Rheumatology

Question 1

PFAPA

Answer 1

Periodic fever, aphthous stomatitis, pharyngitis, adenopathy

Recurrent fever q4-5 days
Abdominal pain
Elevated ESR, CRP during attacks
Spontaneous remission, T&A

Question 2

Takayasu arthritis

Answer 2

Large vessel vasculitis - aorta
Fatigue, malaise, hypertension
Carotidynia

Decreased peripheral artery pulses
Claudication of extremities
BP difference >10
Bruits over aorta, major branches

Question 3

Linear scleroderma

Answer 3

Violaceous band, thickening

20% with extracutaneous manifestations
Arthritis, neuro, autoimmune
Eosinophilia, positive ANA, elevated ESR

Question 4

Wegeners granulomatosis

Answer 4

Necrotizing vasculitis
Sinusitis, hemoptysis, glomerulonephritis

ANCA
Anti proteinase 3 IgG antibodies

Question 5

Microscopic polyangiitis

Answer 5

ANCA

Myeloperoxidase

Question 6

Raynaud’s phenomenon

Answer 6

Triphasic color changes
Cold, stress, exercise

SLE, mixed connective tissue disease, juvenile dermatomyositis, juvenile systemic sclerosis

Question 7

Sarcoidosis

Answer 7

Noncaseating granulomas
ACE
Hilar lymphadenopathy

Respiratory symptoms, erythema nodosum
Posterioir uveitis
Nephritis

Question 8

Familial mediterranean fever

Answer 8

Fever, abdominal pain, arthritis

Tx: colchicine