Rheum and Derm

Question 1

interpret this arthrocentesis:

clear fluid, 1500 WBCs, negative gram stain

Answer 1

NORMAL. <2000WBCs is normal.

either a normal join or osteoarthritis

Question 2

Mnemonic for drugs that induce lupus: SHIP

Answer 2

Sulfasalazine
Hydralazine
Isoniazid
Procainamide
Statins

Question 3

if arthrocentesis shows septic joint (WBC>50,000) but gram stain doesn’t show anything, what is next step?

Answer 3

get chocolate agar culture and/or nucleic acid amplification test for GONORRHEA (even tho it’s gram neg, a lot of times it doesnt show up at all on gram stain)

Question 4

antihistone antibody

Answer 4

drug induced lupus

Question 5

most specific antibody for RA

Answer 5

CCP (Anti-cyclic citrullinated peptide)

RF is not specific! it’s sensitive.

Question 6

ds-DNA antibody

Answer 6

specific for lupus + renal involvement

Question 7

ANA is sensitive for lupus but what is specific?

Answer 7

ds-DNA ab

Question 8

smooth muscle antibody

Answer 8

autoimmune hepatitis

Question 9

mitocondrial antibody

Answer 9

Primary biliary cirhosis

Question 10

anti-centromere ab

Answer 10

scleroderma CREST

Question 11

anti Scl-70 (topoisomerase)

Answer 11

systemic scleroderma (CREST+)

Question 12

anti-Jo1 ab

Answer 12

polymyositis

Question 13

if arthrocentesis shows >50,000 WBCs, it’s septic joint regardless. but if it’s <50k but still high, how can u differentiate between inflammatory or septic? (2 ways)

Answer 13

1. gram stain, obvis if something grows it’s septic

2. %PMNs. 50-75% is inflammatory. >75% is septic

Question 14

what is Felty syndrome?

Answer 14

also known as ‘‘super rheumatoid’’ disease, is a severe form of rheumatoid arthritis (RA), characterized by a triad of

1. RA,
2. splenomegaly and
3. neutropenia, resulting in susceptibility to bacterial infections.