Rheumatology Flashcards
Complication of RA
Painful, photophobia, diffuse redness of sclera
Management
Complication
Scleritis
Steroids. Treat underlying disease.
Rupture of globe
Treatment for RA
Methotrexate
Then steroids
Then PPD for monoclonal Ab
Adverse effect of infliximab
Psoriasis
Adverse effect of tocilizumab
Diverticular rupture
OCP failure
HLD
Adverse effect of rituximab
Can deactivate Hep B
Methotrexate monitoring
CBC, AST, Cr q 3 mo
Positive Homan sign
Negative DVT US
Ruptured popliteal (Baker) cyst
RA
Splenomegaly
Neutropenia
Felty syndrome
Polyarthritis
Fever
Evanescent salmon colored/faint pink rash
Juvenile idiopathic rheumatoid arthritis (Still’s disease)
Diseases correlated with Sjogrens
Increased risk of lymphoma and celiac disease
Diagnosing Sjogren
Schirmer (blotting paper) test
- positive if < 5’m wetting in tearing of eyes in 5 min (normal is 15mm in 5min)
If Ab negative, Lip biopsy
Management of Sjogren
Hydration
Pilocarpine
Cevimeline
Bamboo spine
Uveitis
Aortitis
HLA B27+
Ankylosis spondylitis
Management of anklyosing spondylitis
NSAIDs
Then anti-TNF
Keratoderma blenborrhagicum
Reactive arthritis
Management of reactive arthritis
NSAIDs
Arthritis
Pitting nails
Management
Psoriatic arthritis
NSAIDs (mild)
Methotrexate (skin/nail changes)
Oral and genital ulcers
Erythema nodosum
Pathergy+
Aneurysm
Management
Bechet’s disease
Colchicine (mucocutaneous)
Steroids, TNF inhibitors (moderate to severe)
Caribbean
Fever
Arthritis
Chikungunya
Flowing ossification if anterior longitudinal ligament
Diffuse idiopathic skeletal hyperostosis (DISH)
Most important risk factor for osteoarthritis
Obesity
Osteophytes formation
Osteoarthritis
Anterior hip pain on external and internal rotation
Osteoarthritis
Potential reason for Tscore discrepancy (Lumbar spine -1.0, iliac spine -2.6)
Osteophytes in lumbar vertebrae
Lateral hip pain
Greater trochanter pain syndrome
Gouty attack
On chlorthalidone
Switch to losartan
Rhomboid crystals
Weakly + birefringence
Chondrocalcinosis
Pseudogout
Calcium pyrophosphate dihydrate disease
Diseased associated with calcium pyrophosphate dihydrate disease
Hemochromatosis
Hyperparathyroidism
Shoulder pain
Washing back while showering
Lateral shoulder pain while lying down
Rotator cuff tendinopathy
Fall on outstretched hand
Shoulder pain
Cannot abduct arm and keep up to 90 deg
Rotator cuff tear
Affected muscle in lateral epicondylitis
Extensor carpi radialis brevis
Affect muscle in carpal tunnel syndrome
Abductor pollicis brevis
Unable to hold paper between fingers
Ulnar nerve entrapment
Affected muscles in De Quervains tenosynovitis
Abductor pollicis longus
Extensor pollicis brevis
Saturday night palsy
Compression of radial nerve at spiral groove in middle of arm
Management for dupuytrens contracture
Collagenase injections
DM
Inability to completely extend fingers
Diabetic cheiropathy
Diabetic hand syndrome
Diabetic cheiropathy
+
Dupuytrens contracture
DM
Pelvic and thigh pain
Atrophy and weakness of thigh muscle
Diabetic amyotrophy
Knee pain
Medial aspect
2in below join line
Pes anserine pain syndrome
Heel spur
Tender at base of calcaneus
Tender with squeezing heel
Plantar fasciitis
Management for fibromyalgia
Amitryptyline
Episodic swelling of ears
Cartilaginous portion of ear swollen
Relapsing polychondritis
Abdominal pain
Renal insufficiency
Hep B sAg positive
PAN
Italian. Jewish. Arab.
High fever. Swollen knee
Father with similar symptoms
Familial Mediterranean fever
Clinical findings that suggest secondary Raynaud
Age > 40
Abnormal nail fold capillaries
Digital ulcerations
Swelling of arms and legs sparing hands and feet
Orange peel like quality of skin
Eos+
Eosinophilic fasciitis
Dermatomyositis
Mechanic hands
ILD
Raynaud
Anti-synthetase syndrome
Distal weakness > proximal
Endomysial inflammation
Basophilic rimmed vacuoles
Inclusion body myositis
No treatment
LE proximal muscle weakness
Vacuoles. No inflammation
Colchicine myopathy
RTA 1
CaPhos stones
Sjogren