Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Royal Super 4th Year Brain > Rheumatology > Flashcards

Rheumatology Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards The Brain flashcards
1
Q

When in the day do symptoms of growing pains typically present?

A

Evening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

x1 example of pain amplification syndrome (a) generalized and (b) localized

A

(a) Fibromyalgia

(b) Complex regional pain syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Examples of autonomic changes that occur with pain amplification syndromes?

A
  • Swelling
  • Atrophy
  • Cold extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of arthritis

A

Joint effusion or swelling

OR =/> than 2 of the following: limited ROM, tenderness/pain with motion, increased heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DDx for monoarthritis

A
  • Structural: trauma, overuse, orthopedic concerns (AVN, SCFE)
  • Infection: acute (SA, OM), chronic (TB, lyme), reactive arthritis
  • Inflammatory: JIA, non-bacterial OM, FMF)
  • Malignancy
  • Hemarthrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DDx for polyarthritis

A
  • Structural: hypermobility, skeletal dysplasia
  • Infection: acute (viral - parvo, bacterial - gonococcal), post-infectious (reactive, rheumatic fever)
  • Inflammatory: JIA, SLE, vasculitis (HSP)
  • Malignancy
  • Pain syndromes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When would you consider looking for specific antibodies after receiving result of ANA? Example of one

A

If ANA is positive at a high titre >1:160

-dsDNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Can routine live vaccines be given to a patient on MTX?

A

No although could get a booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Criteria for JIA

A
  • Juvenile: <16 year old at onset of symptoms
  • Idiopathic: cannot be explained by another medical condition
  • Arthritis: Joint inflammation lasting more than 6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Classification of Juvenile Idiopathic Arthritis (x6)

A
  • Oligoarticular arthritis
  • Polyarticular arthritis
  • Systemic JIA
  • Enthesitis related arthritis
  • Psoriatic arthritis
  • Undifferentiated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of JIA is more common in males than females?

A

-Enthesitis-related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What form of JIA is associated most commonly with uveitis?

A

Oligoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What form of JIA is associated with acute uveitis (symptomatic)?

A

Enthesitis-related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What form of JIA is associated with the majority of cases being ANA positive?

A

Oligoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What form of JIA is associated with HLA-B27 positive?

A

Enthesitis-related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Criteria for psoriatic arthritis

A
  • Arthritis + psoriasis

- OR arthritis plus 2 of the following: nail pits, dactylitis, 1st degree relative with psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is Complex Regional Pain Syndrome defined (aka criteria)?

A
  • Pain out of proportion of hx and exam
  • At least one symptom of autonomic dysfunction
  • One symptom of allodynia/hyperalgesia/motor dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What to treat FMF with and why?

A
  • Colchicine

- To decrease intensity/frequency/duration of episodes + prevent amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is amyloidosis?

A

-Serum AA = acute phase reactant found in high levels during FMF attacks –> cleaved + deposits into organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common presenting sign of amyloidosis?

A

Proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the hallmark cutaneous sign of FMF? And where does it typically present?

A

Erysipeloid erythematous rash

-Ankle/foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some other symptoms in FMF apart from fever and rash (x2)?

A
  • Arthritis

- Serositis (abdo pain, pleurtic chest pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment plan for oligoarthritis?

A
  • NSAIDs +/- joint injections

- If poor response –> second line DMARDs

24
Q

What form of JIA is more closely associated with development of MAS?

A

-Systemic JIA

25
Q

What is the gold standard for diagnosing JDM?

A

EMG

26
Q

What is the most (a) sensitive and (b) specific tests for SLE?

A

(a) ANA

(b) anti-dsDNA, anti-Smith

27
Q

What does synechiae mean?

A

Irregular pupil

28
Q

Tx for PFAPA

A

T+A

x1 dose of oral pred at beginning of flare

29
Q

What dx do you think of with a salmon rash?

A

sJIA

30
Q

In terms of # of criteria, what do you need to make a diagnosis of rheumatic fever?

A

-2 major
-1 major + 2 minor
PLUS evidence of GAS infection
-Exception is chorea

31
Q

Major + minor manifestations of rheumatic fever

A 
Major = polyarthritis, carditis, chorea, erythema marginatum, subcut nodules
Minor = fever, arthralgia, elevated ESR/CRP, prolonged PR
32
Q

Management of acute rheumatic fever

A
  • Penicillin x10 days
  • ASA + NSAIDs for arthritis
  • ASA + steroids for carditis
33
Q

Prophylactic therapy for rheumatic fever

A
  • Without carditis = 5 years or till 21 years of age
  • With carditis = 10 years or till 21 years of age
  • With carditis + residual disease = 10 years or till 40 years old
34
Q

For FMF vs PFAPA how long does the fever typically last for?

A 
FMF = <72 hours
PFAPA = 5 days
35
Q

SLE-ACR Classification criteria

A
  • need 4/11*
  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Serositis
  • Oral/nasal ulcers
  • Arthritis
  • Neuro: seizures, psychosis
  • Heme disorder
  • Renal disorder
  • Immune disorder
  • Positive ANA
36
Q

Indications for testing for Antiphospholipid Ab Syndrome

A
  • SLE yearly
  • Unexplained PTT prolongation
  • Multiple abortions
  • Thrombosis
37
Q

Dermatomyositis - criteria

A
  • need 4/5*
  • Symmetrical proximal muscle weakness
  • Derm changes: heliotrope rash, Gottron’s papules
  • Elevated muscle enzymes (CK, AST, LDH)
  • Abnormal EMG (although would do MR now)
  • Abnormal muscle biopsy
38
Q

Dermatomyositis - complications

A
  • Dysphagia - swallowing dysfunction
  • Dysphonia
  • Dyspnea - resp failure with severe weakness
  • Interstitial lung disease
  • Arthritis
  • Joint contractures
  • Cutaneous/mucosal ulcerations
  • Constitutional features (fever, fatigue)
39
Q

Dermatomyositis - nail changes

A
  • Drop out
  • Dilatation
  • Tortuosity
40
Q

Typical treatment for Dermatomyositis

A
  • Steroids
  • MTX
  • IVIG for more severe cases
41
Q

What is an important but often missed step in the examination of a patient with IgA vasculitis or HSP?

A

GU exam - looking for orchitis

42
Q

Management of HSP

A
  • Supportive
  • Analgesia (NSAIDs) for joint pain
  • Steroids if severe abdo pain or renal disease
43
Q

Monitoring for HSP

A
  • UA + BP weekly until rash resolves
  • Then biweekly
  • Then monthly for 6 months
44
Q

What is the other name for Sever disease?

A

Calcaneal apophysitis

45
Q

How many degrees on scoliometer would you worry about in office?

A

> /= 7 degrees

46
Q

What is the other name for tibia varum?

A

Blount disease

47
Q

How to differentiate Blount disease from genu varum?

A

Measure the metaphyseal - diaphyseal angle on XR

48
Q

What dx to think of with back pain associated with hyperlordosis, paraspinal muscle spasm, and hamstring tightness?

A

Spondylolysis

49
Q

Most common childhood wrist fracture?

A

Buckle fracture

50
Q

What dx to think of with quotian fever?

A

sJIA

51
Q

What to think of with synechiae?

A

Uveitis

52
Q

What common classification of medications can cause exacerbation of Raynaud’s?

A

Stimulants

53
Q

If you have a HSP like presentation - what would be the most important bloodtest to do?

A

CBC - ensure no thrombocytopenia

54
Q

Recurrent pain to clavicle and jaw bones - what dx + first line tx?

A

CRMO + NSAIDs

55
Q

What periodic fever syndrome can have significant peritonitis?

A

FMF

Royal Super 4th Year Brain (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions