Rheum Flashcards
What do intigrins do
Enable leuks to exit blood stream
Absent in leukocyte deficiency–
Will have delayed umbilical cord detachment
What is the main function if PTH
Increase bone reabsorbtion aka increase ca
Phosphate is decreased in serum (put out in urine)
What does pth act on
Osteoblasts, which increase rank, which matures osteoclasts
What can block rank and why do you care
Osteoprogesterin blocks rank
When estrogen gets low, osteoprogesterin gets low, clasts over activate, and…
OSTEOPOROSIS occurs
Gram negative oxidase positive rod causing itchy rash
Psuedmona
Hot tub folliculitis
Blue black deposits on sclera and ear with joint pain
Alkaptonuria
Also urine turns black in the sun
What does fibrillin do
Glycoprotein scaffold for elastin
What are the typical lab values for osteoporosis
Totally normal ca, phos, and PTH
What mediates muscle tone in nervous system
Golgi tendon organ
What is linked to drug induced lupus
Drugs metabolized by acetylation
Ex: INH
Rhomboid crystals with knee pain
Psueodo gout
Crystal made up of calcium pyro phosphate w/ + bifringence
What is the first line treatment for gout
NSAID
What drug do you NOT give DURING a gout attack
Uric acid lowering drugs
Ex: xanthine oxidase inhibitor
These PREVENT gout but make active gout worse
What do gout needles look like?
Needle shaped
Negative bifringence
Remembering the contraction of muscle bands
HIZ shrinkage (these shorten)
A band is Always the same length
Problems with umbilical cord detachment and recurrent skin infections w/I puss
Leukocyte adhesion deficiency
AR
No CD18 , no intigrins
What is the MOST important factor for osteoporosis
Genetics
Proximal muscle weakness
Over expression MHC 1 on sacrolema
Polymyositis
Cd8 infiltration leads to myocyte damage
This auto antibody is the most specific for RA
Citralunated peptide
A patient with cancer and high serum calcium likely has what elevated?
Parathyroid hormone related protein.
Reparative kneeling may lead to what?
Pre patellar bursa
What allows the binding of myosin to actin?
Calcium binding to troponin c
inhibits neutrophil motility and activity, leading to a net anti-inflammatory effect. This has proven useful in the treatment of acute gout flares.
Colchacine
What biopsy is characteristic of polyarteritis nodosa
Multisystem involvement with biopsy showing transmural inflammation of arterial walls with fibrinoid necrosis.
Small and medium vessels.
Do psgn and acute rhematic fever usually happen together
No.
If arf is present, most likely the complication will be pancarditis
Mitral stenosis occurs years after original illness
Define Parkinson’s cogwheel rigidity
Passive movement has ratchet like resistance
Joint problems that arise with a myloprofilferative disorder (ie polycythemia vera)
Gout
Myloprofilferative disorder has increased irate production
What is seen in mitochondrial myopiathies
Red ragged fibers
What is a first line treatment for RA
Methotrexate
What are pth levels like in sarcoidosis
Low
Sarcoidosis has vit d activation by macs which increases ca absorption
What medicine is structurally similar to pyrophosphate
Bisphosphonate
Half of the patients with lambert eaton also have this?
Malignancy
Classically small cell carcinoma
What muscle controls external shoulder rotation in the cuff
Infraspinatus
Classic autoantibody in polymyositis
Anti jo 1
antibody is directed against the histidyl-tRNA synthetase
Anti nuclear (very easy to confuse with SLE)
Does an LP help you determine if there is osteomyolitis
No
Get an MRI
The suffix cept for Rx will clue you in for
A receptor molecule
The nib in a drug name clues you in for
Kinase inhibitor
Anti mitochondria antibody indicates
Primary biliary sclerosis
Anti cyclic citrulated antibody is
RA
Lab finding for ACTIVE SLE attack
Reduced complement (due to immune complex deposition in organs)
Also weirdly they can have a hard palate ulcer
Define a contracture
a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints.
Excess matrix metaloproteins
What is a t tube
Part of sarcolema
Allows cordoninated contraction
What kind of signaling does RANK do
Rank signals NFKB to osteoclasts precursor
What is succinylcholine
Fast acting depolerizing Neuromusclual block
What kind of block is pancuronium
Non depolerizing block.
How do you reverse a nondepolerizing NMH block
Neostigmine
Examination showing tenderness in snuff box
Scaphoid fx
Risk of a vascular necrosis
Why bone problems do ppis lead to
Ppi decreases stomach acid
Calcium doesn’t absorb
Osteoporosis may occure
Will the medial lymph system of the leg drain to the popliteal
No.
Medial runs from medial foot to superficial inguinal nodes
Where would a lesion be if popliteal and superficial inguinal lymphs are big
Lateral leg
Having a rash + muscle weakness is
Dermatomyositis
What is the other name for churge straus + what s/s
Eosinophilic Granulomatis with polyangitis
Late onset asthma**
Other “allergy” type stuff
Medium sized vasculitis
Panca (ab vs pmn myeloperoxidase)
Osteoporosis can be promoted by what simple drug class
Glucocorticoid
Also ppi
Abusing anabolic steroids might lead to this skin finding
Acne
What is etanercept a decoy for
Tnf a
Diffuse muscle pain ontop of giant cell arteritis is known as
Polymyalgia rhematica
Which nerve is anterior and lateral on the elbow
Radial
What nerve is anterior and medial on the elbow
Median
If RA were to affect the spine, which region would it be
Cervical
b/c of PUD, a gout pt cannot use NSAID as first line rx. Now what?
colchicine
inhibits microtubule polymerization
Besides your abs, what m helps you go from supine to sitting w/o using hands
Psoas major
What ligament is damaged in nursemaids elbow
Annular ligament
nursemaid= radial head subluxation
What is the halmark of rickets histology
increase in unmineralized osteoid matrix
What is the primary vessel messed up for femoral head osteonecrosis
medial circulflex
What is Denosumab
RANK L inhibitor
