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GK PANCE > Rheum > Flashcards

Rheum Flashcards

1
Q

What is the hallmark symptom for polymyalgis rheumatica?

A

proximal muscle (shoulders, neck, hip girdle) stiffness and aching, especially in the morning

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2
Q

What is the most specific Dx test for SLE?

A

Anti double-stranded DNA & Anti-Smith AB

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3
Q

What inflammatory condition is strongly associated with giant cell (temporal) arteritis?

A

polymyalgia rheumatica

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4
Q

What problem associated with temporal arteritis can progress to complete vision loss?

A

Monocular amaurosis fugax

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5
Q

What will Muscle Bx of fibro show?

A

moth eaten appearance

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6
Q

What systemic sxs are associated with Polymalgia rheumatica?

A

fever, malaise, weight loss

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7
Q

Tx for polymyalgia rheumatica

A

low-dose prednisone

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8
Q

Drug induced causes of SLE

A

HIPPS:

Hydralazine

INH

Procainamide

Phenytoin

Sulfonamides

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9
Q

Tx for Polymyositis and Dermatomyositis

A

high-dose corticosteroids

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10
Q

Dx for Sjogrens Syndrome

A

Anti-Ro, Anti-La

+ Schirmer Test (dec tear production)

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11
Q

What lab marker is elevated with polymalgia rheumatica?

A

ESR (erythrocye sedimentation rate) >40 mm/hr

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12
Q

widespread muscular pain, poor sleep/memory problems

increase in pain perception (increase in substance P)

extreme fatigue

A

Fibro

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13
Q

What antibody is specific for Myositis?

A

Anti-Jo 1 Ab

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14
Q

recent difficulty grooming (brushing hair), dressing, transferring from seated or supone to standing positions

A

polymyalgia rheumatica

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15
Q

Autoimmune disorder that attacks exocrine glands (salivary)–>xerostomia, dry eyes, parotid enlargement

A

Sjogrens Syndrome

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16
Q

symptoms worsen after inactivity

which inflammatory disease?

A

Polymyalgia Rheumatica

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17
Q

Tx for Sjogrens Syndrome

A

Pilocarpine (cholinergic for xerostomia)

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18
Q

idiopathic inflammatory muscle disease of proximal limbs, neck, pharynx.

A

Polymyositis

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19
Q

Main Tx for SLE

A

hydroxychloroquine

NSAIDS, steroids, immunosuppressants

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20
Q

symmetric aching and stiffness about the shoulders, hip girdle, neck, torso

A

polymyalgia rheumatica

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21
Q

What antibody is specific for Dermatomyositis?

A

Anti-Mi-2 Ab

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22
Q

Malar Rash

A

spares nasolabial folds (SLE)

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23
Q

Malar rash including nasolabial folds

A

Dermatomyositis

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24
Q

Dx for Scleroderma

A

+ Anticentromere AB (limited dz, more specific)

+ Anti-SCL-70 (diffuse dz)

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25
Q

Tight, shiny, thickened skin

+

CREST syndrome

A

Scleroderma (systemic sclerosis)

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26
Q

Tx for scleroderma

A

DMARDS (hydroxychloroquine, methotrexate)

Corticosteroids

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27
Q

Dx for Polymyositis

A

Increased muscle enzymes (Increased aldolase, creatinine kinase)

+ Anti-Jo 1 Ab

+ Anti-SRP Ab

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28
Q

What else can be positive in an SLE workup that can come up as a false positive for syphilis?

A

Antiphospholipid AB Syndrome:

Anticardiolipin Ab is + in this syndrome and is associated w/ a false + VDRL/RPR

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29
Q
A
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30
Q

Poikiloderma: photosensitive, erythematous rash on face, neck, anterior chest “v sign”

A

Dermatomyositis

31
Q

How can you differentiate polymyositis and dermatomyositis?

A

Dermatomyositis has:

heliotrope (blue-purple) upper eyelid discoloration

AND

Gottron’s papules: raised violaceous scaly eruptions on knuckles

32
Q

Dx for fibro

A

11/18 trigger point tenderness > 3mos

33
Q

Dx for polymyalgia rheumatica

A

Clinical

34
Q

Tx for fibro

A

TCAs

Pregabalin = only FDA approved

35
Q

Best initial test for SLE

A

ANA

36
Q

CPx of Polymyositis

A

Painless Progressive symmetrical proximal muscle weakness

37
Q

Difference in Presentation b/w OA and RA

A

OA: asymmetric evening big joint stiffness that worsens through the day & changes in weather

RA: symmetric morning small joint stiffness that improves through the day

38
Q

boutonniere deformity and swan-neck deformity

A

RA

39
Q

Heberden & Bouchard’s node

A

OA

40
Q

Tx for Osteoarthritis

A

Initially: Acetaminophen

NSAIDS (more effective)

41
Q

What medication reduces permanent joint damage in RA?

A

DMARDS: Methotrexate

42
Q

1st line Tx for RA

A

DMARDS: Methotrexate

43
Q

1st line Tx for pain control in RA

A

NSAIDS

2nd line: CS

44
Q

SES of Methotrexate

A

hepatotoxicity

stomatitis

interstitial pneumonitis

45
Q

Main SE w/Hydroxychloroquine

A

Retinal Toxicity: fundoscope exam q 6-12 mos

46
Q

What medical condition must you rule out prior to starting any DMARDS?

A

Must do a PPD to r/o TB

47
Q

chronic large-vessel vasculitis that affects the Aorta, Aortic Arch & Pulmonary Arteries

A

Takayasu’s Arteritis

48
Q

CPx of Takayasu’s Arteritis

A

vessel stenosis/occlusion/ischemia: Coronary Artery MI, TIA, CVA

Lower extremity claudication

49
Q

What will PE of Takayasu’s Arteritis show?

A

arterial bruits

diminished pulses

asymmetric BP measurements

50
Q

Dx for Takayasu’s Arteritis

A

Angiography

51
Q

Tx for Takayasu’s Arteritis

A

High Dose Corticosteroids

52
Q

Asthma

Hypereosinophilia

Chronic Rhinosinusitis

A

Eosinophilic Granulomatosis with Polyangiitis

53
Q

adult onset asthma

A

Eosinophilic granulomatosis w/ polyangiitis

54
Q

What will labs show in EPA

A

Increased EOS

+P-ANCA

55
Q

Tx for EPA

A

corticosteroids

56
Q

Granulomatosis w/polyangiitis (Wegener’s) affects which 3 parts of the body?

A

Nose (Upper Respiratory)

Lungs (Lower Respiratory)

Kidneys

57
Q

Upper Resp Tract sxs in Granulomatosis w/ Polyangiitis

A

saddle-nose deformity

refractory sinusitis

58
Q

Lower Respiratory Tract Sxs in Granulomatosis w/ Polyangiitis

A

hemoptysis

SOB

CXR: cavitating lung nodules

59
Q

Tx for Granulomatosis w/ Polyangiitis (Wegener’s)

A

CS + Cyclophosphamide

60
Q

Labs in Wegener’s

A

Wegener just C-ant:

+ C-ANCA

61
Q

Difference between Granulomatosis w/ Polyangiitis & Microscopic Polyangiitis

A

Microscopic Polyangiitis does not have necrotic or granulomatous inflammation like GPA

No upper resp. tract sxs like in GPA

62
Q

CPx of Microscopic Polyangiitis

A

Palpable purpura

Mononeuritis Multiplex

acute glomerulonephritis

63
Q

Dx for MPA

A

+P-ANCA

64
Q

Tx for MPA

A
65
Q

CPx of Henoch Schonlein Purpura (HSP

A

“HSP affects IgA”

Hematuria

Synovial: arthritis/arthralgias

Palpable Purpura

Abdominal Pain

66
Q

Dx for Henoch Schonlein Purpura (HSP)

A

Kidney Bx: mesangial IgA Deposits

Normal COags & Normal Platelets

67
Q

Tx for Henoch Schonlein Purpura

A

Supportive

68
Q

CPx of Goodpasture’s Disease

A

Think “GP”

Glomerulonephritis (rapidly progressing) + Pulm hemorrhage (hemoptysis)

69
Q

Dx of Goodpasture’s Disease

A

Biopsy: Linear IgG deposits in glomeruli or alveoli

70
Q

Tx for Goodpasture’s Disease

A

Glucocorticoids

Plasmapheresis

71
Q

Which diseases are +P-ANCA?

A

Microscopic Polyangiitis

EPA

Ulcerative Colitis

Primary Sclerosing Cholangitis

72
Q

Which diseases are +C-ANCA?

A

Wegener’s Granulomatosis

73
Q
A

GK PANCE (26 decks)

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