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ICM Infectious Disease > Rheum in STEP 1 Book > Flashcards

Rheum in STEP 1 Book Flashcards

1
Q

What happens to joints in Osteoarthritis?

A

Wear and tear destroys articular cartilage

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2
Q

What does Osteoarthritis look like in patients?

A

Sclerosis, bone spurs, Heberden nodules in DIPs, Bouchard nodes (PIP), no MCP involvement

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3
Q

What can predispose for osteoarthritis?

A

Age, obesity, and joint trauma

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4
Q

What should trigger you to an Osteoarthritis case?

A

Pain in weight bearing joints, cartilage loss begins medially, noninflammatory

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5
Q

How do you treat Osteoarthrits?

A

Acetaminophen
NSAIDS
Intra-articular glucocorticoids

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6
Q

What causes RA?

A

Autoimmune reaction mediated by cytokines and type 3 and 4 hypersensitivity reactions

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7
Q

What do the joints look like in RA?

A

Pannus formation
Subcutaneous rheumatoid nodules
Ulnar deviation of fingers
Swan neck and Boutonniere deformities

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8
Q

RA has strong association with HLA what?

A

HLA DR4

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9
Q

Patient key characteristics that can help focus in on RA?

A

Morning stiffness more than 30 minutes
Systemic symptoms
Symmetric joint involvement

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10
Q

Treatment for Rheumatoid Arthritis?

A

NSAIDS
Glucocorticoids
TNF-a inhibitors

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11
Q

Sjogren’s syndrome destroys what?

A

Exocrine glands such as salivary and lacrimal with lymphocytic infiltration

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12
Q

What primary disorder can Sjogren’s be associated with?

A

RA

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13
Q

Complications of Sjogren’s?

A

Dental carries
Lymphoma (parotid enlargement)
Mucosa associated Lymphoid Tissue (MALT)

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14
Q

Patient findings in Sjogren’s?

A

Inflammatory joint pain
Decreased tears or saliva
Antinuclear antibodies SS-A SS-B
Bilateral parotid enlargment

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15
Q

What crystal causes gout?

A

Monosodium urate crystals

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16
Q

What two things can cause hyperuricemia?

A

Underexcretion

Overproduction

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17
Q

Which is the more likely cause of hyperuricemia?

A

Underexcretion

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18
Q

Shape and color of gout crystals?

A

Needle shaped and yellow under parallel light, blue under perpendicular. - birefringent

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19
Q

Symmetric or asymmetric in gout?

A

Asymmetric

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20
Q

Classic manifestation of Gout?

A

Swollen, red, and painful MTP joint of big toe

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21
Q

In Gout tophi normally form where?

A

External ear, olecranon bursa, or Achilles tendon

22
Q

Interaction between uric acid metabolism and alcohol?

A

Alcohol metabolites compete for same excretion sites in kidney as uric acid which leads to acid buildup in blood

23
Q

Treatment for Gout?

A

NSAIDS
Glucocorticoids
Xanthine oxidase inhibitors

24
Q

What crystals are involved in Psuedogout?

A

Calcium pyrophospahte

25
Q

Which joint does Pseudogout normally hit?

A

Knee in those older than 50

26
Q

What color are Pseudogout crystals?

A

Blue when parallel to the light

27
Q

Disease associated with Psuedogout?

A

Hemochromatosis
Hyperparathyroidism
Osteoarthritis

28
Q

Treatment for Pseudogout?

A

NSAIDS
Glucocorticoids
Colchicine for prophylaxis

29
Q

Common causes for infectious arthritis?

A

Staph aureus
Streptococcus
Neisseria gonorrhoeae

30
Q

How does Gonococcal arthritis present?

A

Migratory arthritis with asymmetric pattern

31
Q

3 main symptoms of Gonococcal arthritis?

A

Synovitis (Knee)
Tenosynovitis (Hand)
Dermatitis (Pustules)
(STD mnemonic)

32
Q

What are seronegative spondyloarthropathies?

A

Arthritis without RF, strong association with HLA B27 that occurs more often in males

33
Q

What gene is coded for by HLA B27?

A

MHC Class 1

34
Q

Diseases that fall into the category of Seronegative spondyloarthopathies? (PAIR mnemonic)

A

Psoriatic arthritis
Ankylosing Spondylosis
Inflammatory Bowel Disease
Reactive Arthritis (Reiter’s Syndrome)

35
Q

What does Psoriatic Arthritis present as?

A

Asymmetric and patchy involvement

Sausage fingers

36
Q

Anylosing spondylosis presents as?

A

Chronic inflammatory disease of spine and sacroiliac joints, Stiff spine, vertebral fusion, uveitis, aortic regurgitation

37
Q

Inflammatory bowel disease presents as?

A

Inflammatory diseases such as Chron’s disease and ulcerative colitis often accompanied by ankylosing spondylitis or peripheral arthritis

38
Q

Classic triad of Reiter’s Syndrome? (Can’t see, can’t hear, can’t bend my knee”)

A

Conjunctivits
Urethritis
Arthritis

39
Q

What can trigger Reiter’s syndrome ?

A

Post-GI infection

40
Q

Classic presentation of SLE?

A

Rash, joint pain, and fever

41
Q

What type of hypersensitivity reaction is SLE?

A

Type 3

42
Q

Common causes of death in SLE?

A

Cardiovascular disease (Wart like vegetations on heart valves)
Infections
Renal disease

43
Q

Anti-dsDNA antibodies in SLE say what?

A 
Poor prognosis (renal disease)
Specific
44
Q

Antihistone antibodies sensitive for what?

A

Drug induced lupus

45
Q

Immune complex formation causes what changes to complement?

A

Decrease in C3, C4, and CH50

46
Q

How to you treat SLE?

A

NSAIDs
Steroids
Immunosuppressants
Hydroxychloroquine

47
Q

What is Antiphospholipid syndrome?

A

Primary or secondary autoimmune disorder most commonly in SLE

48
Q

What lab findings are there in Anti-phospholipid syndrome?

A

Lupus anticoagulant
Anti-cardiolipin
Anti-B2 glycoprotein antibodies

49
Q

How do you treat Anti-phospholipid syndrome?

A

Systemic anticoagulation

50
Q

Anticardiolipin and Lupus anticoagulant can cause what?

A

False positive VDRL and prolonged PTT

51
Q

RASH OR PAIN mnemonic for SLE?

A 
Rash
Arthritis
Soft Tissues
Hematologic disorders
Oral/nasopharyngeal
Renal Disease, Raynaud's
Photosensitivity, Positive VLDR
Antinuclear antibodies (ANA)
Immunosuppresents
Neurologic disorders

ICM Infectious Disease (19 decks)

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