rheumatoid arthritis Flashcards
how do you diagnose the myositis?
proximal muscle biopsy, anti Jo-1
what complication are you concerned about for the myositis?
malignancy
what is the schober test for?
ankylosing spondylitis
scleroderma patients w/ dyspnea on exertion diagnosed w/ diffuse are most likely to have what?
pulmonary fibrosis
treatment for raynaud’s?
cold avoidance and CCB
a 6 y/o that’s ANA positive and 4 painful joints presents to the clinic, what is the treatment?
send to optho for iritis
what is the MC inflammatory arthritis?
rheumatoid arthritis
what category of systemic sclerosis is associated w/ pulmonary hypertension?
limited
common drugs that affect gout?
HCTZ, niacin, ASA, alcohol
what lab is assocaiated w/ psoriatic arthritis?
uric acid
first line treatment for ankylosing spondylitis?
NSAIDS, refer cardiology and ophthamology
what is MC presenting feature of polymyositis and dermatomyositis?
muscle weakness, but no pain
what are the genetic risk factors in sjogren’s?
anti-ro and LA, hypergammaglobinemia IgG
what do you give as treatment to avoid blindness in giant cell arteritis?
low dose aspirin
what does CREST stand for?
Calcinosis cutis Raynauds syndrome Esophageal dysmotility Sclerodactyly Telangectasis
what genetic risk factor is associated w/ limited sclerosis?
anti-centromere
mother positive for SSA/ SSB what are you concerned the baby will have?
heart block in
31 y/o shows up with new onset raynauds what do you do?
ANA and naifold capillary exam
what disorder is improved by exercise but not improved by rest?
ankylosing spondylitis
what is the most important complication of sjogren’s?
lymphoma
what is the MC form of chilhood arthritis?
juvenile idiopathic arthritis (oligoarticular?)
who is behcet’s syndrome common in
young adults 25-35, turkish, middle eastern, asian
renal crisis is commonly associated w/ what disease and what is the treatment?
systemic sclerosis, ACEI
fibromyalgia is primarily manifested by what?
diffuse pain and fatigue
what groups do the myositis affect?
proximal muscle groups symmetrically
you have a woman that’s 30 y/o that comes into the ER w/ rheumatoid arthritis and complains of chest pain what should you do?
work up for MI because the rheumatoid predisposes you to younger cardiovascular disease
which of the lupus are most sensitive to photosensitive?
subacute cutaneous
a pateitn presents w/ a rash on their face and hands, but the hands spare the extensor surfaces, what does this person have?
actue cutaneous lupus
what is the most common heart defect associated w/ ankylosing spondylitis?
1st degree AV block
someone 25-35 of turkish or middle eastern descent w/ a vasculitis issue would most likely have this genetic risk factor?
HLA-B51
what is the MC presenting feature of SLE?
arthritis
what is the schirmer test associated w/?
sjogren disease
what is the treatment for the myositis?
high dose corticosteroid
what will be positive in a patient with drug induced lupus?
anti-Histone
what category of systemic sclerosis is associated w/ intersitital lung disease and pulmonary fibrosis?
diffuse
what is the treatment for takyasu?
high dose prednisone
what are the signs that are associated w/ the dermatomyositis?
heliotrope rash, shawl sign, gottron’s sign, mechanics hands
scleroderma patients w/ dyspenea on exertion diagnosied w/ limited are most likely to have what?
pulmonary HTN
a woman presents presents w/ symmetric joint pain that spares the DIP, fever, anemia, dry mouth and dry eyes, what does she have and what is the best treatment?
rheumatoid arthritis with extraarticular sjogren syndrome, methotrexate, w/ NSAID/corticosteroid bridge. also make sure that the person stays active
people with sjogrens are at an increased risk for what?
lymphoma
what is the prognosis for systemic sclerosis?
18-24 months, then it starts to get better
what are the genetic risk factors for lupus?
ANA, anti-Sm, anti-dsDNA, SSA, SSB, anti-histone, decreased compliment during flare
what does psoriatic arthritis mimic?
RA, but RF negative
<7 y/o female complains of pain in <=4 joints that the parents though initially thought was growing pains, but it isnt in the joint. What lab would you test, what complication are you worried about, and what is the diagnosis?
ANA, iritis, oligoarticular JIA
when do you start treatment with DMARDS for patient with rheumatoid arthritis?
immediately
anti-ro is what?
SSA
if anticentromere is negative which scleroderma is it unlikely to be?
diffuse
what group of people are associated w/ systemic scleosis?
choctaw indians
what will show for lupus nephritis?
proteinuria/hematuria
what is the age group for oligoarticular arthritis?
1-7 y/o and <4 joint groups
what do you need to test for before give a biologic DMARD?
TB, hep B, C, lymphoma
what is the treatment for all the spondyloarthropathies except for enteropathic?
nsaid
who do we not give corticosteroid to?
scleroderma because of renal crisis
what drugs will cause a drug induced lupus?
chlorpromazine, methyldopa, hydralzine, procainamide, isoniazid, quinidine
what do patients w/ scleroderma need to have as part of their diagnosis?
raynauds
scaly erythematous annular rash that spares the face, located on torso and limbs. they were in the sun and then the rash came, what lab would you expect them to be positive for?
anti-Ro SSA
what is the MC type of vasculitis in adults?
giant cell arteritis`
when I get cold my hands will become red, then white, then blue, within 1 year I developed rapid changes in skin texture, w/ sever arthralgia, weight loss, and tendon friction rubs. I also have dyspenea and hypertension?
diffuse scleroderma
what is the hallmark of bechet?
panful apthous ulcers
if somebody has polymylagia rheumatica what should you be considering and why?
giant cell arteritis because of the risk of vision loss
what has the strongest association w/ raynauds phenomenon?
systemic sclerosis
how long do you need to have back pain for ankylosing spondylitis?
> 3 monts
what does hla dr3 cause?
lupus and sjogren
what is the genetic risk factor for behcet’s?
HLA-B51
what is the age group for seronegative polyarticular JIA?
8-12 y/o
what is the MC patten or psoriatic arthritis?
asymmetric oligoarthritis or hands and feet
what genetic risk factor is associated diffuse sclerosis?
Scl 70
what is associated w/ arteries and veins and all 3 sizes of vessels?
behcet
what is a common sign of psoriatic arthritis?
nail pitting, pencil in cup
what is the leading cause of death w/ lupus?
end stage renal disease?
how long is someone’s eyes dry for in sjogren?
> 3 months, also it’s kerato sicca is MC sign
what is the antibody specific to mixed connective tissue disease?
anti-u1-RNP (high ana w/ speckeled pattern)
what are the other names for takayasu’s arteritis?
pulseless, or occlussive thromboarotopathy
a teenage girl presents w/ >=5 joint groups pain, RF+, what is most likely her condition?
seropositive polyarticular
what is the MC cause of death in mixed connective tissue disease?
pulmonary HTN
what markers are the most accurate to monitor lupus and what are the most useful?
complement and anti-dsDNA most accurate, ESR and CRP most useful
anti-la is what?
SSB
if someone has a positive anti-Jo-1, what complication are you concerned about?
malignancy
30-40y/o woman presents w/ chest pain in the ER. the nurse said she had a rheum disorder, but can’t remember what she said. What genetic risk factors would most support the disease that correlates w/ MI?
HLA-DRB1, anti-ccp, RF, and it’s rheumatoid arthritis
if someone had unilateral parotid gland enlargement with dry eyes and dry mouth what are you concerned for?
lymphoma
what are some keys to all the seronegative spondyloarthopathies?
HLA-B27, uveitis, absence of autoantibodies, RF factor negative
treatment for osteoporosis prevention
Stop smoking, Weight-bearing exercise, Calcium/Vitamin D, & Bisphosphonate
