Rheumatology Flashcards
What is the diagnosis associated with complete heart block in neonate?
Neonatal lupus erythematous
What is the most likely diagnosis of patient with purpuric rash on buttocks, abdominal pain, arthralgia, hematuria and proteinuria?
IgA vasculitis (Henoch Schonlein Purpura)
What is the most likely diagnosis for patient under 16 years old with daily self resolving fever, swelling of joints for more than 6 weeks and macular salmon pink rash on trunk and proximal extremities when febrile?
Systemic Juvenile Idiopathic Arthritis
What is the most likely diagnosis of patient with arthritis of small joints especially of the DIP joint of finger for more than 6 weeks, abnormal nail findings, risk of anterior uveitis and periostitis (new bone formation despite no fracture) on Xray?
Psoriatic juvenile idiopathic arthritis
What test is specific for systemic lupus erythematosus?
anti-double stranded DNA antibody
What is the most likely diagnosis of patient with progressive proximal muscle weakness, elevated CK (creatine kinase), abnormal EMG, muscle biopsy changes, heliotrope sign and Gottren papules?
Juvenile Dermatomyositis (tx: high dose steroids)
… is swollen eyelids with distinctive reddish purple rash involving the upper eyelids and suggestive of Juvenile Dermatomyositis
Heliotrope Sign
… are papular erythematous, papulosquamosus lesion on dorsal surface of knuckles and associated with Juvenile Dermatomyositis
Grotton papules
A patient with monoarticular arthritis of lower extremities with associated pain and swelling at insertion of Achilles tendon and of plantar fascia on the calcaneus, dysuria/ urethritis, mucocutaneous lesions of mouth and genitals and conjunctivitis in setting of Chlamydia/ Campylobacter/ Shigella/ Salmonella infection most likely suffers from…
Reactive Arthritis
can’t see, can’t pee, can’t climb a tree
What is the most likely diagnosis for patient age 6 months to 7 years who presents with fever, cervical lymphadenopathy, oral aphthous ulcers, and sore throat which resolves in 5 days but recurs every 4 weeks? What is treatment?
PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and cervical adenitis)
(tx: steroids)
What is the most likely diagnosis for patient presenting with sacroiliac joint tenderness, pain and swelling at Achilles insertion, positive HLA-B27, morning stiffness and family history?
Enthesitis- related arthropathy
What is the treatment for reactive arthritis?
NSAIDs
obtain baseline labs
What is the most likely diagnosis for patient with hip/ thigh pain with lower extremity held slightly externally rotated and internal rotation produces pain in setting of SLE/ chronic steroid use/ connective tissue disorder?
Avascular Necrosis of femoral head
What is the most likely diagnosis for patient with chorea (neuro deficits), oral ulcers, serositis, renal disease, anemia, leukopenia, malar rash, discoid rash, photosensitivity and positive ANA?
Systemic Lupus Erythematosus (SLE)
what is the most likely diagnosis for patient with history of systemic JIA presenting with persistent fever, hepatosplenomegaly, increased ferritin, cytopenia, liver dysfunction, coagulopathy, decreased fibrinogen, and hemophagocytosis by histiocytes on bone marrow?
Macrophage activation syndrome
What is the most common cause of septic arthritis?
S. Aureus
What two conditions are associated with worse prognosis for patient with SLE (lupus)?
- nephritis
2. neuro abnormalities
What is the most likely diagnosis for patient with fever for 3-7 days every 1-2 months, abdominal pain, diarrhea, nondestructive large joint arthritis, and macular rash with negative ANA?
Hyperimmunoglobuin D syndrome
dx: immunoglobulin D and E elevated
What is the most likely diagnosis for patient with recurrent fevers, urticaria and joint pain who develops sensorineural hearing loss and renal failure as get older?
Muckle-Wells syndrome
tx: IL- 1 inhibitors like anakinra, rilonacept, canakinumab
What is the most likely diagnosis for patient presenting with Raynaud’s phenomenon (finger pain with white, blue, red discoloration in cold), tortuous dilated vessels in nailbed and positive anti-U1 RNP antibody?
Mixed Connective Tissue Disease
risk of pulmonary HTN
What is the most likely diagnosis for patient of Mediterranean decent presenting with recurrent episodes of fever, abdominal pain, testicular pain, and swelling of knee and ankles?
Familial Mediterranean Fever
What is the treatment of choice for complex regional pain syndrome (exaggerated and prolonged pain without fracture after an injury)?
Physical therapy
What GI manifestation is associated with IgA vasculitis (formerly known as Henoch Schonlein purpura)?
Intussusception
