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MJ- F3 E2: MSK/Rheum > Rheum popcorn 1 > Flashcards

Rheum popcorn 1 Flashcards

1
Q

Is Tophi seen in acute or chronic gout?

A

Chronic

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2
Q

Synovial fluid analysis showing:

  • Monosodium urate crystals
  • Needle shaped
  • Negative birefringent crystals
A

Gout

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3
Q

Punched out (“rat bite”) erosions seen on imaging

A

Gout

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4
Q

1st line tx for Acute Gout?

A

NSAIDs (Indomethacin or Naproxen)

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5
Q

1st line Pharmacologic prophylactic tx for Gout?

A

Allopurinol

(Colchicine also an option)

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6
Q

Where is pseudogout most common?

A

knee

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7
Q

Imaging shows fine, linear densitites in articular tissues

A

Pseudogout

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8
Q

Joint aspiration shows:

  • Calcium Pyrophosphate cystals
  • Rhomboid shaped
  • Positively birefringent
A

Pseudogout

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9
Q

Tx for acute attacks of pseudogout?

A

NSAIDs

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10
Q

Prophylaxis for pseudogout?

A

Colchicine

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11
Q

Heberden’s and Bouchard’s nodes on hands due to osteophyte formation

A

Osteoarthritis

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12
Q

Sxs of what?

  • Insidious onset
  • worse w/ activity
  • relieved w/ rest
  • Stiffness in AM doesnt last longer than 30 min
A

OA

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13
Q

Does NOT spare the spine. What DOES spare the spine

A

Does NOT spare spine= OA

Spares spine= RA

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14
Q

Joint space narrowing and osteophytes seen on x-ray

A

OA

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15
Q

Tx for what?

  • NSAIDs- oral and topical (Diclofenac)
  • Topical Capsaicin
  • Duloxetine
  • etc
A

OA

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16
Q

Which condition spares the spine and SI joints

A

RA

(mainly affects the hands)

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17
Q

What condition is it common to see subcutaneous nodules?

A

RA

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18
Q

What is the most specific blood test for RA?

A

Anti-CCP

(RF is not always positive)

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19
Q

Imaging shows:

  • Early changes: Juxta-articular demineralization, soft tissue swelling
A

RA

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20
Q

What is 1st line tx for RA?

A

NSAIDs for symptomatic relief

1st line DMARD= Methotrexate

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21
Q

T/F: It is safe to take Methotrexate in pregnancy. Why?

A

False. It is teratogenic

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22
Q

T/F: Methotrexate can cause stomatitis

A

True

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23
Q

Which conventional DMARD used to tx RA can cause Pigmentary retinitis so should be followed by optho

A

Hydroxychloroquine

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24
Q

What is the name of the Janus kinase inhibitor that is a biologic DMARD used to tx RA?

Is this tolerated well?

A

Tofacitinib

Works very well and is well tolerated

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25
Which condition has **Boutonniere deformity** and **Swan neck deformity**? (Boutenniere= DIP extension and PIP flexion, Swan= DIP felxion and PIP extension)
RA
26
Which condition has **intermittent daily fevers and arthritis**?
Systemic Juvenile Idiopathic Arthritis
27
Is Ankylosing Spondylitis worse in the AM or PM? Does it improve or worsen w/ activity?
AM IMPROVES w/ activity
28
What condition do you see: * Flattening of the normal lumbar curve * Exaggeration of the thoracic curve
Ankylosing Spondylitis
29
Labs for which condition: * Elevation of ESR * **+HLA B27**
Ankylosing Spondylitis
30
**Bamboo Sign** seen on x-ray
Ankylosing Spondylitis
31
1st line tx for Ankylosing Spondylitis
NSAIDs
32
* Mono-/polyarthritis * **Nail pitting** * **Onycholysis** * **Sausage digits**
Psoriatic arthritis
33
**Pencil deformity** seen on x-ray
Psoriatic Arthritis
34
What is the 1st and 2nd line tx of Psoriatic arthritis
1st line- NSAIDs 2nd line- Methotrexate
35
Can't see (**uveitis/conjunctivitis)** Can't pee (**urethritis**) Can't climb a tree (**arthritis**)
Reactive Arthritis- "Reiters"
36
Is Reactive Arthritis HLA-B27 positive or negative?
positive
37
What condition do you see **Keratoderma blennorrhagicum**?
Reactive Arthritis
38
How do you tx Reactive arthritis?
NSAIDs abx for STI
39
Autoimmune disorder in young black women +ANA
SLE
40
MC systemic symptom in SLE?
Fatigue
41
Which condition has a **Butterfly rash**
SLE
42
SLE is associated with which vascular phenomenon?
Raynauds Phenomenon
43
Diagnostic labs for which condition: * +ANA * _**Anti-dsDNA\*\***_ (high spec and sens) * **Anti-Sm** (high sens)
SLE
44
Tx for what condition? * Sun protection * Hydroxychloroquine * NSAIDs/corticosteroids prn * etc
SLE
45
When it comes to SLE and pregnancy, it is important to monitor for which condition? SLE makes you risk of what 3 things in relation to pregnancy
* Antiphospholipid syndrome (can be comorbid w/ SLE) * SLE= increased rate of miscarriages, preterm and IUGR
46
What is the name of the Systemic Lupus Erythematosus variant that has: **Inflammation and scarring lesions of the face**, neck, etc
Discoid lupus | (See Discoid Plaques)
47
**Minocycline, Diltiazem and Isoniazid** can cause a systemic drug-induced \_\_\_\_
Lupus
48
Neonatal Lupus has what 2 things?
Congenital heart block Rash on face: head--\> eyes
49
If you have a patient with SLE who is having **recurrent pregnancy loss**, what comorbid condition should you check for?
Antiphospholipid antibody syndrome
50
How do you dx Antiphospholipid Antibody syndrome?
One clinical event + Positive antibody blood test (s)
51
What is the tx for Antiphospholipid Antibody Syndrome
Warfarin for life | (SQ heparin if preg)
52
What phenomenon is associated with Scleroderma?
Raynaud Phenomenon
53
What is first line pharmacologic tx for Raynaud's phenomenon
CCBs
54
CREST syndrome of Limited Scleroderma primarily affects what 2 body parts
Face and hands
55
What is the MC type of scleroderma
Limited- CREST syndrome
56
Scleroderma: What is **CREST syndrome**
**C**alcinosis cutis **R**aynaud phenomenon **E**sophageal dysfunction **S**clerodactyly **T**elangiectasias
57
What is the MC + lab test in CREST Scleroderma
+ anti-centromere antibody
58
Is there a cure for Scleroderma?
No monitor for HTN
59
Which condition: * Inflammation of striated muscle * **_PAINLESS_ muscle weakness** around neck, shoulders, hips * **Dysphagia**
Polymyositis and Dermatomyositis
60
Which condition has the following skin rash: * Malar * **Heliotrope** * **Gottron's papules** * **Shawl sign**
Dermatomyositis
61
What is the definitive diagnostic test for Polymyositis and Dermatomyositis?
Muscle Biopsy
62
How do you tx Polymyositis and Dermatomyositis? (2)
**_High dose steroids_** DMARDS (Methotrexate, azathioprine)
63
Autoimmune disorder that attacks the **salivary and lacrimal glands**
Sjogren syndrome
64
Clinical presentation: * Dry mouth (Xerostomia) * Dry eyes * **Enlarged Parotid glands**
Sjorgen syndrome
65
What is the definitive dx of Sjogren syndrome?
Lip Biopsy
66
How do you tx Sjogren syndrome?
Symptomatic tx \*Avoid anticholinergics/antihistamines

MJ- F3 E2: MSK/Rheum (7 decks)

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