rheumatology

Question 1

american college of rheumatology guidelines to diagnose temporal arthritis

Answer 1

3: 5
1. onset after 50 yo
2. new headache
3. esr greater than 50
4. abnormal temporal artery (tender/ non-pulsatile
5. biopsy shows monocellular cell infiltration or granuloma

Question 2

sjogren syndrome is a risk factor for what neck lump

Answer 2

non hodgkin’s lymphoma

Question 3

uveitis definition and what is it associated with

Answer 3

inflammation in the middle layer of the eye- clinical signs is a painful red eye with diminished vision. It is associated with HLA B27 positive inflammatory arthropathies.

Question 4

mouth ulcers are a sign of?

Answer 4

inflammatory bowel disease crohns associated with arthropathy

Question 5

lung signs of fibrosis can be associated with what rheum condition?

Answer 5

rheumatoid arthritis and treatment for rheum (methotrexate)

Question 6

How do you check a joint for septic arthritis

Answer 6

examination- infection- red hot swollen

athrocentesi

Question 7

What is the treatment for Rheumatoid arthritis

Answer 7

1. disease modifying anti-rheumatic drugs
2. Biologics (if 2 DMARDS fail)
3. steroids for acute flares
4. NSAIDS for pain relief does not effect disease progression.

Question 8

What are the DMARDS?

Answer 8

Methotrexate
Sulfasalazine
hydroxychloroquine

Question 9

What are the biologics used for RA?

Answer 9

Infliximab (TNF alpha inh)
Rituximab
Tocilizumab
Abatacept

Question 10

What are some SE of methotrexate?

Answer 10

pneumonitis, interstitial lung fibrosis, ulcers, hepatotoxicity
anemia

Question 11

What a re some SE of Sulfalazine

Answer 11

rash, reduced sperm count, oral ulcers

Question 12

what are the SE for Hydroxychloroquine

Answer 12

irreversible retinopathy

Question 13

What are the SE of biologics

Answer 13

TB or HEP B reactivation

opportunistic infections, HF, hypersensitivity reactions, SLE type illness

Question 14

What are the SE of steroids

Answer 14

skin- skin atrophy 
stretch marks 
purpura
acne
CV- hypertension 
Metabolic weight gain, moon like facies 
hyperglycemia, hypocalcemia 
CNS- mood disorders, psychosis 
eyes- cataracts, glaucoma 
other- adrenal cortical atrophy adrenal insufficiency, avascular necrosis of the bone, osteoporosis, myopathy 
peptic ulcer disease

Question 15

What can you see on x-ray for RA?

Answer 15

Ulnar deviation of the MCP
juxta-articular osteopenia
MCP or ICP subluxation
swan neck deformatities