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Internal Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Polyatricular symmetric arthritis seen in

A

RA
SLE
Hep B
Parvovirus B19

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2
Q

Monoarticular arthritis seen in

A 
Osteoarthritis
Crystal induced (Gout, pseudogout)
Septic( gonococcus)
Traumatic
Hemarthrosis
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3
Q

What is migratory polyarthritis

A

Shifting of inflammation and pain from one joint to another and relieve of previous joint

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4
Q

Migratory arthropathy is seen in

A

Rheumatic fever
Disseminated gonoccocal
Lymes ds

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5
Q

Oligoarticular assymetric

A

Osteoarthritis of small joints of hands
Ankylosing spondylitis
Rarely polyarticular gout

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6
Q

Features of joint inflammation

A 
Joint stiffness in morning >1hr
Erythema
Warmth
Inc ESR
Inc CRP
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7
Q

Eg of inflammatory arthritis

A

RA

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8
Q

What should be checked in synovial fluid

A

3cs:crystals
Cells
Culture
Gram stain

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9
Q

Diff bw crystals of gout and psedogout

A

Gout:negative birefringent, needle shaped

Pseudogout: positive, rhomboid shape

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10
Q

What is wbc range in synovial fluid of inflammatory arthritis

A

5000-50000 WBC/mm3

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11
Q

Wbc in septic arthritis

A

> 50,000 wbc/mm3

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12
Q

4 basic questions to be asked in case of evaluating a patient with arthrits

A
  1. distribution(asymm/symmetric) and no. Of joints (mono/poly)
  2. symptons acute/chronic
  3. systemic symptoms
  4. evidence of joint inflammation
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13
Q

Can ANAs be found in normal people?

A

Yes in 5% of normal person(especially speckled pattern)

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14
Q

ANA pattern in SLE

A

Peripheral/rim

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15
Q

Centromere ANA pattern seen in

A

CREST (c to remember)

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16
Q

ANA pattern seen in systemic sclerosis

A

Nucleolar

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17
Q

ANA mostly found in SLE

A

Anti dsDNA
Anti SM
Anti Ro

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18
Q

Specific ANA in drug indiced lupus

A

Anti -histone

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19
Q

ANA in CREST

A

Anti centromere

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20
Q

Anti RNP specific to

A

Mixed connective tissue ds(100%)

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21
Q

What is RF

A

Is an autoantibody against Fc portion IgG

22
Q

Can RF be found in normal individuals

A

Yes 5%

23
Q

cANCA and pANCA found in

A

C-wegeners granulomatosis

P- PAN, churg stauss

24
Q

What are the common lab abnormalities ass with Anti phospholipid Ab syn

A
  1. Prolonged PTT

2. False positive RPR/VDRL

25
Q

Distribution of joints affected in RA

A

Symmetric
Mostly of hands-wrist ,MCP, PIP.

NEVER:
DIP
joints of lower back (but cervical involovement seen in 25-80% :atlantoaxial subluxation)

26
Q

Felty and kaplan syndrome

A

RA+ splenomegaly + neutropenia

RA+ pneumoconiosis

27
Q

Predominant infilterating cell in RA

A

T lympocyte

28
Q

Boutonnaires and swan neck deformity seen in

A

RA

29
Q

Most likely reason in patient with RA who complains of occipital headache and upper extremity tingling sensation

A

Atlantoaxial subluxation

30
Q

Most likely reason in patient with RA who complains of occipital headache and upper extremity tingling sensation

A

Atlantoaxial subluxation

31
Q

Most common cause of disability in SLE

A

Lupus nephriti

32
Q

Rash of SLE

A

Maculopapular which is photosensitive , leaves no scar
Butterfly shape

Not seen in drug induced lupus

33
Q

Rash of DLE

A

Face and scalp
Circular rash
Raised rim
Disfiguring (central atrophy and scarring)

34
Q

Pregant SLE patients need to bd screened for which Ab

A

Anti Ro/SSA
Passively cross placenta
Cause neonatal lupus and heart block

35
Q

Symmetric polyarticular joint involvement in

A 
RA 
SLE
SSc
Sjorgen
Hep B
Parvovirus B 19
36
Q

What is CREST syndrome

A 
C calcinosis
R Raynauds 
E esophageal dysmotility
S sclerodactyly
T telengiectasia
37
Q

What is primary raynauds phenomenon

A

Also called raynauds ds
Without associated underlying disease

Secondry: associated with disease eg scleoderma

38
Q

How to differntiate be 1 and 2 raynauds on examination

A

Done by nailfold cappiloscopy test

Enlarged,dilated or absent nailfold capillaries noted in scleoderma and other AI ds.

39
Q

What are seronegative arthropathies

A

AS
Reactive
Psoriatic
Enteropathic arthropathy

Called so because of absence of ANA and RF

40
Q

Most common presentation of AS

A

Chronic lower back pain

Morning stiffness lasting atleast 1 hr improves with exercise

41
Q

MC extraarticular manifestation of AS

A

Anterior uveitis

Aortic insufficiency leading to chf and 3 degree heart block

42
Q

Reiters syndrome

A

Reiter’s Syndrome is a reactive arthritis that develops in response to an infection and characterized by a triad of arthritis, conjunctivits, and nonspecific urethritis.

Reiter syndrome) occurs after a nongonococcal urethritis (chlamydia, ureaplasma). These patients have distinct mucocutaneous manifestations: keratoderma blennorrhagica, circinate balanitis, oral or genital ulcers, conjunctivitis, and arthritis.

43
Q

causes of ReA

A
  1. Post veneral -Urethritis

2. Post enteric -Diarrhoea caused by invasive org.( camp , shigella , salmonella)

44
Q

Circinate balanitis

A

comprising a serpiginous annulardermatitisof theglans penis.

Circinate balanitis is the most common cutaneous manifestation of reactive arthritis

45
Q

Keratoderma blennorrhagica

A

Keratodermablennorrhagicum meaning keratinized (kerato-) skin (derma-) mucousy (blenno-) discharge (-rrhagia) (also calledkeratoderma blennorrhagica)are skin lesions commonly found on thepalmsandsoles.

One of the manifestation of Re A

46
Q

Psoritic arthritis hand changes

A 
Typical skin rash
Pencil in cup deformity
Mouse ear appearance
Nail pitting
Sausage shaped finger
47
Q

What is mc joint involved in osteoarthritis

A

Weight bearing joint(Knee,hip)

Small joints of fingers(PIP , DIP , base of thumb)

Monoarthritis/ assymetric oligarticular

48
Q

Osteophytes in PIP and DIP

A

Bouchard

Herbeden nodes

49
Q

Why serum uric acid level is not app for dx of gout?

A

The serum uric acid during the acute attack may be normal or low. On the other hand, many people have elevated serum uric acid levels and never develop gout. Thus, the serum uric acid level is of no value in the diagnosis of acute urate arthropathy. This is why the diagnosis is made by the analysis of synovial fluid.

50
Q

Fish like scales seen in

A

Icthyoses

3 types
Icthyoses vulgaris AD
X linked icthyoses
Lamellar icthyosis

51
Q

Icthyosis vegaris

A

AD
Deficiency in filagggrin
Both males and females
Small, branny , except on shins where large.
Pasted in centre with upturned edge.
Extensors of limbs, lower back.
Associated with- hyperlinear palms and soles, keratosis pilaris , atopic diathesis

52
Q

X linked icyhyoses

A 
Only males
Deficiecy in steroid sulfate
Large dark , tightly adherent
Sites: generalised, flexures enctoached
Ass: corneal opacities , cryptorchidism

Internal Medicine (9 decks)

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