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Step 2 > Rheum/Derm > Flashcards

Rheum/Derm Flashcards

1
Q

Uricosuric agents and allopurinol toxicity

A

Hypersensitivity- rash, hemolysis, allergic interstitial nephritis

SJS, toxic epidermal necrolysis

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2
Q

Colchicine toxicity

A

Diarrhea

Supression of WBC production

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3
Q

Older, slow worse with use

DIP, PIP, hip, and knee joints affected

A

Osteoarthritis

Dx:
<200 WBC in synovial fluic

X-ray: osteophytes and narrowing of joint space

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4
Q

Men, acute, associated with over-eating and binge drinking

1st big toe affected

A

Gout

Dx:
2000-50000 WBC
Negatively biofringent needles

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5
Q

Hemachromatosis
Hyperparathyroidism

Wrist and knees

A

CPPD

Dx:
2000-50000 WBC
Positively biofringent rhomboids

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6
Q

Young female with morning stiffness that improves with use

Multiple joints of hands and feet

A

RA

Anti-cyclic citrulinated peptide (anti-CCP)

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7
Q

High fever, very acute

single joint affected

A

Septic arthritis

Dx:&raquo_space;50000 neutrophils, culture fluid

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8
Q

Back pain
History of cancer
PE: vertebral tenderness, sensory level, hyperreflexia

A

Cord compression

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9
Q

Back pain
Fever
High EST
PE: vertebral tenderness, sensory level, hyperreflexia

A

Epidural abscess

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10
Q

Back pain
Bowel/bladder incontience
Erectile dysfunction
PE: bilateral leg weakness, saddle area anesthesia

A

Cauda equina syndrome

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11
Q

Back pain
Male under 40yo, pain worsens with rest and improves with activity
PE: decreased mobility in chest

A

Ankylosing spondylitis

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12
Q

Back pain
Pain and numbness of medial calf or foot
PE: loss of knee and ankle reflex, positive straight leg raise

A

Disk herniation

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13
Q

Anti-TNF AE

A

Reactiviation of tuberculosis

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14
Q

Hydroxychoroquine AE

A

Ocular

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15
Q

Sulfasalazine AE

A

Rash and hemoptysis

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16
Q

Rituximab AE

A

Infection

17
Q

Gold Salt AE

A

Nephrotic syndrome

18
Q

Methotrexate AE

A

Liver, lung, BM

19
Q

Young person
High spiking fevers (104)
Rash-salmon colored on chest and abdomen

Splenomegaly
+/- pericardial effusion
+/- mild joint symptoms

A

JRA

Dx:
anemia 
hypoalbuminemia
leukocytosis 
Ferritin markedly elevated

Tx: NSAID - steroids- anti-TNF

20
Q

Cancers associated to with dermatomyositis

A

Ovary
Lung
GI
Lymphoma

21
Q

Diagnosis of Poymyositis or dermatomyositis

A

Initial tests: CPK and aldolase
Accurate test: Lung bx

Anti-Jo associated with lung fibrosis

22
Q

Diagnosis of Sjogren

A

Initial- Schrimer test (filter paper)
Accurate- lip or parotid gland biopsy

Initial blood test- SS-A (Ro) and SS-B (La)

Evaluate for lymphoma

23
Q 
Glomerulonephritis 
Foot drop 
Stroke in a young person 
Abdominal pain worse with eating 
Lower extremity ulcers
A

Polyarteritis nodosa

Dx:
Most accurate- bx of symptomatic site

Angiography of renal, mesenteric, hepatic artery- beading
p-ANCA <20% (anti-myeloperoxidase Ab)

Tx: prednisone and cyclophosphamide

24
Q

URI: sinusitis, otitis media, mastoiditis, oral or gingival involvment
Lower respiratory tract infections
Renal insufficiency

A

Wegner’s (granulomatosis with polyangitis)

Dx:
Best initial - c-ANCA (anti-proteinase 3 Ab)
Accurate: Bx Lung>Renal>Sinus

Tx: prednisone and cyclophosphamide

25
Q

Lung disease
Renal disease
Asthama
Eosinophilia

A

Churg-Strauss

DX: p-ANCA, bx

Treat: prednisone and cyclophosphamide

26
Q 
Kiddo 
GI- pain bleeding intususseption 
purpura 
arthralgias 
hematuria
A

Henoch-Schnolein

Clinical dx, bx most accurate- leukoclastic vasculitis

Resolve spontaneously, steroids if severe

27
Q 
Hepatitis C:
Joint pain
Glomerulonephritis 
Purpuric skin lesions 
Neuropathy
A

Cryoglobulinemia- IgM Ab

Dx: positive RF factor and cold precipitable immune complexes

No use in steroids, treat underlying cause- HCV

28
Q

Septic arthritis etiology

A
  1. Staph
  2. Strep
  3. Gram -ve rods

Empiricially treat with ceftriaxone and vancomycin

29
Q

Prosthetic joint infection

A

Lucency around implantation of joint on imaging
Joint is physically loose

Treat: remove the joint, treat with abx for 6-8 weeks, replace joint

Recently placed joint with infection = s. epi

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