Rheumatology Flashcards
Specific autoantibody for SLE
Anti-ds DNA antibody
Sensitive autoAb for SLE
ANA
Autoantibody for drug induced lupus
Anti histone antibody
Autoantibody for diffuse scleroderma
Anti-scl 70
Autoantibody for limited scleroderma
Anti centromere
CREST SYNDROME
Limited scleroderma
C Calcinosis
R Raynauds phenomenon
E Esophageal dysmotility
S Sclerodactyly
T Telangiectasia
Autoantibody in polymyositis
Anti-Jo1
Autoantibody in sjogrens syndrome
Anti-Ro
Anti-La
Autoantibody for churg Strauss syndrome
P-ANCA
Autoantibody for GPA (WEGENERS)
C-ANCA
Autoantibody in Rheumatoid arthritis
Rheumatoid factor (initial)
Anti - CCP (most specific)
Autoantibody for celiac disease
Anti tissue glutaminase
Anti gliadin
Anti endomysial
Autoantibody for primary biliary cirrhosis and Autoimmune hepatitis
Anti mitochondrial
Anti smooth muscle
SLE TREATMENT
Hydroxychloroquine
NSAIDS
PREDNISOLONE (SEVERE CASES)
CYCLOPHOSPHAMIDE (LIFE THREATENING LUPUS NEPHRITIS& VASCULITIS)
SLE PRESENTATION (13)
1.Low grade Fever
2.Fatigue
3.Mouth ulcers
4.Malar rash (butterfly rash)
5 Photosensitivity(discoid rash)
6.Raynauds phenomenon
7.Arthralgia
8.Myalgia
9.Polyarthritis
10.Libmann sacks endocarditis
11.Pleuritis
12.Pericarditis
13.Glomerulonephritis
C3 and C4 levels in SLE
Reduced
Drug induced lupus
Hydralazine
Chlorpromazine
Isoniazid
Chronic fatigue syndrome also known as
Myalgic encephalitis
Post exertional malaise or
Activity induced muscle fatigue is seen in
Chronic fatigue syndrome
Chronic widespread diffuse pain in the joint and muscles
Morning stiffness
Exacerbated in response to pressure
Fibromyalgia
Raised serum creatinine kinase with anti jo 1 antibody
Symmetrical Diffuse muscle weakness
Polymyositis
Treatment steroids
Raised serum creatinine kinase
ANA
Muscle weakness
Skin manifestations like heliotrope rash,Gottrons papules,shawl sign
Deematomyositis
Raised serum creatinine kinase
ANA
Muscle weakness
Skin manifestations like heliotrope rash,
Gottrons papules,shawl sign
Heliotrope rash (bluish purple discoloration on the upper eyelids with periorbital edema)seen in
Deematomyositis
Gottrons papules (purple red scaly rashes over extensor surfaces of joints and fingers)seen in
Deematomyositis
Pain and morning stiffness
Difficulty getting out of bed
With raised ESR and CRP
Polymyalgia rheumatica
Polymyalgia vs myositis
Myositis (weakness > pain) with raised CK
Polymyalgia (pain> weakness) with normal CK
Giant cell arteritis or temporal arteritis
Is a/w
Polymyalgia rheumatica
Headache
Scalp tenderness
Jaw claudication
Transient visual field loss
Temporal arteritis
Treatment: high dose prednisolone
Parotid and lacrimal gland enlargement
Dey eyes dry mouth
Sjogrens syndrome
Eye drop to treat dry eyes
Hypromellose
Abnormal growth of connective tissue
Increased fibroblast activity
Systemic sclerosis
Thickening of skin
Raynauds phenomenon
Renal crisis is seen in
Diffuse scleroderma
Seronegative spondyloarthritis
PAIR B
P PSORIATIC ARTHRITIS
A ANKYLOSING SPONDYLITIS
I IBD ASSOCIATED ARTHRITIS
R REITERS SYNDROME
B BEHCETS DISEASE
Predominantly involve axial and peripheral joints
A/w HLA B27
Seronegative spondyloarthritis
Recurrent oral and genital ulcers
Anterior or posterior uveitis / retinal vasculitis
Pathergy / erythema nodosum
BEHCETS disease
Yound males
Back pain
Morning stiffness
Pain improves with activity
Anterior uveitis
Xray sacrilitis
ANKYLOSING SPONDYLITIS
Treatment:
Physiotherapy
NSAIDS
Oral corticosteroids
Etanercept and Adalimumab(severe)
Can’t see
Can’t pee
Can’t climb a tree
REITERS arthritis
Conjunctivitis
Urethritis
Arthritis
Reactive / REITERS arthritis
M/c/c for reiters syndrome
C. Pneumoniae
C. Trachomatis
Occurs 2-4 weeks after a GU or GI infection
Risk factors for gout
Diet with meat and alcohol
Ckd
Diuretics
Tumour cell lysis (chemotherapy)
Treatment for acute gout
NSAIDS
Colchicine
Corticosteroids
Treatment for prevention of gout
Allopurinol
Reduces the formation of uric acid
Septic arthritis is caused by
S aureus
Acute severe joint pain
Warmth erythema tenderness and Swelling of joints
Limited ROM
Fever
Septic arthritis
Investigation and treatment of septic arthritis
Joint aspirations and IV antibiotics (flucloxacillin)
Bone pain
Reduced s. Ca , s. Po4
Increased ALP
Osteomalacia
Tenosynovitis of Extensor pollicis brevis
And Abductor pollicis longus
De Quervains disease
Eosinophilic granulomatosis with polyangitis
Churg Strauss disease
PAVE churg Strauss syndrome
P-ANCA
ASTHMA
VASCULITIS -BIOPSY
EOSINOPHILIA INCREASED IGE
NASAL POLYPS
PURPURA
GLOMERULONEPHRITIS
Chronic sinusitis
Nasal crusting
Saddle nose deformity
Haemoptysis
Dyspnea
Epistaxis
Hematuria
Granulomatosis with polyangitis
Saddle nose deformity
Gummas
Aneurysm
Tabes dorsalis
Neurosyphilis
Necrotizing inflammation of the medium sized arteries
Polyarteritis nodosa
Mononeuritis multiplex
Skin manifestations
Abd pain pancreatitis
Myalgia arthralgia
Headache fever weight loss
Polyarteritis nodosa
Rheumatoid arthritis deformity
Swan neck and boutonniere deformity
DMARDS
Methotrexate
Sulfasalazine
Leflunomide
Hydroxychloroquine
NSAIDS for acute RA and corticosteroids for flares
Dry mouth
Enlarged parotid and lacrimal gland
D/t sarcoidosis tb or lymphoma
Miculicz syndrome
Lofgrens syndrome
BHL
En
Polyarthralgia
Fever
Lofflers syndrome
Eosinophilic accumulation in lung in response to a parasitic infection
Heerfordt syndrome
Uveitis secondary to sarcoidosis
Parotid enlargement
Fever
Ray loves knives
Raynauds phenomenon
Treatment Nifedipine
Major criteria
Rheumatic fever
Subcutaneous nodules
Pan carditis
Arthritis (polyarthritis)
Chorea
Erythema marginatum
Minor criteria for rheumatic fever
Fever
Arthralgia
Previous RH or RHD
Increased ESR or CRP
Prolonged PR interval in ECG
