Rheumatology Flashcards
Pneumonic for possible SLE symptoms?
MD SOAP BRAIN
List some possible SLE symptoms?
MD SOAP BRAIN
- Malar/Discoid rash
- Serositis - chest pain
- Oral ulcers
- Arthritis
- Photosensitivity
- Blood - anemia
- Renal failure
- ANA (+)
- Immunologic
- Neuro = cerebritis
List some possible SLE symptoms?
MD SOAP BRAIN
- Malar/Discoid rash
- Serositis
- Oral ulcers
- Arthritis
- Photosensitivity
- Bleeding - anemia
- Renal failure
- ANA (+)
- Immunologic
- Neuro - cerebritis
What are 4 possible antibodies seen with SLE?
ANA
dsDNA
Anti-Smith
Anti-Histone
Levels of ESR/CRP and C3/C4 with SLE?
ESR/CRP = High
C3/C4 = LOW
What is the treatment for SLE?
Hydroxychloroquine +/- steroids during flare
What are 3 possible medicines that commonly cause Drug-Induced SLE?
Hydralazine
Procainamide
Alpha-Methyldopa
What specific antibody is often positive with Drug-Induced SLE?
Anti-Histone
Treatment for Drug-Induced SLE?
Discontinue causative medication
With SLE, it can commonly cause Renal manifestations. What is the treatment?
IV Cyclophosphamide
With SLE, it can commonly cause Renal manifestations. What is the treatment?
IV Cyclophosphamide
Where will the RA present?
Smaller joints - hands/feet and SYMMETRIC!
If the ____ joint is involved… it is NOT RA
DIP
Common characteristic of pain with RA?
Long-lasting morning stiffness
What is the most specific marker for RA?
Anti-CCP is more specific than RF
What will be seen on X-ray with RA?
Erosions/Periarticular Osteopenia
– Due to pannus formation which erodes bone
1st and 2nd line drugs to treat RA?
- Methotrexate
- Leflunomide
1st and 2nd line drugs to treat RA?
- Methotrexate
- Leflunomide
3 common side effects of Methotrexate?
- Liver toxicity
- Oral ulcers
- Macrocytic anemia
How do you offset Methotrexate adverse effects?
Give folic acid
What antibody is usually positive with Limited Scleroderma?
Anti-Centromere
Pneumonic for Scleroderma symptoms?
CREST
What are some symptoms seen with Limited Scleroderma?
CREST
- Calcinosis
- Raynaud’s
- Esophageal motility
- Sclerodactyly
- Telangiectasias
How does Diffuse Scleroderma differ from Limited Scleroderma?
Diffuse = CREST + visceral involvement
What antibody is often positive with Diffuse Scleroderma?
Anti- scl 70 Topoisomerase
What is the treatment for Scleroderma?
Supportive
What complication can occur with Scleroderma?
Pulmonary HTN
What are 2 possible signs of Diffuse Scleroderma in addition to CREST?
ILD
Constrictive Pericarditis
What causes Sjogren’s Syndrome?
Lymphoplasmacytic exocrine gland destruction
3 signs of Sjogren’s Syndrome?
Dry eyes
Dry mouth
Parotid swelling
3 signs of Sjogren’s Syndrome?
Dry eyes
Dry mouth
Parotid swelling
What antibody will be positive with Sjogren’s?
Anti-RO/LA
Treatment for Sjogren’s?
Artificial tears/saliva
With the inflammatory myopathies (dermatomyositis/polymyositis//ibm), what are the signs?
Proximal muscle weakness
Derm findings
List 3 possible derm findings for the inflammatory myopathies (dermatomyositis/polymyositis/ibm)?
Heliotrope rash = purple around eyes
Gottran’s papules
Shawl sign = skin exposed to sun gets rash
What marker is often elevated with the inflammatory myopathies? What are 2 possible positive antibodies?
HIGH CK
(+) Anti-mi and (+) Anti-Jo
How will Pseudogout look on arthrocentesis?
Positively birefringent rhomboid crystals of calcium-phosphate
How will Gout look on arthrocentesis?
Negatively birefringent needles of monosodium urate
What is the treatment for Gout/Pseudogout flares?
Colchicine or NSAIDs
2 treatment options for chronic gout?
Allopurinol
Probenecid if under excreter
How will Ankylosing Spondylitis present?
Low back pain that is worse in the morning
= Sacroiliitis
How will the spine look with Ankylosing Spondylitis?
“Bamboo spine”
What can be seen with Psoriatic Arthritis?
- Arthritis
- Psoriasis
- Nail pitting
What can be seen with Reactive Arthritis?
- Urethritis
- Conjunctivitis
- Arthritis
What are 4 seronegative but HLA-B27 diseases?
- Ankylosing Spondylitis
- Psoriatic Arthritis
- Reactive Arthritis
- IBD-Related
Describe how Complex Regional Pain Syndrome will present?
Trauma/injury –> Heals
–> Burning pain, swelling, redness, loss of ROM
Burning pain with swelling, erythema, etc. following trauma to a region is?
Complex Regional Pain Syndrome
What can be seen on X-ray of the region affected with Complex Regional Pain Syndrome?
Demineralization/Osteopenia
If you diagnose a patient with an inflammatory myopathy like Dermatomyositis, what should you do next?
Screen for malignancies!!
What pathology in the cervical spine are patient’s with RA at risk for?
AA subluxation
What will you see with Polymyalgia Rheumatica?
Proximal muscle stiffness/pain
+ HIGH ESR/CRP
If you see proximal muscle stiffness/pain with elevated inflammatory markers, what is the likely diagnosis?
Polymyalgia Rheumatica
What is the treatment for Polymyalgia Rheumatica?
Steroids
What is Polymyalgia Rheumatic often associated with?
Giant Cell Arteritis
What is a possible adverse effect of SLE patients taking Hydroxychloroquine?
Retinopathy/vision loss