Rheumatology Flashcards
What are the possible causes of monoarticular arthritis?
Septic arthritis, doubt, calcium pyrophosphate disease, tumor, trauma, and viral
Give a brief description of Becet’s disease. It responds well to what treatment?
It is a chronic inflammatory disease of unknown etiology characterized by recurrent oral, genital apthous ulcerations, uveitis, skin lesions, and other multisystem disorders associated with superficial and deep venous thromboses, arterial aneurysms, and occlusions and thromboses. The disease responds well to antiplatelet therapy.
What are the possible causes of symmetric polyarthritis?
RA, SLE, psoriatic arthritis, osteoarthritis, scleroderma, Lyme disease, rheumatic fever, gout, CPPD, and hepatic
What are the possible causes of asymmetric polyarthritis?
HLA be 27 disease: psoriatic, ankylosing spondylitis, reactive arthritis, inflammatory bowel disease. Doubt, CPPD, Lyme and viral.
What are the criteria for RA diagnosis?
A patient with greater than or equal to six points is unequivocally classified as an RA patient, providing they have synovitis in greater than or equal to one joint and that there is no other diagnosis better explaining the synovitis.
Involvement of one large joint equals zero points. 2 to 10 large joints equals one point. 1 to 3 small joints, with or without involvement of large joints, equals two points. 4 to 10 small joints, with or without involvement of large joints, equals three points. Greater than 10 joints, with the involvement of at least one small joint, equals five points.
Negative RF and negative ACPA gives zero points. Low positive RF or low positive ACPA gives two points. High positive RF or high positive ACPA gives three points.
Elevated ESR or elevated CRP gets one point.
One point for symptoms lasting six weeks or longer.
What are the diagnostic criteria for SLE and how many of them are needed to make the diagnosis?
Four of the following 11 diagnostic criteria make the diagnosis:
Malar rash, photosensitivity, arthritis, renal disease, hematological disorder, immunologic disorder (antibody), discoid rash, oral ulcers, serositis, neurological disease, and abnormal ANAs.
3/11 means the diagnosis is probable.
What is the association of insulin resistance and cardiovascular risk with rheumatologic disease?
Insulin resistance is present and 50 to 60% of patients with RAA and 30% of patients with SLE. Cardiovascular risk equals that of diabetics for RA.
How fast do you have to get a temporal artery biopsy in a patient with temporal arthritis that you have started on steroids?
Within 72 hours or the sensitivity is lost.
What is the treatment for temporal arteritis with visual symptoms?
IV Solu-Medrol 250 mg every six hours for 3 to 5 days then switch to PO.
What other treatment should be considered in postmenopausal women on steroids for PMR and temporal arteritis?
Bisphosphonates are recommended.
What is Lofgren syndrome?
Erythema nodosum, hilar adenopathy, and polyarthralgias. In these patients a probable diagnosis of sarcoid can be made without a biopsy.
