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F3 E2 Shea > 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
Q

Which condition has Boutonniere deformity and Swan neck deformity?

(Boutenniere= DIP extension and PIP flexion, Swan= DIP felxion and PIP extension)

A

RA

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26
Q

Which condition has intermittent daily fevers and arthritis?

A

Systemic Juvenile Idiopathic Arthritis

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27
Q

Is Ankylosing Spondylitis worse in the AM or PM?

Does it improve or worsen w/ activity?

A

AM

IMPROVES w/ activity

28
Q

What condition do you see:

  • Flattening of the normal lumbar curve
  • Exaggeration of the thoracic curve
A

Ankylosing Spondylitis

29
Q

Labs for which condition:

  • Elevation of ESR
  • +HLA B27
A

Ankylosing Spondylitis

30
Q

Bamboo Sign seen on x-ray

A

Ankylosing Spondylitis

31
Q

1st line tx for Ankylosing Spondylitis

A

NSAIDs

32
Q
  • Mono-/polyarthritis
  • Nail pitting
  • Onycholysis
  • Sausage digits
A

Psoriatic arthritis

33
Q

Pencil deformity seen on x-ray

A

Psoriatic Arthritis

34
Q

What is the 1st and 2nd line tx of Psoriatic arthritis

A

1st line- NSAIDs

2nd line- Methotrexate

35
Q

Can’t see (uveitis/conjunctivitis)

Can’t pee (urethritis)

Can’t climb a tree (arthritis)

A

Reactive Arthritis- “Reiters”

36
Q

Is Reactive Arthritis HLA-B27 positive or negative?

A

positive

37
Q

What condition do you see Keratoderma blennorrhagicum?

A

Reactive Arthritis

38
Q

How do you tx Reactive arthritis?

A

NSAIDs

abx for STI

39
Q

Autoimmune disorder in young black women

+ANA

A

SLE

40
Q

MC systemic symptom in SLE?

A

Fatigue

41
Q

Which condition has a Butterfly rash

A

SLE

42
Q

SLE is associated with which vascular phenomenon?

A

Raynauds Phenomenon

43
Q

Diagnostic labs for which condition:

  • +ANA
  • _Anti-dsDNA**_ (high spec and sens)
  • Anti-Sm (high sens)
A

SLE

44
Q

Tx for what condition?

  • Sun protection
  • Hydroxychloroquine
  • NSAIDs/corticosteroids prn
  • etc
A

SLE

45
Q

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

A
  • Antiphospholipid syndrome (can be comorbid w/ SLE)
  • SLE= increased rate of miscarriages, preterm and IUGR
46
Q

What is the name of the Systemic Lupus Erythematosus variant that has:

Inflammation and scarring lesions of the face, neck, etc

A

Discoid lupus

(See Discoid Plaques)

47
Q

Minocycline, Diltiazem and Isoniazid can cause a systemic drug-induced ____

A

Lupus

48
Q

Neonatal Lupus has what 2 things?

A

Congenital heart block

Rash on face: head–> eyes

49
Q

If you have a patient with SLE who is having recurrent pregnancy loss, what comorbid condition should you check for?

A

Antiphospholipid antibody syndrome

50
Q

How do you dx Antiphospholipid Antibody syndrome?

A

One clinical event + Positive antibody blood test (s)

51
Q

What is the tx for Antiphospholipid Antibody Syndrome

A

Warfarin for life

(SQ heparin if preg)

52
Q

What phenomenon is associated with Scleroderma?

A

Raynaud Phenomenon

53
Q

What is first line pharmacologic tx for Raynaud’s phenomenon

A

CCBs

54
Q

CREST syndrome of Limited Scleroderma primarily affects what 2 body parts

A

Face and hands

55
Q

What is the MC type of scleroderma

A

Limited- CREST syndrome

56
Q

Scleroderma:

What is CREST syndrome

A

Calcinosis cutis

Raynaud phenomenon

Esophageal dysfunction

Sclerodactyly

Telangiectasias

57
Q

What is the MC + lab test in CREST Scleroderma

A

+ anti-centromere antibody

58
Q

Is there a cure for Scleroderma?

A

No

monitor for HTN

59
Q

Which condition:

  • Inflammation of striated muscle
  • PAINLESS muscle weakness around neck, shoulders, hips
  • Dysphagia
A

Polymyositis and Dermatomyositis

60
Q

Which condition has the following skin rash:

  • Malar
  • Heliotrope
  • Gottron’s papules
  • Shawl sign
A

Dermatomyositis

61
Q

What is the definitive diagnostic test for Polymyositis and Dermatomyositis?

A

Muscle Biopsy

62
Q

How do you tx Polymyositis and Dermatomyositis? (2)

A

High dose steroids

DMARDS (Methotrexate, azathioprine)

63
Q

Autoimmune disorder that attacks the salivary and lacrimal glands

A

Sjogren syndrome

64
Q

Clinical presentation:

  • Dry mouth (Xerostomia)
  • Dry eyes
  • Enlarged Parotid glands
A

Sjorgen syndrome

65
Q

What is the definitive dx of Sjogren syndrome?

A

Lip Biopsy

66
Q

How do you tx Sjogren syndrome?

A

Symptomatic tx

*Avoid anticholinergics/antihistamines

F3 E2 Shea (14 decks)

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