Rheum Popcorn 2 Flashcards
Who gets osteoporosis most commonly?
Postmenopausal white women
How is fx risk determined in osteoporosis?
FRAX tool
Risk factors for what?
- Previous low trauma fx
- Chronic Glucocorticoids
- RA
Osteoporosis fracture risk
Gold standard for dx of osteoporosis?
Duel-energy x-ray absorptiometry (DEXA) scan
What T-score is diagnostic for oosteoporosis
< -2.5
What is the best non-pharmacologic tx for osteoporosis
Exercise
1st line tx for osteoporosis?
Vit D and calcium
Bisphosphonates
Biphosphonates are contraindicated in what condition
CKD
Black box warning for biphosphonates?
ONJ
T/F: sex hormone replacement is appropriate therapy for osteoporosis?
FALSE
What is the MC complication of Osteoporosis? How do you monitor?
Vertebral fx
Monitor for height loss
Dx of what condition:
- Chronic wide spread pain for >6wks
- All 4 quadrants of the body
- 11/18 tender points
Fibromyalgia
What is the only treatment option for Fibromyalgia that has evidence for helping with FM pain?
Exercise
Tx for Fibromyalgia?
Exercise
Amitryptyline
(NO OPIOIDS)
Systemic findings
+
Lung and kidney findings`
Vasculitis syndromes, AKA Vasculitides
Which condition is MC in F>50y/o and is assoc. w/ Giant cell arteritis
Polymyalgia Rheumatica
(large vessel disorder)
Stiffness/aching in neck, shoulder and pelvic girdle but NO weakness
Polymyalgia Rheumatica
How you you dx Polymyalgia Rheumatica?
Clinical
How do you tx Polymyalgia Rheumatica?
Low dose Prednisone
(should respond w/in 72 hrs)
Polymyalgia Rheumatica:
- NO muscle weakness like ______ and _____
- Does NOT cause blindness like ______
- Responds to low dose prednisone, where _____ requires high dose
- NO muscle weakness like Polymyositis and Polyarteritis nodosa
- Does NOT cause blindness like Temporal Arteritis
- Responds to low dose prednisone, where TA requires high dose
Necrotizing inflammation of med and sm arteries w/o GN
NO lung involvement
Polyarteritis Nodosa
MC organ affected in Polyarteritis Nodosa?
Skin
(Livedo reticularis, subcutaneous nodules, skin ulcers, distal gangrene)
What is the preferred dx of Polyarteritis Nodosa?
Tissue bx of involved organ
Is polyarteritis Nodosa ANCA pos or neg?
Neg
How do you tx Polyarteritis Nodosa?
High dose Corticosteroids
Which dz?
- Boys <5y/o
- Strawberry tongue
- Severe diaper rash
- F >5d
Kawasaki Dz
What are pts w/ Kawasaki Disease at high risk for
Coronary Aneurysm
How do you tx Kawasaki Disease
High dose ASA
IVIG
Triad of what condition?
- Upper resp
- Lower resp
- Kidney (glomerular nephritis)
Granulomatosis w/ Polyangitis
What imaging is preferred in Granulomatosis w/ Polyangitis?
CT
The following is commonly seen in what condition
- Nasal cong
- OM
- Sinusitis
- Mastoiditis
- Gingivitis
- Stridor
(MIld, benign Resp sxs that don’t get better w/ tx)
Granulomatosis w/ Polyangitis
How do you tx Granulomatosis w/ Polyangitis?
Cyclophosphamide + Corticosteroids
OR
Rituximab + Corticosteroids
What is the MC associated condition w/ Eosinophilic Granulomatosis?
Asthma
What is the gold standard for Dx of Eosinophilic Granulomatosis w/ Polyangitis
Lung Biopsy
How do you tx Eosinophilic Granulomatosis w/ Polyangitis
Systemic Glucocorticoids
What is the MC systemic vasculitis in children?
IgA Vasculitis (“Henoch Schoenlein Purpura)
- Acute onset fever
- Palpable purpura on LE and buttocks
IgA Vasculitis
What is the tetrad for IgA Vasculitis? (A GAP)
- Purpura
- Arthritis
- Glomerulonephritis
- Abdominal pain
“Big 3” of Which condition:
- LE purpura
- Arthritis in knees and ankles
- Hematuria
IgA Vasculitis
What is the prognosis and tx of IgA vasculitis
Self-limiting
Tx: supportive, analgesics, low-dose steroids
Which condition is MC in 20-40y/o Mediterraneans
Behcet’s Syndrome
Recurrent, painful mucocutaneous ulcers of mouth and genitals
Behcet’s Syndrome
Pathergy phenomenon is associated with which syndrome?
Behcet’s syndrome
1st line tx for Behcet’s Disease
Prednisone
