RHEUMATOLOGY Flashcards
PASTEST AND CO
Diseases associated with low c3 c4
SLE
Cryoglobulinemias
PSG
ANCA diseases are pauci-imune.no complement unless severe.so no low c3 c4.Also they are anti-neurtophilic so thats their pathophysio.
wagners vs microscopic polyangitis vs good-pasteur
Wagnars = URT + LRT + RENAL
Good pasteur = LRT + RENAL
Microscopic polyangits = LRT + ABDOMEN +- RENAL
concept about anca and pr3 and mpo in ANCA associated vasculitis
The body produced autoantibodies i.e anti-PR3 or anti-MPO(broader term is cANCA OR pANCA).these antibodies target specific antigens inside neutrophils(pr3 or mpo).This than leads to specific staining (either c-ANCA if PR3 was target or p-ANCA if MPO was the target) detected by imunofluroscence.Best and specific test is to detect antibodies by ELISA (anti pr3 or mpo).Neutrophils in return become activated leading to vasculitis.
triad of FMF and tx
Fever Rash (erypsiloid on shin and dorsum of foot) Serositis
Colchicine for prophalaxis and long term management.NSAIDs for acute.Steroids and IL1 inhibitor Anakinra in colchicine resistant cases.
milwaukee shoulder
severe erosive arhritis of shoulder with hemorrhagic effusion in old ladies.
most common joint findings in SLE
SLE leads to
1.Arthralgia : no inflamation,no errosion,nothing. just pain.most common)
2.NON-errosive arhtritis : soft tissue swelling (synovitis)and pain.no errosions.2nd most common
3.Jaccouds arhtropay : joint deformity due to ligament laxity(overstetching and infalmation over time).REVERSIBLE.can lead to swan neck and other deformities.no errosions.also seen in RA.joint deformity is non reversible in RA.
Eosinophilic Fascitis features :
1.Swelling and tenderness of forearms(lateral aspect) along with induration of skin (pleu de orange).
2.Carpal tunnel syndrome (bilateral)
3.Flexion contraction of the fingers.
4.Blood eosinophilia
5.Hypergamaglobulinemia.
6.Raised ESR.
Diagnosis is confirmed by biopsy.
Hand joints involved in OA,RA and Psoriatic arthritis
OA = CMP(1st) AND DIP
RA = MCP AND PIP
PSORIATIC = DIP
dianostistic manouver for Thracic outlet syndrome.
Adson Test
1.head up
2.turn head towards effected side.(tightens the sclanae muscles)
3.Symptoms reproduce(loss of radial pulse e.g).positive test.
==>the diappearance of pulse on abducting the arm is suggestive of TOS.
positive squeeze test is in which disease
RA.pain on squeezing the wrist e,g.
in treatment of Ankylosing spondylitis,if therpay with two different NSAIDS (given at diff offc) fails, what is the next step?
ANTI-TNF therapy.adalimumab or etanercept.
DMARDS like sulfasala are only indicated if peripheral arhtritis is present.(25%)
feartures of enteropathic arthritis
1.arthritis(mostly oligo) that flares up with the flares of IBD(crohns more likely).
2.can be assocaited with flaring up of other symptoms like erythema nodusum,uveitis and apthous mouth ulcers.
whcich nerve is compressed in pronator teres syndrome
Median nerve.
most common disease patern of RA
Chronic and persistent with relapsing remitting course.
cause of excessive hair loss in SLE
Telogen effluvism
most common involvement in sle?
skin or joints.
Joints 80% (arthralgia or arthrtis.arthralgia is more common and is peripheral and symetrical.
skin is 75%.
investigation of choice for baker cyst
USG
what is Brodies abscess
A form of chronic osteomyelitis with insidous onset (6months e.g) located near the metaphysis.Dull pain is the usual symptom.X-ray findings are typical with ‘lytic lesions with sclerotic margin’.common in teenagers.
What is charcot joint
severe joint deformity in weight bearing joints like ankle in association with sensory neuropathy (decrease sensitivity and repitive trauma.not sensed by patient)
Occurs sec to DM,syphillis,syringomyelia,alcoholic neuropathy.
joint arthroscopy findings in RA
1.Increase vascular proliferation of synovial membrane and leakage.there can be membrane folds too.
2.increase neytrophils in early stages.
3.decrease viscosity (due to inflamatory cells being present and outpowering the gellatinous synovium).However,viscosity increase in OA (non inflamatory condition).
most common cause of secondary raynauds is ?
Systemic Sclerosis
ischemic optic neuropathy is seen in which 3 rheuma conditions (from common to less common)
1.Temporal arteritis
2.GPA
3.SLE
most common pulmonary manifestation of SLE is ?
Pleurisy and pleural effusion.
what is preiser’s disease ?
Bilateral avascular necrosis of the scaphoid bone.
scaphoid fracture features are :
1.pain in the anatomical snuff box and scaphoid tubercle.
2.pain on ulnar deviation of wrist (pronated wrist to be precise).
3.Hx of trauma or occupational history.
typical pattern of erosive osteoarthritis
gull-wing or inverted T pattern of erosions.In erosive osteoarhtritis there are erosions (hence the name) BUT there is NO peri-articular osteoporosis (like RA).
in normal osteoarthritis,there are no erosions.
