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PM&R > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What is the most destructive element in RA?

A

Pannus formation

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2
Q

What criteria needs to be fulfilled to diagnose RA?

A

Score of greater than or equal to 6/10 on ACR/EULAR classification criteria

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3
Q

Morning stiffness in major arthritides: duration and location for OA, RA, ank spon?

A

OA: < 30 mins; DIP, knees, hips
RA: > 1 hr; MCP, PIP, MTP joints
Ank spon: 3 hrs; lumbosacral spine

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4
Q

Synovial fluid testing numbers for RA

A

Low viscosity
WBC 1000-75000
Greater than 70% PMN’s
Transparent-cloudy

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5
Q

Where can erosions be seen in RA? Is DIP involved? Symmetric or asymmetric?

A

Ulnar styloid and metatarsal head of MTP joint;
no;
Starts maybe asymmetric, but progresses to symmetric

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6
Q

What is the pathology behind Boutonniere deformity? How to manage?

A

Weakness or rupture of terminal portion of extensor hood at PIP;
Boutonniere ring splint

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7
Q

For swan neck deformity, which of MCP, PIP, DIP are in flexion/extension?

A

MCP = flexed; PIP = extended; DIP = flexed

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8
Q

What is a concern with RA and cervical spine? With cervical flexion, what A-A space is considered abnormal?

A

Atlanto-axial joint subluxation, most common being anterior subluxations;
Greater than 2.5-3 mm

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9
Q

In what rheum pathologies do you see subcutaneous nodules?

A

RA, gout

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10
Q

What can be seen with RA pericarditis?

A

Chest pain, pericardial friction rub, EKG abnormalities (diffuse ST elevations)

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11
Q

Felty’s syndrome triad?

A

RA, splenomegaly, leukopenia

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12
Q

Mild RA requires what type of exercise program?

A

Isometric program

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13
Q

In OA, increased water content of OA cartilage leads to

A

damage of the collagen network

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14
Q

DISH hallmark is what?

A

Ossification spanning four contiguous vertebral bodies (3 or more intervertebral discs);
see ossification of ALL

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15
Q

What are the most common joints involved in oligoarticular JIA? Other key features?

A

Knee, followed by ankle, wrist, then elbows (KAWE)

ANA and HLA-B27 positive, RA neg; iridocyclitis such that ophthalmology referral mandatory, no erosions

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16
Q

With JIA, why avoid salicylates?

A

Reyes’ syndrome

17
Q

Pseudogout has associations with which medical conditions?

A

Hypothyroidism, hypoMg, hypophos;
Hyperparathyroidism;
Amyloid, hemochromatosis

18
Q

Hallmark of AS?

A

B/l sacroiliitis

19
Q

Cervical ankylosis develops in ______ % of patients who have AS for _______ yrs or longer

A

75; 16

20
Q

Triad of reactive arthritis? What can patients with this progress to?

A

Conjunctivitis, arthritis, non-gonococcal urethritis;

AS

21
Q

Radiographic findings in Reactive arthritis?

A
  1. Lover’s heel (erosion and periosteal changes at insertion of plantar fascia and Achilles tendons)
  2. Asymmetric SI joint involvement
  3. Syndesmophytes
  4. Pencil-in-cup deformities
22
Q

Psoriatic arthritis is associated with what other disease? What joints are most involved?

A

HIV; foot and ankle

23
Q

Acronym for SLE criteria?

A 
DOPAMINE RASH
D: Discoid rash
O: Oral ulcers
P: Photosensitivity
A: Arthritis
M: Malar rash
I: Immunologic disorder
NE: Neuro disorder
R: Renal disorder
A: Abnormal ANA titer
S: Serositis
H: Hematologic disorder
24
Q

Which type of poly/dermatomyositis is associated with malignancy?

A

Type 3

25
Q

Juvenile dermatomyositis associated with

A
  1. generalized vasculitis
  2. heliotrope rash
  3. clumsiness
  4. female preponderance
  5. responds well to steroids
26
Q

Among MCTD, RA, SLE, scleroderma, polymyositis, and Sjogren’s, which are both ANA and RF +?

A

RA, MCTD, Sjogren’s

27
Q

For septic arthritis, most common organism in adults vs kids?

A

Gonorrhea for adults, S aureus in kids

28
Q

Most common cause of septic arthritis in kids 6 mos to 2 yoa?

A

Haemophilus influenza

29
Q

Sjogren’s could have involvement of which gland?

A

Parotid

30
Q

How does hemophilic arthropathy manifest?

A

Blood in joint depositing hemosiderin into the synovial lining leading to synovial proliferation and pannus formation

31
Q

Most likely causes of Charcot joint?

A

Syringomyelia for shoulder;
tabes dorsalis for syphilis at knee;
diabetic neuropathy for ankle

32
Q

SCFE is linked with

A

endocrinopathies (hypothyroidism most common)

33
Q

CRPS: describe the findings at the different stages

A
  1. Acute: Swelling, allodynia, hyperhydrosis, increased blood flow with temp and skin-color changes
  2. Dystrophic: persistent pain, atrophic skin changes, decreased temp
  3. Atrophic: Skin cool, glossy; atrophy
34
Q

In CRPS, which extremity is affected most in kids vs adults? What is treatment for adults? What imaging is most impactful for adults?

A

Upper in adults, lower in kids;
Symp blocks;
Triple-phase bone scans

35
Q

What is most common extensor tendon injury?

A

Mallet finger

PM&R (12 decks)

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