Rheum/MSK Part 2 Flashcards
Systemic Sclerosis
Limited Cutaneous, what is the most common bad pathology?
Pulmonary Hypertension
Limited Cutaneous Systemic Sclerosis -> CREST syndrome
Systemic Sclerosis
What is the most common long term disease with diffuse cutaneous systemic sclerosis?
Interstitial Lung Disease
Scleroderma Renal Crisis
With reference to knee pain?
Lateral Knee pain reprodued on palpitation, flexion and extension of knees?
IT band syndrome
With reference to knee pain
What anterior knee pain can be reproduced with squatting?
Patellofemoral Syndrome
Back pain with these features, what is the next step?
Recent UTI
Age > 50
Noctural Pain
MRI Lumbar Spine
Concern for Vetebral osteomyelitis, need blood cultures
Systemic Sclerosis
What long term disease consequence occurs with limited cutaneous systemic sclerosis?
Pulmonary Hyptertension
Systemic Sclerosis
What GI condition can occur that can cause recurrent bleeding and chronic anemia?
Gastric Antral Vascular Ectasia (GAVE or “watermelon stomach”)
Systemic Sclerosis
If a patient has active alveolitis or rapidly progressive interstitial lung disease, what is the treatment?
Cyclophosphamide
Sjogren Syndrome
What is the gold standard to diagnosis?
Lip Biopsy
Systemic Sclerosis
Where does Limited Cutaneous appear?
Where does Diffuse Cutaneous appear?
Limited: Mostly Fingers
Diffuse: Trunk and Proximal Limbs
Systemic Sclerosis
What subtype is assoicated with CREST syndrome?
Limited Cutaneous Systemic Sclerosis
Complex Regional Pain Syndrome
What will be seen on an XR?
Patchy Bone Demineralization
What disease process has the following:
Neuropathic Pain
Autonomic Dysfunction
Swelling
Dystrophy (Hail loss, skin thinning, ulcers)
Movement disorder
Complex Regional Pain Syndrome
Bisphosphonates can treat non-osteoporosis pain
Rheumatoid Arthritis
What treatment is mild to moderate?
What treatment is moderate to severe?
Mild to Mod: Sulfasalazine and Hydroxychloroquine
Mod to Severe: Methotrexate
What MSK disease has the following concern?
When a needle is inserted, a papule > 2mm develops within 24-48 hours in the same area?
Behcet Disease
The description is a positive pathergy test
What disease treatment is needed?
PMHx of RA or Gout, arthrocentesis has WBC 3-5k, fever, redness, or inflmmation
Anti-staph antibiotics (concern for septic bursa)
Can the following medications be used together for RA treatment?
Hydroxychloroquine
Sulfasalazine
Methotrexate
Yes, this regimen is more effective than monotherapy with methotrexate or sulfasalazine plus hydroxychloroquine
What medication class can have the following side effects?
Pancytopenia
positive ANA formation
positive Lupus-Like Syndrome
Demyelinating Disorder
TNF alpha inhibitor therapy
If a patient’s RA is not responding to methotrexate, what is the first biologic medication?
Tofacitinib
Osteoarthritis has two variants, what are they?
Erosive OA
DISH
What is the following:
Asymptomatic for of OA, similar to degenerative spondylosis or ankylosing spondylitis, ossification of the anterolateral aspect of the vertebral bodies, particulary anterior longitudinal ligament, more than 4 contiguous vertebrae. No disk-space narrowing nor syndesmophytes are visibile
DISH (Diffuse Idiopathic Skeletal Hyperostosis)
Hypertrophic osteoarthropathy has what unique physical exam finding?
Pain is alleviated by elevating the affected limbs
If a patient has an explosive onset or severe flare up of psoriatic arthritis, what type of testing should be done?
HIV testing
NSAID, antimalarial drugs, and oral steroid withdrawl may exacerbate what autoimmune disease?
Psoriasis
What cardiac symptoms can be seen in Ankylosing Spondylitis?
Aortic Valvular Regurgitation, Aortic Aneurysm, and cardiac conduction defects
What medications are used to treat primary Raynaud Disease?
Nifedipine
Amlodipine
Felodipine
Sildenafil
Nitroglycerin Paste
What medications are the first line therapy for gout?
NSAIDs
Colchicine
Steroids
Should Colchicine be used in kidney failure?
No
A patient has a gout flare:
When should a uric acid level be done and allopurinol restarted?
2 weeks after gout
Aspirin, loop diuretics, and HCTZ can cause an increase in what MSK condition?
Gout
A patient’s knee starts to hurt
What is this and the disease association?
Calcium Pyrophosphate Depostion (Pseudo-gout)
Chondrocalcinosis
Polymyalgia rheumatica is painless or painful?
Polymyositis is painless or painful?
Polymyalgia Rheumatica -> painful, strength is intact
Polymyositis -> painless, strength is diminished
What disease process has the following concerns:
Barbotage and Ultrasound guided lavage is done in order to help alleviated calcified tendons?
Calcific Tendonitis
What is the following
Repetive Bone/Joint Trauma secondary to a neuropathy (usually diabetes), patient has persistent foot/ankle pain, what could this?
Charcot Arthropathy
Tx: Foot Cast and offload weight bearing
An immunocompromised patient develops Tinea Corpis (fungal infection of body, not groin), how should this be treated?
Oral Terbinafie, itraconazole, or fluconazole
What type of infection has a culture treated with potassium hydroxide that shows branching hyphae?
Tinea Infection
