Rheumatology Flashcards
Most common type of arthritis?
Osteoarthritis
Most potent risk factor for osteoarthritis?
Age
Two major factors contributing to the development of OA?
Joint loading
Joint vulnerability
Nodes found in the PIP joint in OA?
Bouchards nodes
B Bouchards comes first in the alphabet before H of Heberden
Nodes found on the DIP joint OA?
Heberdens nodes
Most common site of symptomatic osteoarthritis?
Knee
Pathologic sine qua non of osteoarthritis?
Hyaline articular cartilage loss
Mainstay of tx in OA?
Nonpharmacologic
Altering joint loading and improving function of joint protection
Initial analgesic of choice for OA ?
Acetaminophen
Most common side effects of oral NSAIDs ?
Upper GI Toxicity
Maximum dose of Acetaminophen in OA ?
1 gram TID
Earliest involved joints in RA?
Small joints of hands and feet
Subluxation of the 1st MCP joint with hyperextension of 1st IP joint?
Z- line deformity
Inward and Outward
Rheumatoid Arthritis: 2D Echo with doppler
- Mild left ventricular compliance abnormality
- Ejection fraction of 70%
- Minimal pericardial effusion
Rheumatoid Arthritis Xray pf hands and feet?
- Subluxations
- Osteopenia
- Bony erosions
Nodular RA , Splenomegaly and Neutropenia?
Felty’s Syndrome
DMARDs in RA?
- Methotrexate
- Sulfasalazine
- Hydroxychloroquine
- Leflunomide
Category X DMARDs
Methotrexate
Leflunomide
Onset of action of DMARDs ?
6 to 12 weeks
Most serious toxicity associated with use of hydroxychloroquine ?
- Irreversible retinal damage
- Cardiotoxicity
- Blood dyscrasia
Triple therapy in RA?
Methotrexate
Sulfasalazine
Hydroxychloroquine
Monitoring of serum creatinine, CBC, and liver function tests during Methotrexate therapy?
2 to 3 months
Biological in RA by inhibiting the co-stimulation of T cells by blocking CD 28- CD 80/ 86 interactions
Abatacept
TB screening required prior to initiation of the following biologics?
- TNF alpha inhibitors: infiximab, etanercept, adalimumab, golimumab
- Abatancept
- Anakinra
- IL-6 Inh: tocilizumab, sarilumab
Hallmark features for psoriatic arthritis?
Dactylitis: swelling of fingers and toes “sausage like appearance”
Enthesitis :Swelling / inflammation of more than one enthesis ( joint / tendon area)
Most common acute rash in SLE?
Malar Rash
Most common chronic dermatitis in SLE?
Discoid Rash