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Rheumatology > Rheum final review pt3 > Flashcards

Rheum final review pt3 Flashcards

1
Q

NY 1984 Criteria for Ankylosing Sponylitis:

A
  1. **Low back pain and stiffness for more than 3 months that improves with exercise, but is not relieved by rest (this shows it’s an inflammatory-type)
  2. Limitation of motion of the lumbar spine in both the sagittal and frontal planes
  3. Limitation of chest expansion relative to normal values correlated for age and sex (b/c costal junctions may be fused)
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2
Q

Nondrug therapy for Spondyloarthropathies

A

sx improves with exercise

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3
Q

infectious organisms in GI (1), GU (4) that lead to reactive arthritis:

A

GU: Chlamydia trachomatis
GI: SHIGELLA, SALMONELLA, CAMPYLOBACTER, YERSINIA

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4
Q

Classic triad of Reactive Arthritis

A

ARTHRITIS
UVEITIS/CONJUNCTIVITIS
URETHRITIS
(can have 2 of 3 though)

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5
Q

of fishing trip with subsequent Campylobacter and resultant ___

A

Reactive Arthritis

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6
Q

Pattern associated w/ IBD-Associated Arthritis (Crohn’s, UC) (a little bit different) (2)

A

Arthritis may precede GI tract symptoms

Can occur in a peripheral axial joint pattern or mixed pattern

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7
Q

Skin and nail findings in Psoriatic Arthritis (5)

A

skin/nail: Nail pitting, Onycholysis (transverse ridging), Dactylitis of the second toe, sausage digits & rash,

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8
Q

Distinguishing x-ray finding of Psoriatic Arthritis

A

*Psoriatic Arthritis has both erosive component & an overgrowth of bone

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9
Q

GI complaints can be in any type of __

A

arthritis

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10
Q

Genetic association of Spondyloarthropathies:

A

HLA-B27

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11
Q

HLA-B27 is a key genetic factor to test for in:

A

AS

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12
Q

Avg age of getting Crystal-induced arthritis

A

75-80 years old

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13
Q

Gout vs Pseudogout crystals

A

Gout: Uric acid crystal
Pseudogout: calcium pyrophosphate

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14
Q

1 in 4 patients develop gout who have ___

A

hyperuricemia

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15
Q

What is the mechanism for Gout?

A

Hyperuricemia with elevated serum uric acid (uric acid pool)

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16
Q

2 key clinical sx of Acute Gout

A

acute monoarticular arthritis with crystal deposition

17
Q

What x-ray finding is an overlap between OA and RA?

A

Subchondral cyst formation

18
Q

The 3 ways you do x-rays in Rheumatology:

A

weight-bearing
standing
bilateral

19
Q

What is a prognosticator for anterior uveitis (with Juvenile Rheumatoid Arthritis)?

A

ANA positive

20
Q

4 control points of FMS:

A

Mid-forehead
Thumbnail
Volar surface of mid-forearm
Anterior mid-thigh

21
Q

a key sx of FMS is ___ sleep

A

Non-restorative

22
Q

Name the 4 big types of Spondyloarthritis

Which is prototypical?

A

Ankylosing spondylitis (AS)* - Prototypical
Psoriatic arthritis (PSA)* - primarily in spine, not in peripheral joints
Reactive arthritis (ReA)* - caused by infxn
Inflammatory Bowel disease (IBD) associated arthritis*
Crohn’s disease
Ulcerative colitis

23
Q

If a patient has Advanced Sacroilitis (late stage ankylosing spondylitis), don’t ever _____.
Do what instead?

A

Don’t ever inject the tendon.

Put on NSAIDs

24
Q

What is the tx for Reactive Arthritis? (if they can handle it)
Why wouldn’t they be able to handle it?

A

Full dose NSAIDs

Won’t tolerate if: Salmonella or other GI acute ill infxn

25
Q

Psoriasis

5 most common sites of skin involvement

A 
Elbows
Knees
Behind ear
Umbilicus
Gluteal cleft
26
Q

Lupus big car scenario:

A

Lupus is an Autoimmune complex – body recognizes nucleus of cell as foreign. Then a whole bunch of autoimune antibiotics attack & make very large proteins. So these are like big trains with big cars. These big protein immune complexes get stuck in areas that transfer fluid from one space into another. So the kidney (nephritis), BBB, skin (through diff mechanism), lung pleura (fluid in pleural space), lining of heart (pericarditis). We don’t know why it happens

27
Q

What distinguishes the Malar rash of SLE from Rosacea?

A

SLE malar rash does not spare nasolabial folds*

28
Q

The main medication for SLE is:

A

Hydroxychloroquine (Plaquenil)

29
Q

Limited vs systemic/diffuse Scleroderma

A

Above elbow crease or knee crease = diffuse, systemic.

30
Q

CREST Syndrome is a variant of ____. What does it stand for?

A

Scleroderma.

calcinosis
raynaud’s
esophageal dysmotility
sclerodactyly
telangestasia
31
Q

The 2 key phys exam symptoms of Sjorgen’s Syndrome

A

Dry eye, dry mouth

32
Q

What is the unique, symptom of Myositis?

A

WEAKNESS in proximal muscles (not pain or stiffness, but weakness)

33
Q

Name 2 common autoantibodies found in Myositis

A

Anti-PM-Scl

Anti-Jo-1

Rheumatology (3 decks)

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