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Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Most accurate test for Rheumatoid arthritis?

A

Anti-cyclic citrullinated peptide (anti-CCP)

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2
Q

Rheumatoid Arthritis defined as having 4 of the following 8 criteria present?

A
  1. Morning stiffness lasting longer than 1 hour
  2. Wrist and finger involvement (MCP, PIP)
  3. Swelling of at least 3 joints
  4. Symmetric involvement
  5. Rheumatoid nodules
  6. X-ray abnormalities showing erosions
  7. Positive Rheumatoid Factor or anti-CCP
  8. Elevated CRP or ESR
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3
Q

What is Felty’s Syndrome?

A

Rheumatoid arthritis along with splenomegaly and neutropenia

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4
Q

Adverse effects of Methotrexate?

A

Bone marrow suppression, pneumonitis

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5
Q

Next step for management of RA if methotrexate fails?

A

TNF-inhibitors (Infliximab, Adalimumab, Etanercept)

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6
Q

Role of hydroxychloroquine in RA? What do you need to monitor when using it?

A

Can be used in mild disease. Monitor for retinopathy with regular eye exams.

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7
Q

Role of steroids in RA?

A

Bridge to DMARD therapy. Use in acutely ill patient with severe inflammation.

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8
Q

Young male presents with back stiffness, worse at night, relieved by leaning forward. HLA-B27 positive. RF negative. Diagnosis?

A

Ankylosing Spondylitis

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9
Q

Comorbidities that may present with Ankylosing Spondylitis?

A

Uveitis, Aortitis, Restrictive lung disease

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10
Q

Treatment for Ankylosing Spondylitis?

A

NSAIDS, Biological agents (Infliximab or Adalimumab), Sulfasalazine

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11
Q

Infectious organisms associated with Reiter’s Syndrome (Reactive Arthritis)?

A

Chlamydia, Shigella, Salmonella, Yersinia, Campylobacter

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12
Q

4 main seronegative spondyloarthropathies?

A
  • Ankylosing Spondylitis
  • Reactive Arthritis
  • Psoriatic Arthritis
  • Juvenile Rheumatoid Arthritis
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13
Q

Defining characterestics of seronegative spondyloarthropathies?

A
  • Negative for Rheumatoid Factor
  • Predilection for the spine
  • Sacroiliac Joint involvement
  • HLA-B27 positive
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14
Q

Physical exam findings in psoriatic arthritis apart from psoriasis and joint pain?

A
  • Nail pitting
  • DIP involvement (unlike RA)
  • “Sausage shaped” digits (dactylitis)
  • Enthesitis (inflammation of tendon insertion sites)
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15
Q

Physical exam findings other than joint pain in Juvenile Rheumatoid Arthritis?

A
  • Fever
  • Salmon colored rash
  • Polyarthritis
  • Lymphadenopathy
  • Myalgias
  • Maybe hepatomegaly with elevated transaminases
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16
Q

Lab findings in Juvenile Rheumatoid Arthritis?

A
  • Very high ferritin
  • Leukocytosis
  • Negative RF/ANA
17
Q

Presentation of Whipple Disease?

A

Diarrhea, fat malabsorption, weight loss along with joint pain.

18
Q

Treatment for Whipple Disease?

A

Bactrim

19
Q

Suspicious of Osteoarthritis. What type of labs should you order?

A

X-ray

-ANA, RF, anti-CCP, Rheumatoid Factor

Medicine (10 decks)

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