Rheumatology

Question 1

Recurrent oral aphthous ulcers that are painful, genital ulcers, anterior uveitis, erythema nodosu thrombosis -

Answer 1

behcet disease

Question 2

ER and ADD of hip = ?

Answer 2

fem fracture

Question 3

Sx: fever, urticarial rash, arthralgia, LAD. Timeline: 1-2wks after beta-lactam or sulfa abx.

dx and tx

Answer 3

dx - serum sickness-like raction

tx - stop anx

Question 4

neutropenia + SM + RA = ?

Answer 4

felty

Question 5

Mgmt of dysplasia based on age

Answer 5

Mgmt of dysplasia: less than four mo = hip u/s greater than four mo = hip xr

Question 6

bilateral hilar LAD

Answer 6

sarcoid

Question 7

SLE and APL - what coag change?

Answer 7

incr aPTT

Question 8

why does Systemic sclerosis/scleroderma cause esophageal sx

Answer 8

ddt smooth muscle atrophy and fibrosis

Question 9

Vasculitis (large artery)
1. Aortic involvement = early Constitutional sx (wt loss), later arterio-occlusive, pulse deficits, bruits in supraclavicular fossa, BP discrepancies. 10-40yo.

dx and tx?

Answer 9

TAKAYASU ARTERITIS.

CS tx

Question 10

Vasculitis (large artery) 2. >50yo, temproal or scalp tenderness. Jaw claudication is most specific. Chronic pain and stiffness of shoulders and hips (polymyalgia rheumatica).

dx?

Answer 10

GIANT CELL ARTERITIS.

Question 11

purulent monoartcular &/OR triad o

tenosynovitis, dermatitis, ASYMMETRIC polyarthralgias. - dx?

Answer 11

disseminated gono

Question 12

succinylchline MOA (Na and K, pre or post )

what trauma do you not use sux?

Answer 12

Succinylcholine triggers INflux of sodium ions and EFflux of K ions at postsynaptic ACh receptors - for temporary paralysis during intubation.

If severe hyperK (as in crush injury/rhabd then succinylcholine would put pt at risk for cardiac arrhytmia. Better to use roc.

Question 13

Disease modifying antirheumatic drugs examples

Answer 13

MTX, fleuflonomide, hydroxychloroquine, Sulfasalazine, TNF-inhin

Question 14

> 50yo, >1mo pain and STIFFNESS in hips and shoulder GIRDLE, morning stiffness >1hr, constitutional sx (wt loss, malaise), ESR >40, anemia possible. TX: GC.

Answer 14

Polymyagia rheumatica - is frequently associated iwth Giant Cell arteritis (aka temporal arteritis).

Question 15

ESR elevation, hyperFerritinemia, hypergammaglobulinemia, thrombocytosis, anemia (ML dt chronic inflammatoion and iron deficiency) **Ferritin and platelets are acute phase reactants, as is GGT
common labs for what in kids <16?
at least 6 weeks of mornign stiffness with gradula loss of motion femlaes>males

Answer 15

juvenile idiopathic arthritis