 antibodies; rx steroids

41
Q

Pt p/w uveitis, urethritis, and arthritis; penile ulcer, Dx? a/w?

A

Reactive arthritis (Reiter’s, seronegative spondyloarthropathy); Post-GI (Shigella, Salmonella, Yersinia, Campylobacter) or Chlamydia; a/w HLA-B27, RF/ANA negative

42
Q

Pt. p/w exertional dyspnea cxr b/l basilar reticulonodular infiltrates, elevated antitopoisomerase or anti-Scl-70 and ANA, normal anti-centromere ab

A

interstitial pulmonary fibrosis from diffuse cutaneous systemic sclerosis (DCSS)

43
Q

45yof p/w fatigue, myalgia, proximal muscle weakness, sluggish ankle reflex, normal ESR, elevated CK, dx?

A

Hypothyroid myalgia, check TSH

44
Q

10 yof p/w wk of high-spiking fevers, arthritis, salmon-colored macular rash lymphadenopathy, HSM; dx?

A

Systemic-onset juvenile rheumatoid arthritis (JRA)

45
Q

Enlarged DIP (Heberden’s) and PIP (Bouchard’s) joints, w joint space narrowing, subchondral sclerosis, osteophytes, and subchondral cysts.

A

Osteoarthritis

46
Q

Smoker p/w lower lobe lesion, wt loss, symmetric proximal muscle weakness, erythematous rash on dorsum of fingers and upper eyelids; dx?

A

Dermatomyositis, paraneoplastic (a/w malignancies); inflammatory damage of muscle fibers w/ elevated CK, (Gottron’s fingers)

47
Q

Pt. w celiac dz p/w pruritic herpetiform rash of small erythematous vesicular papules; dx/rx?

A

Dermatitis Herpetiformis; rx Dapsone and gluten free

48
Q

Recurrent nasal discharge, post nasal drip, anosomia, asthma hx, NSAID use; dx?

A

Aspirin associated nasal drip with Nasal Polyps

49
Q

sinusitis, hemoptysis, hematuria, red cell casts; CXR: large nodular densities.

A

Granulomatosis with polyangiitis (Wegener); focal necrotizing vasculitis, n. granulomas in the lung, n. glomerulonephritis; rx cyclophosphamide, corticosteroids.

50
Q

Necrotizing vasculitis involving lung, kidneys, skin with pauci-immune glomerulonephritis and palpable purpura, mononeuritis multiplex

A

Microscopic polyangiitis, rx cyclophosphamide and corticosteroids.

51
Q

Asthmatic p/w sinusitis, palpable purpura, peripheral neuropathy (wrist/foot drop), eosinophilia, pulmonary infiltrates; dx, rx?

A

Churg-Strauss syndrome; p-ANCA, IgE; Can also involve heart, GI, kidneys (pauci-immune glomerulonephritis)

52
Q

Recurrent oral aphthous and genital ulcers, eye lesions, skin lesions, and a positive pathergy test (a pinprick that turns into a pustule)

A

Behçet’s dz, systemic vasculitis that affects arteries and veins of all sizes

53
Q

25yoF p/w absent or decreased brachial artery pulse, subclavian bruit, pain along the vessels, unequal pulses, claudications

A

Takayasu’s arteritis, also known as “pulseless disease

54
Q

44yoF p/w headaches, fever, anemia, tender temporal regions, elevated ESR, alkPhos, IgG, complement, normochromic anemia

A

Temporal arteritis, also known as giant cell arteritis; high dose steroids

55
Q

wart-like vegetations on both sides of valve.

A

Libman-Sacks endocarditis - SLE

56
Q

Pt. p/w RHF, GERD, HTN, thick skinned swollen fingers, elevated antitopoisomerase or anti-Scl-70 and ANA, normal anti-centromere ab

A

Systemic sclerosis (DCSS) (widespread Scleroderma), fibrosis of pulmonary (RHF), esophagus (GERD), kidneys (HTN)

57
Q

Minutes post transfusion hypotension, respiratory distress and shock; dx/rx?

A

IgA deficiency anaphylactic reaction; rx intramuscular epinephrine w/ respiratory support

58
Q

Within an hour post blood transfusion p/w fever, chills, flank pain, hemoglobinuria; dx?

A

ABO mismatch hemolytic transfusion reaction, may progress to DIC

59
Q

SE for Cyclosporine and Tacrilimus (Calcineurin inhibitors)

A

Nephrotoxic, HypERkalemia, HTN, tremor; Hirsutism and gum hyperplasia unique ot Cyclosporine

60
Q

SE for Mycophenolate (IMDPH purine synthesis inhibitor)?

A

Bone Marrow suppression

61
Q

SE for Azathioprine (purine analogue)?

A

Dose related leukopenia, diarrhea, hepatotoxicity

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