Rheumatology

Question 1

Periop with Rheumatoid arthritis

Answer 1

r/o atlantoaxial subluxation - cervical spine xray, risk of paralysis

Question 2

Drug induced Lupus from anti-TNF

Answer 2

check ANA/DSDNA ab - can be caused by anti-TNF drugs, new onset fever, rash, arthralgia, myalgia, pleuritis, pancytopenia, proteinuria, active urine sediment,

Question 3

Drug induced Lupus from meds OTHER than anti-TNF

Answer 3

+ANA, +anti-histone, +SSDNA

Question 4

Trochanteric bursitis

Answer 4

pain with walking and lying on side - tenderness in lateral aspect of hip with direct palpation - localized pain - rest, ice, aspiration of bursa, injection of analgesics

Question 5

Iliotibial band syndrome

Answer 5

young athletes (runner/cyclist) - lateral hip pain - radiates down leg - pain along band down to knee - streching of band by adduction of knee reproduces pain - worse with running or cycling

Question 6

Osteoarthritis of hip

Answer 6

groin/gluteal pain - pain elicited by passive ROM

Question 7

Lumbar rediculopathy

Answer 7

pain in lateral hip - area NOT tender to palpation - straight leg test postive + , NOT exacerbated by walking - +parathesia/weakness of leg

Question 8

Meralgia parasthetica

Answer 8

entrapment of lateral femoral cutaneous nerve - parathesia over anterolateral thigh - purely senory - NO MOTOR SX, no wkness - DM, obesity, tight fitting pants/belts (waiters…)