Rheumatology Flashcards
What is rheumatoid factor?
an IgM against IgG Fc
What are tophi?
gout crystals + giant cells
What is podagra?
big toe inflammaiton
What is CREST syndrome?
C:calcinosis R: Raynaud's E: Esophageal dysmotility S: Sclerodactyly T: Telangiectasia
What Ab is assoc with CREST?
anti-centromere ab
What diseases have Raynaud’s syndrome
scleroderma
Takayasu’s
RA
SLE
What platelet count do most types of vasculitides have?
low platelets
Which vasculitis has a high platelet count?
Kawasaki disease
Which vasculitis has normal platelet count?
Henoch-Schonlein Purpura
What is osteoarthritis?
pain worse with activity
PIP/DIP joints
What is rheumatoid arthritis?
pain worse in morning
MCP/PIP joints
What is Still’s disease?
juvenile RA
What is Pseudogout?
pyrophosphate crystals in knees and wrists
What is gout?
urate crystals in big toe
neg birefringence
What is myositis?
1 muscle hurts
What is polymyositis?
> 1 muscle weak
What is dermatomyositis?
myositis + rash
What is fibromyalgia?
hurt all the time
11 trigger points
What is polymyalgia rheumatica?
weak shoulders
temporal arteritis
What is SLE (lupus)?
discoid rash
What is scleroderma?
tight skin
fibrosis
What is Takayasu Arteritis?
pulseless Asian women
aorta inflammation
What is Polyarteritis Nodosa?
p-ANCA Ab
attacks gut/kidney
Hep B
What is Wegner’s Granulomatosis?
c-ANCA Ab
attacks ENT, lungs, kidney
What is Goodpasture’s?
anti-GBM ab
attacks lung/kidney
RPGN
What is Reiter’s syndrome?
males that can’t see, can’t pee, can’t climb a tree
What is Sjogren’s syndrome?
females that have dry eyes/mouth
RA
What is Behcet’s syndrome?
oral and genital ulcers
uveitis
What is Churg-Strauss?
asthma
eosinohils
multi-organ involvement
What is Felty’s syndrome?
RA
leukopeia
spenomegaly
What is Kawasaki’s Disease?
CRASH
C: conjunctivitis
R: rash (palms/soles)
A: aneurysm (coronary artery–> MI in kids)
S: strawberry tongue
H: hot (fever >102 for at least 3 days + cervical lymphadenopathy)
What is the complication of temporal ateritis?
blindness
What is another name for temporal arteritis?
giant cell arteritis
How do you diagnose temporal arteritis?
temporal artery biopsy
What is the rule of 60’s for temporal arteritis?
age>60
ESR>60
60mg prednisone to tx
What condition is assoc with one muscle hurting?
myositis
What condition is assoc with several muscles hurting?
polymyositis
What condition is assoc with musle pain plus rash?
dermatomyositis
What condition is assoc with inflamed muscle insertions?
fibrositis
What condition causes pain of muscle and muscle insertion?
fibromyalgia
What condition is assoc with shoulder girdle hurting most?
polymyalgia rheumatica
What condition is assoc with visceral cancer?
dermatomyositis (colon cancer)
What condition is assoc with Rifampin, INH, Statins,Prednisone, and hypothyroidism?
myositis
What condition is treated with amitriptyline?
fibromyalgia
What condition is increased in temporal arteritis?
polymyalgia rheumatica
What condition is assoc with multiple trigger points?
fibromyalgia
What condition is assoc with muscle pain when moving?
fibrositis
What condition is assoc with heliotropic rash?
dermatomyositis
What condition is assoc with a throbbing temporal headache?
temporal arteritis
What drugs cause myositis?
rifampin
INH
statins
prednisone
What disease causes myositis?
hypothyroidism
What is the treatment for multiple sclerosis?
#1 steroids #2 blocking immunoglobulins (TNF-beta) #3 plasmapheresis
What structure does MS like to attack
medial longitudinal fasciculus–> internuclear opthalmoplegia
What is the diagnosis for a middle aged woman with optic neuritis (eye problem)?
multiple sclerosis
What is the equivalent disease to MS in children
metachromatic leukodystrophy
What vasculitis occurs 2 wks after a common cold?
Berger’s
What disease presents as a smoking Jew with necrotizing vasculitis?
Buerger’s
What disease has a family history of deafness and cataracts?
Alport’s
What vasculitis has a strawberry tongue?
Kawasaki’s
What vasculitis has fibrin split products?
DIC
What vasculitis presents 2 wks after E. coli gastroenteritis?
hemolytic uremic syndrome
What vasculitis presents with fever, thrombocytopenia, and neuro problems?
ITP
What vasculitis attacks midsize arteries (particularly in GI and kidney)?
polyarteritis nodosa
What vasculitis affects the sinuses, lung, and kidney
Wegner’s Granulomatosis
What vasculitis has linear immunofluorescence on GBM with lung involvement?
Goodpasture’s
What vasculitis has pulmonary infiltrates with eosinophilia?
Churg-Strauss
What glomerulonephritis occurs two weeks after a sore throat?
Post-Strep Glomerulonephritis
What vasculitis presents two wks after vaccination?
serum sickness
What disease leads to septic emboli?
subacute bacterial endocarditis
What is the only vasculitis with a normal platelet count?
HSP
What is the only vasculitis with a high platelet count?
Kawasaki’s
What is the MCC of death in SLE?
renal failure
What protein is decreased in all vasculitides?
haptoglobin
What cellular response is seen in all vasculitides?
T cells and macrophages
What are the clues for Kawasaki?
mucositis
rash on palms and soles
cervical lymph nodes
fever>102 for >3days
What are the clues for TTP?
fever
thrombocytopenia
neurologic problems
What are the clues for polyarteritis nodosa?
midsized arteries (GI and renal)
associated with Hep B
p-ANCA
What are the clues for Churg-Strauss?
allergic vasculitis
What are the clues for SBE?
caused by strep viridens
What are the clues for MPGN I?
tram tracks with C3 nephritic factor in basement membrane
What are the clues for MPGN II?
tram tracks with low complement (dense deposit disease)
What are clues for CREST?
mildest form of scleroderma
patchy involvement
What are the clues for scleroderma?
anti-scl70 Ab
anti-sm muscle Ab
What are clues for progressive systemic sclerosis?
scleroderma with organ involvement
What are clues for rheumatoid arthritis?
symmetrical polyarteritis
worse in morning
What are clues for juvenile rheumatoid arthritis?
arthritis with iridesis
What are clues for Felty’s?
RA + leukopenia + splenomegaly
What are clues for Behcet’s?
RA + GI ulcers
What are clues for Sjogren’s?
RA + dry eyes, dry mouth
What is the vasculitis with GI bleeding, intussusception, and normal platelet count?
HSP
What is the vasculitis whose most common cause of sepsis?
DIC
What is the most common cause of renal failure in children?
HUS
What is the vasculitis with which Hep B is assoc with?
PAN
What vasculitis causes pulmonary infiltrate with eosinophilia?
Churg-Strauss
What vasculitis has xerophthalmia and xerostomia?
sjogren’s
What is the most common cause of arthritis in a middle aged female?
rheumatoid arthritis
What is the only arthritis that attacks the synovium?
rheumatoid arthritis