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Medicine Clerkship > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Differential for hot swollen joint?

A

Septic arthritis, gout, pseudogout, hemarthrosis

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2
Q

How to work up hot and painful joint?

A

Tap it

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3
Q

Appearance of normal joint fluid

A

Serous,

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4
Q

Appearance of OA joint fluid

A

Normal! Serous

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5
Q

Appearance of inflammatory joint fluid

A

Cloudy, between 5 and 50,000 WBC

Poly predominance

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6
Q

Appearance of crystal arthropathy fluid?

A

Cloudy, between 5 and 50,000 WBC

Poly predominance. Intracellular crystals

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7
Q

Appearance of septic joint fluid

A

> 50,000 WBC, Opaque, 90% polys. + gram stain (except for GC)

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8
Q

Sexually active female with hot swollen joint?

A

Think gonococcal arthritis. Careful because it doesn’t gram stain well

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9
Q

ANA

A

Lupus

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10
Q

Anti-CCP

A

RA

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11
Q

RF

A

RA

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12
Q

Anti-histone

A

Drug induced lupus, procainamide, isoniazid, hydralazine

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13
Q

Anti ds DNA

A

Lupus, correlates with renal disease

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14
Q

Centromere

A

CREST

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15
Q

Anti topoisomerase

A

Scleroderma (systemic)

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16
Q

Anti smooth muscle

A

Autoimmune hepatitis

17
Q

Ro+lA

A

Sjogrens

18
Q

Antimitochondrial

A

PBC

19
Q

Anti Jo

A

Myositis

20
Q

Lupus

A

Autoimmune complex formation and deposition

21
Q

Symptoms of LUPUS

A

MD SOAP BRAIN

Malar Rash
Discoid rash
Serositis
oral ulcers
arthritis
photosensitivity
blood (decreased ph and decresed hgb)
Renal failure
ana
immunologic complex
neuro (cerebritis, transverse myelitis)

Liebman sach’s endocarditis

22
Q

How to diagnose lupus

A

Need 4 sxs with ANA and DSDNA
U/A with biopsy for nephritis
Get complement levels (will be decreased) during a flare
ESR and CRP to track progress

23
Q

How to treat Lupus?

A

Treat arthritis and serositis with NSAIDS (or hydroxychloroquine)
Treat flare with steroids
Treat severe disease with cyclophosphamide

24
Q

RA

A

Autoimmune, affects women>men >40 years old. Pannus formation with joint destruction. Periarticular osteopenia.

25
Q

Symptoms of RA

A

Symmetric joint involvement that spares dips. Morning stiffness, nodules filled with cholesterol, C1 and C2 spinal involvement

26
Q

Diagnosis of RA

A

Anti CCP and RF

27
Q

How to treat RA?

A

NSAIDs for symptomatic relief
DMARDS for everybody –MTX
If severe, then biologics like infliximab.
Steroids during a flare

28
Q

Felty syndrome

A

RA + neutropenia + splenomegaly

29
Q

Scleroderma

A

Collagen deposition that replaces smooth muscle

CREST and systemic

30
Q

CREST syndrome

A

Calcinosis, raynauds, esophageal dysmotility, sclerodactyly, telangiectasias

31
Q

Systemic sclerosis

A

Interstitial lung disease and scleroderma renal crisis (malignant hypertension with renal failure, hemolytic anemia and thrombocytopenia)

32
Q

Pulmonary hypertension in scleroderma

A

Happens in both crest syndrome and systemic sclerosis

33
Q

How to treat scleroderma

A

Can’t do anything, can, however, treat interstitial lung disease with cyclophosphamide.

34
Q

How to treat scleroderma renal crisis?

A

ACE inhibitors

35
Q

Sjogren’s Disease

A

Lymphocytic infiltration of exocrine glands,

dry eyes, dry mouth, parotid swelling. Shermer test
Treat with artificial tears and saliva.

36
Q

Inclusion body myositis vs polymyositis vs dermatomyositis pathogenesis

A

Inclusion - t cell mediated
polymyositis - t cell mediated
dermatomyositis - immune complex deposition

37
Q

How do patients with myositis present

A

Proximal muscle weakness with painful muscles.

Grotton’s papules, heliotrope rash, shawl sign

38
Q

How to diagnose myositis

A

EMG, muscle biopsy, anti jo

39
Q

How to treat myositis

A

Steroids or find the cancer.

Medicine Clerkship (12 decks)

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