Rheum Flashcards
Polyarteritis nodosa
Vasculitis - string of beads, aneurysms
Medium vessels all over body
Associated with Hep B
Arthritis, myalgia
Kidney failure
Abdo pain - mesenteric ischaemia
Neuro symptoms - sensory, neuropathic pain - mononeuritis multiplex
All rheum investigations negative
Seronegative - what does it mean
No specific abs associated
Can have HLA associations
Livedo reticularis
Polyarteritis nodosa
Antiphospholipid syndrome
Erythema Ab igne (hot water bottles)
Behcet’s syndrome
Symptoms
Management
Mucosal ulceration
Oral and genital
Anterior uveitis
Erythema nodosum (painful red nodules on shin)
Skin and joint problems —- inflammation throughout body
No definitive diagnosis - pathergy test (exaggerated skin injury after minor trauma)
Takayasu’s arteritis
Symptoms
Investigation
Absent radial pulse
Cramping in arm
Right carotid pulse feels week, bruit
Early diastolic murmur (aortic regurgitation)
Female, middle aged
IX. CT angio
Systemic vs diffuse sclerosis
Anti-scl 70 — diffuse cutaneous (widespread skin and viscera)
Anti-centromerere —- limited (scleroderma), CREST
Monitor for renal and pulmonary involvement
Anti-Histone Abx disease associated
Drug induced SLE
PMH diffuse cutaneous systemic sclerosis
Of: severe headache (high blood pressure), acute kidney injury
Scleroderma renal crisis
Mx. ACEi - captopril
High Bp - acute Investigations
Look for end organ damage
Fundoscopy
Urine dip
ECG
Adult onset still’s disease
Fever above 39 on several consecutive days
Transient skin rash
Muscle pain
Lymph node pain
ARTHRALGIA & MYALGIA
Familial Mediterranean fever
Mediterranean person - inherited condition
Genetic, triggers - stress, infection, vigorous exercise
Generalised severe abdominal pain
Febrile episodic
Bilateral hot ankle Rash on —- looks like cellulitis (but bilateral cellulitis is quite rare)
Inflammation - arthritis, pleuritis, peritonitis
Mx. Colchicine
Can result in amyloidosis if not treated
Mx raynaud’s
Nifedipine
Do not give beta blockers as make it worse
Fibromyalgia symptoms and key points
Chronic widespread body pain
Fatigue
Mood
Sleep difficulties
20-40s, females
Co morbid rheum problems
FHx
