Rheumatology Flashcards
What is Pseudogout?
Calcium pyrophosphate dihydrate (CPPD) crystal disease
Pseudo-gout risk factors?
Hemochromatosis, hyperparathyroidism
diabetes, hypothyroidism, Wilson disease
Joints affected by Pseudo-gout?
Large joints such as knee and wrists
Most Accurate test for Pseudogout and what does it show?
Arthrocentesis
(+) birefringent Rhomboid-shaped crystals
Blue when parallel to polarized light
Pseudo gout treatment?
Initial: NSAIDs
Intrarticular steroids (tramcinolone, colchicine)
Prophylaxis: Colchicine
What type of crystals are seen in Pseudogout?
Calcium pyrophosphate dihydrate crystals
(+) birefringent rhomboid-shaped crystals
blue when parallel to polarized light
What type of crystals are seen in Gout?
Uric acid crystals
(-) birefringent needle-shaped crystals
yellow when parallel to polarized light
What are the important side effects of Colchicine?
Diarrhea
Bone marrow suppression (neutropenia)
Which is the best HTN medication for someone with Gout?
Losartan
Because it lowers uric acid
Which medications are contraindicated in Gout, with renal injury, and which is safe?
Contraindicated: Probenecid, NSAIDs, Sulfinpyrazone
Safe: Allopurinol
What are the adverse effects of Allopurinol?
Hypersensitivity reaction
Toxic epidermal necrolysis (Stevens-Johnson syndrome)
What is the hallmark feature of myasthenia gravis?
Resolution of muscular weakness with rest
What is the common age group for Myasthenia gravis?
Women ages 18 - 25
How does Myasthenia gravis present?
Intermittent dysarthria, dysphagia, drooping eyelids, and diplopia. Generalized weakness often develops within a year. Weakness worsens during the day with resolution at rest.
