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Last EOR exam > Rheum & HEENT > Flashcards

Rheum & HEENT Flashcards

1
Q

Autoimmune multi organ disorder of connective tissue

A

Systemic Lupus Erythematosus- SLE

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2
Q

what are risks of Systemic Lupus Erythematosus- SLE

A

genetic
enviromental- sun exposure, infection, estrogen
drugs- Procainamide, hydralazine, izonide & quinidine

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3
Q

What drugs cause Lupus

A

Procainamide
Hydralazine
Izonide
quinidine

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4
Q

Key terms for this diagnosis- female, joint pian, fever, facial rash, pericarditis, pleuritis, annular erythemic patches
glomerulonephritis, retitinis oral ulcers and alopecia

A

Systemic Lupus Erythematosus- SLE

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5
Q

what is the best initial test for Systemic Lupus Erythematosus-
what is the most specific

A

inital= Anti-necular antibody- ANA
not specific
most specific= anti double stranded DNA & Anti-smith

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6
Q

what test for lupus induced arterial/venous thrombosis

is best

A

Antiphosphlipid antibody syndrome APLS

risk of clots

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7
Q

women with lupus positive for Antiphosphlipid antibody syndrome have an increase for what?

A

Frequent miscarriages

livedo reticulars - purply rash

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8
Q

Treatment for Lupus

A 
Hydroxychloroquine for skin 
sun protection
NSAID's - for joint pain
acetaminophen- for joint pain
cytotoxic drugs- methotrexate, cyclophosphamide
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9
Q

Systemic connective tissue disorder with thickening of the skin, lungs, heart, kidney and GI tract

A

Scleroderma - systemic sclerosis

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10
Q

key terms for this diagnosis- tight shiny thickened skin, calcinosis cutis, raynaud’s, esophageal dysmolity, telangectasia

A 
Scleroderma 
CREST syndrome "limited" 
Calcinosis of the fingers
Raynauds
Esophageal dysmolitiy
Telangectasia
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11
Q

What is the best test for CREST syndrome ?

A

limited scleroderma

Anti-centromere antibody

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12
Q

What is the best test for scleroderma diffuse/multiple organ involvement

A

Anti-SCL-70 antibody

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13
Q

Treatment for acute Scleroderma

A

Steroids

raynaud’s-> vasodilators CCB’s

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14
Q

Autoimmune disease attacking the exocrine glands
slaviary glands leading to xerostoma, lacrimal glands keratoconjunctivitis sicca
parotid enlargement

A

Sjogren’s syndrome

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15
Q

what are secondary causes of Sjogren’s syndrome

A
  1. occurs with other autoimmune diseases

2. Viruses - aggration of lymphocytes

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16
Q

Sjogren’s syndrome has increase risk of what

A

Lymphoma

Non-Hodgkin’s lymphoma

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17
Q

what are the best tests for Sjogren’s syndrome

A

Anti- SS-A RO
Anti-SS-B LA
Schirmer test- decrease tear production

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18
Q

Schirmer test for what ?

A

Sjogren’s syndrome

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19
Q

Treatment for Sjogren’s syndrome

A
  1. artifical tears
  2. pilocarpine (cholinergic) for dry mouth
  3. Cevimeline
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20
Q

Key terms for this diagnosis- widespread muscular pain, fatigue, muscle tenderness, headaches, sleep/memory issues

A

Fibromyalgia

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21
Q

what are the terms to diagnosis Fibromyalgia

A

11/18 trigger points for 3 months

biopsy has “moth eaten” appearance

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22
Q

Treatment for Fibromyalgia

A 
Pregablin * FDA approved 
TCA's 
Amitripilyine 
imiparine 
nortitriptyline
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23
Q

Autoimmune Inflammatory condition causing synovitis, bursitis and tenosynovitis leading to aching/stiffness of proximal joints mainly on neck, shoulder and hips

A

Polymyalgia Rheumatica

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24
Q

Polymyalgia Rheumatica is closely related to what other disease

A

Giant cell arteritis

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25
Q

key terms for this diagnosis- joint pain and stiffness for more than 30mins in the morning
joints that hurt are pelvic, shoulder and hips
No muscle weakness

A

Polymyalgia Rheumatica

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26
Q

Labs for Polymyalgia Rheumatica

A

no specific
ESR +
normochromic nomocytic anemia

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27
Q

autoimmune inflammatory muscle disease of symmetrical proximal limbs, neck and pharynx
usually painless!

A

Polymyositis & Dermatomyositis (PMDM)

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28
Q

Labs positive Polymyositis & Dermatomyositis

A

Aldolase
Creatine Kinase
abnormal EMG
Anti-Jo antibody

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29
Q

what test is specific for Polymyositis

A

Anti-SRP antibody

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30
Q

what test is specific for Dermatomyositis

A

Anti-Mi-2 antibody

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31
Q

Key terms for this diagnosis- heliotrope rash, gottron’s papules, photosensitivie poikiloderma & alopecia

A

Dermatomyositis
heliotropic rash- upper eyelid discoloration
Gottron’s papules- purple knuckles
poikioderma- shawl, V-sign

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32
Q

What is the treatment for Polymyositis & Dermatomyositis

A

Steroids
methotrexate
Azathioprine
Immunoglobin

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33
Q

Chronic inflammatory disease with persistent symmetric joint pain with bone erosion

A

Rheumatoid Arthritis

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34
Q

What is a pannus

and what disease is it seen in?

A

Granulation tissue that erodes into cartilage and bone

Rheumatoid Arthritis

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35
Q

what are risk factors of Rheumatoid Arthritis

A

Females and smoking

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36
Q

What joints are involved in Rheumatoid Arthritis

A 
MCP 
wrist 
PIP 
Knee MTP 
shoulder 
ankle
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37
Q

Key terms for this diagnosis- symmetric joint pain that is worse with pain. lasting >60min in the morning
Boutonniere and Swan neck deformities with ulnar deviation

A

Rheumatoid Arthritis

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38
Q

What is flexion at the PIP, hyperextension of DIP

A

Boutonniere

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39
Q

Flexion at the DIP joint hyperextension at the PIP joint

A

Swan neck deformity

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40
Q

key terms for this diagnosis- RA + slenomegaly + WBC decreased

A

Felty’s syndrome

41
Q

key terms for this diagnosis- RA + pneumoconiosis

A

Caplan syndrome

42
Q

What is the best initial test for Rheumatoid Arthritis

A

Rheumatoid factor

43
Q

What test is most specific for Rheumatoid Arthritis

A

Anti-Citrullinated peptide antibody

44
Q

Anti-Citrullinated peptide antibody is the test for ?

A

Rheumatoid Arthritis

45
Q

What will an x-ray show of Rheumatoid Arthritis

A

narrowed joint space - osteopenia with erosion’s
subluxation
ulnar deviation of the hand

46
Q

Treatment for Rheumatoid Arthritis

A

DMARD’s
Methotrexate
NSAID’s for pain
low does steroid

47
Q

Chronic disease due to articular cartilage damage and degeneration of joint spaces

A

Osteoarthritis

48
Q

key terms for this diagnosis- obese, chronic disease with cartilage damage of knees, hips, cervical, lumbar spine, hip. sclerosis and osteophyte formation
joints pain that gets worse throughout the day and hurts when it gets cold outside

A

Osteoarthritis

49
Q

Key terms for this diagnosis- Heberden’s node, bouchard nodes, narrow joint spaces in knees, hip cervical/lumbar spine

A

Osteoarthritis

50
Q

what is the term for- palpable osteophytes at the DIP joints

A

Heberden’s node’s in Osteoarthritis

51
Q

what is the term for- PIP osteophytes that is noninflammatory arthritis

A

Bouchard nodes in Osteoarthritis

52
Q

Treatment for Osteoarthritis

A

acetaminophen
steroid injections
sodium hyalurontate
glucosamine & chondroitin

53
Q

what are the 3 types of Juvenile Idiopathic Arthritis

A
  1. Pauci-Articular Oligoarticular
  2. Systemic - acute febrile JIA
  3. Polyarticular
54
Q

Key terms for this diagnosis- teenager or child with joint pain in multiple sites - knees, ankles and small joints and eye pain

A

Pauci-Articular Oligoarticular Juvenile idopathic arthritis

55
Q

what eye disorder is associated with Pauci-Articular Oligoarticular Juvenile idopathic arthritis

A

iridocyclitits- anterior uveitis

  • blurred vision
  • eye rendess
  • dark floaters
  • eye pain
56
Q

key terms for this diagnosis- teenager or child with daily arthritis with high fevers with salmon-colored pink rash with koebner phenomenon. heaptosplenomegaly, lymphadenopathy, serositis pedericardial and pleural effusions

A

Systemic Juvenile idiopathic arthritis

57
Q

What labs are postitive in JIA

A

RF + in 15%
ANA
ESR
CRP

58
Q

Treatment for Systemic Juvenile idiopathic arthritis

A

NSAID’s
Steroids
Methotrexate
and frequent eye exams for iridocyclitis

59
Q

Systemic vasculitis of medium/small arteries leading to necrotizing inflammatory lesions
microaneurysms leading to hemorrhage
in the kidneys, CNS and skin

A

Polyarteritis Nodosa = PAN

60
Q

Key terms for this diagnosis- man with History of Hepatitis B or C
with renal filaure, fever, joint pain, loss of vision temporarlly (fugax), numbess or tingling in fingers, livedo reticularis, ulcers, gangrene, raynaud’s phenomenon

A

Polyarteritis Nodosa = PAN

61
Q

What labs are positive in Polyarteritis Nodosa

A

ESR, ANCA negative

Renal or mesenteric angiograhy to look for aneurysms

62
Q

Treatment for Polyarteritis Nodosa

A

Steroids - cyclophosphamide

if hepatitis plasmapharesis

63
Q

Chronic inflammatory arthropathy of the axial skeleton and sacroiliac joints with progressive stiffness

A

Ankylosing spondylitis

64
Q

Key terms with this diagnosis- chronic low back pain in the morning and decreases with movement through out the day, arthritis in the fingers and toes

A

Ankylosing spondylitis

65
Q

The best diagnostic test for Ankylosing spondylitis

what will imaging look like

A

HLA-B27
ESR
bamboo spine- squaring of the vertebral bodies

66
Q

Treatment for Ankylosing spondylitis

A

NSAID’s
Physcial therapy
TNF-alpha inhibitor - Infliximab
Steroids

67
Q

History of HCV

Idiopathic cell-mediated autoimmune response in the mouth

A

Oral Lichen planus

68
Q

key terms for this diagnosis- history of HCV

autoimmune, lacey white lesions in the mouth

A

Oral Lichen planus

69
Q

What are Wickham Striae

A

Lacy white spots in the mouth seen with Oral Lichen planus

70
Q

Treatment for Oral Lichen planus

A

local or oral steroids

71
Q

What are risk factors for oral leukoplakia

A

tobacco
cigareetts
alcohol
dentures

72
Q

key terms for this diagnosis- precancerous hyperkeratosis due to chronic irritation
painless white patches in the mouth that fail to scrape off

A

oral leukoplakia

73
Q

most severe risk with oral leukoplakia

A

squamous cell carcinoma

74
Q

Treatment for oral leukoplakia

A

Cryotherapy

Laser ablation

75
Q

Key terms for this diagnosis- precancerous lesions similar to leukoplakia but with erythema

A

Erythroplakia

76
Q

90% of Erythroplakia ______ cells

A

dysplastic or squamous cell carcinoma

77
Q

what is the cause of oral hairy leukoplakia

A

Epstein Barr Virus

most commonly seen in HIV patients

78
Q

key terms for this diagnosis- painless white plaues alone the lateral tongue boarder that are irregularly shaped with projections
can not be scraped off

A

oral hairy leukoplakia

79
Q

what is the difference between oral leukoplakia and oral hairy leukoplkia

A

OL- chornic irritation, white patches anywhere in the mouth
OHL- EBV virus infected an immunocompent person causing white patches on the sides of their tongue
* both can not be scraped off

80
Q

Treatment for oral hairy leukoplkia

A

self-limiting

antiretrovirals

81
Q

what are common reasons a person has oral candidiasis

A 
systemic immunosuppresion 
HIV 
chemotheray
inhaler  without spacer 
antibiotic use 
dentures
82
Q

Key terms for this diagnosis- Immunosuppressed patient with white spots in mouth that when scraped bleed and leave behind areas of erythema

A

oral candidiasis

83
Q

Best diagnostic test for oral candidiasis

A

Poatassium Hydroxide - KOH = budding yeast wit hhyphae

84
Q

Treatment for oral candidiasis

A

Nystatin*

Fluconazole

85
Q

Key terms for this diagnosis- small round or oval painful ulcers with an erythematous halo

A

Aphthous ulcers - canker sore or ulcerative stomatitis

86
Q

Treatment for Aphthous ulcers

A

Topical analgesics
Topical steroid- Triamcinolone
Cimetidine (H2 antagonist)

87
Q

What is the most common cause of permanent blindness and vision loss in elderly

A

Macular Degeneration

88
Q

What does the macula in the eye do ?

A

Central vision - color vision

89
Q

What are the two types of Macular Degeneration

A
  1. Dry- Atrophic

2. Wet- Neovascular or Exudative

90
Q

Key terms for this diagnosis- gradual blurring of central vision with small round yellow-white spots on the outer retina

A

Dry Macular Degeneration

* Drusens - white spots in the retina

91
Q

What are Drusens

A

White spots in the retina

seen with Dry Macular Degeneration

92
Q

Key terms for this diagnosis- progressive loss of central vision new abnormal vessels grow under central retina which leak and bleed leading to scaring.

A

Wet Macular Degeneration

93
Q

what is more common wet or dry macular degeneration ?

A

Dry is more common and slower

wet is more rare and progresses more rapidly

94
Q

What are s/s of macular degeneration?

A

Gradual
in both eyes- blurry or loss of central vision
scotomas- blind spots
metamorphopsia- straight lines appear bent
micropsia- affected eye objects can appear smaller

95
Q

definition of this term
Scotomas
seen in what condition?

A

Blind spots

macular degeneration

96
Q

definition of this term
metamorphopsia
seen in what condition?

A

straight lines appear bent

macular degeneration

97
Q

definition of this term
micropsia
seen in what condition?

A

affected eye objects can appear smaller

macular degeneration

98
Q

how can you monitior stability of macular degeneration

A

Amsler Grid

99
Q

Treatment for macular degeneration
Dry
Wet

A

Dry- vitamines A, C, E and Zinc can slow progression

Wet- Bevacizumab- stop new vessel growth

Last EOR exam (6 decks)

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