Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Shelves > Rheum > Flashcards

Rheum Flashcards

1
Q

Pt presents with compression fx and Dexa of -2.7

A

Osteoperosis
T score < -2.5 is diagnostic
Due to reduction in bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

40-45 male smoker with tortuous “corkscrew” lower leg veins. Dx?

A

Thromboangiitis obliterans (Beurger dz)
Pathophys due to smoking
presents with phlebitis and can have Raynaud phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pt with septic arthritis has no organisms on gram stain. Tx?

A

vanco and ceftriaxone
No organisms on Gram stain doesn’t change your tx
Covers Staph and Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Auricular chondritis, seronegative inflammatory arthritis, ocular inflammation, respiratory tract chondritis, inner ear dysfunction

A

Relapsing polychondritis

Inflammatory dz of cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anti-dsDNA b

A

SLE
Steroids are used when pt has: renal involvement, CNS syx, pericarditis, thrombocytopenia, or hemolytic anemia
Other syx can be managed by NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Backpain without neurologic findings

A

Lumbosacral muscle strain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Proximal muscle rash + heliotope rash

A

Dermatomyositis
Anti Jo 1
Workup - EMG, rules out other causes of muscle weakness
Tx - Prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Autoimmune syx with Anti-U1-ribonucleoprotien (U1-RNP)

A

Mixed connective-tissue dz (MCTD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

40 y/o male gets back pain that improves with exercise and wakes him up at night

A

Ankylosing spondylitis
RF -, HLA-B27 +
Schober test on PE to measure mobility of the lumbar spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Respiratory tract and kidney vasculitis, c-ANCA +. Granulomatous inflammation on bx

A

Wegner granulomatosis

Tx - Cyclophosphamid and prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Older male presents with b/l worsening of hearing. Also weird hx of fx’s. Concerning for?

A

Paget dz (osteitis deformans)
Increased bone turnover and abn architecture
Syx - skeletal malformation, deafness, nerve compression, fx’s and high Alk Phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Poorly controlled T2DM presents with warm erythematous foot that she cannot ambulate well with. Decreased pinprick and vibratory sensation.

A

Charcot Joint (neuropathic arthropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Older pt has muscular discomfort especially of the shoulder and pelvis. Hard to find a comfortable position. Strength 5/5

A

Polymyalgia rheumatica

Strong association with temporal arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Limited active and passive range of motion in the shoulder after the arm has been immobilized for several weeks

A

Adhesive capsulitis
More common in older women, DM’s
Self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticentromere Ab

A

CREST (Calcinosis, Raynaud phenomenon, Esophargeal Dysmotility, sclerodactyly, telangiectasia)
Systemic (cutaneous) scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why do sarcoid pts have hypercalcemia?

A

Granulomatous dz -> increased production of calcitriol (1,25-diOH, active vitD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for ankylosing spondylitis

A

Anti-TNF alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx for Paget dz

A

Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tx for pseudogout

A

Colchicene

Inhibit PMN microtubule formation to impair phagocytosis, migration, and chemotaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is deposited in pseudogout?

A

calcium pyrophosphate dihydrate crystal deposition dz

Rhomboid, weak positive birefringence under polarized light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What easy lab test is helpful in dx’ing temporal arteritis?

A

ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Anti-La, Anti-Ro

A

Sjogren syndrome

Dry mouth, dry eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most common cause of bone metastasis in a female?

A

Breast cancer

Lung cancer is also osteolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hematuria + Hemoptysis

A

Goodpasture

Anti-GBM antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What pulmonary findings can scleroderma pts develop?

A

Interstitial lung dz and Pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Skin finding in sarcoidosis?

A

Erythema nodosum
Painful subq pretibial nodule
Erythema noduosum + hilar adenopathy + acute arthritis Indicates a good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

COD is systemic scleroderma?

A

Pulmonary fibrosis

Pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which tendon is injured in lateral epicondylitis (tennis elbow)

A

Extensor carpi radialis brevis

Forceful and repetitive extension of supination of the hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

SLE pt with livedo reticularis. Dx and other key findings

A

Antiphospholipid Ab syndrome (APLS)

Hypercoagulable state with prolonged aPTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Tx for fibromyalgia?

A

Amitriptyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

In what scenario are OCP’s contraindicated in a SLE pt?

A

When + for antiphospholipid Abs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Best way to treat OA?

A

Exercise and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Gout pt presents with a joint nodule that does not transilluminate

A

Tophaceous gout
Deposited uric acid crystals surrounded by granulomatous inflammation
Tx: allopurinol prevents worsening, remove surgically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Heme onc dz with lytic bone lesions

A

Multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pt presenting with uveitis and b/l hilar lymphadenopathy

A 
Lofgren syndrome
(acute form of sarcoidosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Work up for primary Raynaud pehnomenon?

A

Nail fold microscopy

37
Q

Pt deposits fibrils into all kinda of tissues, especially the heart

A

Amyloidosis
PMH usually for MM, chronic inflammatory dz, lymphoma, dialysis
Can cause restrictive cardiomyopathy, low EKG voltages, and speckles on echo

38
Q

Pt with dysphagia, proximal LE weakness, eleveated CRP and creatinine kinase

A

Inclusion body myositis

Muscle bx - endomysial inflammation and basophilic-rimmed vacuoles in the sarcoplasm

39
Q

Migratory arthralgia, necrotic pustules, dysuria

A

Gonococcal arthritis

IV or IM ceftriaxone

40
Q

1st line tx for carpal tunnel?

A

Wrist splint for 2-6 weeks

Steroid injections or surgery is indicated when thenar atrophy is present

41
Q

Paraneoplastic process with bone pain, clubbing, synovial effustions, periostosis of the tubular bones

A

Hypertrophic pulmonary osteoarthropathy

CXR to i.d. lung cancer

42
Q

Sciatic pain that is produced when sitting or internal rotation of the thigh

A

Piriformis syndrom

Compression of the sciatic n. as it exits the greater sciatic foramen inferior to the piriformis m.

43
Q

Osteomalacia is a defect in?

A

Bone mineralization
Hypophosphatemia
SLE or Sjogren’s -> renal tubular dz (non ag acidosis) -> poor bone mineralization

44
Q

New mother has pain on thumb abduction and extension

A

de Quervain tenosynovitis
Tendonitis of the abductor pollicis longus and extensor pollicis brevis
Finkelstein test

45
Q

How can you prevent recurrent attacks of pseudogout?

A

Colchicine

rhomboid, weak positive birefringence

46
Q

What test should you order if you suspect ILD in a scleroderma pt?

A

High resolution CT

Reticular opacities, ground-glass opacification, fibrosis

47
Q

Common comorbidity of spondylarthritis and sacrolitis?

A

IBD

Tx - sulfasalazine

48
Q

Young pt reports sensation of catching of the knee. Dx and work up?

A

Meniscal tear

MRI of the knee

49
Q

Common bone finding in a SLE pt that has been on chronic steroids?

A

Osteonecrosis
Pain in the groin, thigh, or butt that is worse with activity
Xray may be normal but MRI is more sensitive

50
Q

Cyst found in the back of the knee

A

Popliteal cyst

“Baker cyst”

51
Q

Most significant RF for osteoperosis

A

History of prior fracture

52
Q

What exams are indicated in a pt with a mid clavicular fx?

A

Neurovascular exam

Identify injury to the brachial plexus or subclavian a.

53
Q

Female athlete with low caloric intake and amenorrhea is at risk for?

A

Stress fractures

Due to low density

54
Q

Common triggers of acute gout?

A

Alcohol
Surgery/trauma
Dehydration
Medications (diuretics, abx)

55
Q

Tx for Giant cell arteritis and complete vision loss?

A

High dose IV glucocorticoids (methylprednisolone) x3days followed by po gluco’s

56
Q

Extraarticular involvement in ankylosing spondylitis?

A

Reduced chest expansion/mobility
Enthesitis (tenderness at tendon insertion sites)
Dactylitis (swelling of fingers/toes)
Uveitis (unilateral eye pain and photophobia)

57
Q

What are complications of supracondylar fractures?

A

Brachial a. injury
Median n. injury
Cubitus varus deformity
Compartment syndrome/volkmann ischemic contracture

58
Q

Needle shaped crystals with negative birefringent (yellow parallel, blue perpendicular)

A

Gout

Urate crystals

59
Q

Following a surgery pt has pain out of proportion to injury, pain increases on passive stretch, swelling and tense skin, parethesia

A

Compartment syndrome
Pain worse with passive movement, does not respond to narcotics
Time to fasciotomy largest indicator of prognosis

60
Q

Osteoarthritis pt with unilateral neck pain and numbness of the posterior surface of the forearm

A

Cervical spondylosis

caused by an osteophyte

61
Q

Pt with knee injury stands on one leg with knee slightly bent and on internal rotation the knee elicits a locking sensation and significant pain

A

Medial meniscus tear
Thessaly test
Confirm dx with MRI

62
Q

Causes of spinal stenosis

A

Degenerative arthritis of the spine (OA)
Degenerative disk disease
Thickening of ligamentum flavum

63
Q

Young female SLE pt presents with unilateral weakness, negative CSF

A

Antiphopholipid syndrome
SLE + CVA
3 antiphospholipid antibodies (anticardiolipin, anti-beta2-glycoprotein 1, lupus anticoagulant)

64
Q

Most common cause of asymptomatic elevation of alkaline phosphate in an elderly pt?

A

Paget dz of the bone

65
Q

acute back pain + point tenderness following a trauma

A

Vertebral compression fracture

66
Q

What causes prepatellar bursitis?

A

S. aureus
Get aspirate for cell count and Gram stain
If - -> NSAIDS
If + -> I/d and abx

67
Q

Sharp, localized pain and tenderness over the anteromedial part of the tibial plateau just below the medial joint line of the knee

A

Pes anserinus pain syndrome
Valgus will be negative, Xrays normal
Caused by abn gait, overuse, or trauma

68
Q

Pt has DVT syx with a crescent ecchymosis distal to the medial malleolus

A

Popliteal (Baker) cyst

bruise = crescent sign

69
Q

Common colplicaiton of temporal arteritis

A

Aortic aneurysms

Follow with serial CXR’s

70
Q

Which causes of gout due to increased urate production?

A

Primary idiopathic
Myeloproliferative/lymphoproliferative disorders
Tumor lysis syndrome
Hypoxanthine guanine phosphoribosyl transferase deficiency

71
Q

Which causes of gout are due to under secretion?

A

CKD

Thiazide/loop diuretics

72
Q

1st line tx for RA

A

Methotrexate (DMARD)

Need HBV, HCV, and TB screening prior to starting

73
Q

What should be monitored for a pt taking hydroxychlorquine?

A

Eye exams

Risk of retinopathy

74
Q

CXR with hilar adenopathy w/ or w/o reticulonodular inflitrate. Noncaseating granulomas on bx

A

Sarcoidosis
Hypercalcermia
Tx - glucocorticoids

75
Q

Knee with laxity under valgus stress

A

Medial collateral ligament

76
Q

A pt with compartment syndrome is at risk of what when receiving succinylcholine?

A 
Hyperkalemia/ cardiac arrythmias
Succinylcholine depolarizes (binds post synaptic R to cause influx of Na+ and efflux of K+) -> increased K+ in the serum
Rhabdo due to compartment syndrome also increases risk of hyperkalemia
77
Q

Paget dz is a dysfunction in which cell?

A

Osteoclasts

Elevated Alk Phos

78
Q

If a alkylosing spondilitis pt has back pain after a trauma, be suspicious for?

A

Vertebral compression fx
They are predisposed to osteoperosis
HLA-B27
Aortic regurg is common

79
Q

What should be ordered to confirm diagnosis of polymyositis?

A

Muscle bx

Mononuclear infiltrate surrounding necrotic an regenerating muscle fibers

80
Q

Pt presents with palpable purpura, arthralgia, Renal Dz, Peripheral Neuropathy.
Elevated LFTs, NL C3, low C4

A

Mixed Cryoglobulinemiasyndrome
Mixed because C3 is WNL
Associated with chronic HCV

81
Q

Cyclophosphamide increases the risk of?

A

Bladder carcinoma
Hemorrhagic cystitis
sterility
Myelosuppression

82
Q

Respiratory distress + neuro dysfunction + petechial rash after a long bone fx

A

Fat emoblism

Tx - supportive

83
Q

Pt has chronic diarrhea, weight loss, migratory arthritis, lymphadenopathy and SI bx with periodic acid-Schiff (PAS)-positive macrophages

A 
Whipple's Disease
Tropheryma whippelii (GNR)
84
Q

Pt presents with foot pain. Clicking sensation when the 3rd and 4th metatarsal heads are squeezed together

A

Morton Neuroma

RF’s runners that are increasing their training, poor running mechanics, or female with eating disorder

85
Q

Erythema nodosum + arthralgias

A

Sarcoidosis

Get a CXR

86
Q

Pt receiving DMARD for RA develops mouth sores. Why?

A

Methotrexate toxicity
Antimetabolite agent
AE’s: Hepatotoxicity, stomatitis, cytopenias
Folic acid supplementation is recommended while taking MTX

87
Q

Young asian female with fever, arthralgia, weight loss with numbness/pain in UE x 6 months and elevated ESR

A

Takayasu arteritis

Tx - glucocorticoids

88
Q

A diagnosis of RA increases a patients risk for?

A

Osteoperosis
Osteopenia
Bone fx

89
Q

Monoarthritis + Hyperparathyroidism + chronic hypercalcemia?

A

Pseudogout

Rhomboid-shpaed positve birefringent calcium phosphate crystals

Shelves (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions