Rheumatology 2

Question 1

Proximal muscle weakness and certain characteristic rashes (e.g. Gottron’s papules and periorbital heliotrope rash) are characteristic of _______.

Answer 1

Polymyositis

Question 2

_______ typically occurs in persons older than 50 and is characterized by hip and shoulder pain and stiffness, esp. in the morning.

Answer 2

Polymyalgia rheumatica

Question 3

High creating kinase level and objective findings of proximal muscle weakness merit what further investigations? For what 2 diseases?

Answer 3

Muscle biopsy and/or electromyography. Polymyositis and detmatomyositis.

Question 4

Why don’t young women generally have gout?

Answer 4

Endogenous estrogens are protective.

Question 5

What could cause a premenopausal woman to develop gout?

Answer 5

Proliferative disorder w/hi cell turnover (e.g. Psoriasis, malignancy) or decreased uric acid excretion (e.g. Drugs, alcohol, renal disease, or enzyme deficiency).

Question 6

What are the key radiographic findings of rheumatoid arthritis?

Answer 6

Marginal erosions and juxta-articular osteopenia.

Question 7

What should you suspect in a sexually active pt who develops migratory arthralgias and wrist tenosinovitis?

Answer 7

Disseminated gonococcal infection

Question 8

What is the most common causative organism of nongonococcal septic arthritis in pts with rheumatoid arthritis (and likely the general population as well)?

Answer 8

S. aureus

Question 9

How are limited and diffuse systemic sclerosis differentiated? (Be specific.)

Answer 9

Limited: skin thickening distal to the elbows.
Diffuse: proximal to the elbows

Question 10

Behçet’s disease is characterized by recurrent aphthous oral ulcers + at least 2 of what 4 features?

Answer 10

Recurrent genital ulcers, inflammatory eye disease, cutaneous lesions, an positive pathergy test.

Question 11

What condition typically manifests with urethritis, conjunctivitis, and/or keratoderma blennorrhagica (psoriasis-like rash) on the palms and soles?

Answer 11

Reactive arthritis

Question 12

What 5 bacteria usually cause reactive arthritis?

Answer 12

CCSSY:
Campylobacter, Chlamydia, Salmonella, Shigella, Yersinia.
(Also E. coli)

Question 13

What is pleurisy?

Answer 13

Serositis

Question 14

Anti-cyclic citrullinated peptide (anti-CCP) Ab is specific for _______.

Answer 14

Rheumatoid arthritis

Question 15

Anti-dsDNA is present in less than half of pts with _______, but it is highly specific.

Answer 15

SLE

Question 16

Headaches, visual deficits, and muscle stiffness and aching in an elderly pt should raise suspicion for what?

Answer 16

Giant cell arteritis

Question 17

Pain and morning stiffness in the proximal and axial joints in the absence of weakness, joint swelling, pain, warmth, or restricted movement in a pt over 50 yo suggests what Dx?

Answer 17

Polymyalgia rheumatica

Question 18

What us the Tx for polymyalgia rheumatica?

Answer 18

Prednisone