Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Internal Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

[MSK]

Chronic noniflammatory arthritis, involving the DIP, CMC1, hip, knee joints

A

Osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chronic inflammatory polyarthritis, symmetric involvement, including the PIP, MCP, MTP

A

RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Heberden nodes is also known as ____

A

DIP

B muna bago H

Heberden = HBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bouchard nodes is also known as ____

A

PIP

B muna bago H

Heberden = HBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Joints in the hands affected in OA

A

DIPOA
PIPOA
CMCOA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Joint in the forearm affected by RA

A

Wrist, MCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for Fluid Aspiration and Analysis

A
  1. Monoarthritis
  2. Trauma with effusion
  3. Monoarthritis in a patient with chronic polyarthritis
  4. Suspicion of joint infection, crystal-induced arthritis, hemarthrosos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

[Characteristic of synovial fluid]

>1mL
reduced viscosity
WBC 2000-50,000
Glucose <50mg lower than blood
Translucent
Turbid, yello
A

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

[Characteristic of synovial fluid]

>1mL
Low viscosity
WBC >50,000
<50mg/dL lower than blood
opaque, purulent
culture positive
A

septic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

[Characteristic of synovial fluid]

>1mL
High viscosity
<2000 WBC
glucose equal to blood,
clear amber
A

non-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the best initial treatment for osteoarthritis?

A

X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the best initial management?

A

Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pathologic sine qua non of the disease?

A

hyaline articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

spared joints in OA

A

Wrist, Elbow, Ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common cause chronic knee pain in persons >45 years old

A

OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

[Diagnosis]

35/F hand stiffness, symmetric polyarticular arthritis, stiffness worst in the morning, mild swelling and tenderness over the MCP joints of both hands and knees, elevated ESR

A

Dx: RA
Next diagnostic step: RF, anti-CCP
Accurate test: Anti-CCP antibodies
Initial Tx: DMARDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the cause of ulnar deviation in RA?

A

subluxation of the MCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The inflammation of the ulnar styloid and tenosynovitis of extensor carpi ulnaris leads to ___ in RA

A

subluxation of distal ulna, piano key movement of ulnar styloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

___ syndrome

Ndoular RA
Splenomegaly
Neutropenia

A

Felty’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common pulmonary manifestation of RA?

A

pleuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most common valvular abnormality in RA?

A

mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

[Deformity in RA]

Flexion of the PIP
Hyperextension of DIP

A

Boutonniere deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

[Deformity in RA]

Hyperextension of PIP
Flexion of DIP

A

Swan neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

[Deformity in RA]

subluxation of first MCP
Hyperextension of the 1st IP

A

Z-line deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The most common site of cardiac involvement in RA

A

pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Conditions with positive RF

A
  1. SLE
  2. Sjogren
  3. Subacute bacterial endocarditis
  4. Hep C and C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Most specific serologic marker for RA

A

Anti-CCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the initial radiographic finding in RA?

A

periarticular osteopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Drug class that slows the structural progression of RA

A

DMARD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Drug class that is initially given to control RA before DMARD takes full effect

A

glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Drug class given in acute flares of RA

A

glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the best initial DMARD of RA?

A

methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What DMARDs are safe in pregnancy?

A
  1. Hydroxychlorquine

2. Sulfasalazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

DMARDs that are teratogenic

A

MTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the major concern in using DMARDs

A

increased risk for infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the next best step after Acute Monoarticular arthritis is diagnosed?

A

Diagnostic arthrocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the initial therapy for gout?

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

[diagnosi]

male, obese, sudden onset knee and big toe pain, presence of inflammation

A

Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the most common early clinical presentation of gout?

A

actue arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Vitamin that can cause hyperuricemia

A

Niacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

___ negatively birefringent needle shaped crystal

A

monosodium ureate = gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

___ positively birefringent rhomboid-shaped crystal

A

Calcium pyrophosphate = pseudogout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the characteristic radiologic features of gout?

A

Cystic changes with well-defined erosions and overhanging sclerotic margins and soft tissue masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the first line treatment during acute gouty attack?

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the more effective drug for polyarticular gout?

A

glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Colchicine must me temporarily discontinued at the first sign of what?

A

loose stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

When will you initiate hypouricemic drug therapy?

A
  1. After 2 episodes of acute attacs
  2. Serum uric acid >9
  3. Presence of uric acid stone
  4. Tophi or chronic goit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the drug of choice for uric acid underexcreter?

A

Probenecid, benzbromarone, sulfinpyrazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the drug of choice for uric acid overproducer?

A

allopurino, febuxostat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the most serious side effects of allopurinol?

A 
1. Life-threatening toxic epidermal necrolysis
2 systemic vasculitis
3. bone marrow suppression
4. granulomatous hepatitis
5. renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The hallmark of RA leads to decreased ROM, reduced grip, trigger fingers. What are affected?

A

flexor tendon tenosynovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

___ syndrome

Keratoconjunctivitis sicca
Xerostomia
RA

A

Sjogren Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Most common hematologic abnormality in RA?

A

normochromic normocytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

___ syndrome

Neutropenia
splenomegaly
nodular RA

A

Felty’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Offers greatest sensitivity for detecting synovitis and joint effusions

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Early sign of inflammatory joint disease

A

Bone marrow edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

most commonly affected joint in calcium pyrophosphate deposition disease

A

Knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How to differentiate psoriatic arthritis from RA?

A

In psoriatic arthritis,

  1. Seronegative
  2. DIP, spine, sacroiliac joints
  3. Distinctive radiographic features
  4. Familial aggregation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Asymmetric sacroilitis is a characteristic finding of

A

Axial psoriatic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Radiographic features of PsA from RA

A
  1. DIP involvement/penil-in-cup
  2. Marginal erosions
  3. Small joint ankylosis
  4. Osteolysis of phalangeal and metacarpal bone with telescoping of digits
  5. Periostitis and proliferative new bone at sites of enesthesitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hallmark features of psoriatic arthritis

A

dactylitis, enthesitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the criteria used to classify PsA?

A

CASPAR Criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the components of CASPAR criteria

A

Inflammatory articular disease + >= 3 of:

  1. Current psoriasis (2 points), personal history of psoriasis, family hisotry
  2. Nail dystrophy
  3. Negative test result for RF
  4. Current dactylitis/history of dactilitis
  5. Juxtaarticular new bone formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

[Diagnose]

fever, acute right knee and left wrist pain, papules and pustules on extensor surface of forearms. Synovial fluid analysis reveals leukocytes and PMNs but not organisms on gram stain

A

Dx: Septic arthritis
Etiology: N. gonorrhea
Next step: antibiotic therapy

Important to evaluateL aspiration fo synovial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Commonly involved joints among IV drug user with non-gonoccocal arthritis

A

Sternoclavicular joints
Spine
sacroiliac joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

[diagnose]

fever, chills, rash/papules, migratory arthritis, tenosynovitis

A

Disseminated gonococcal arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

[Septic arthritis synovial fluid analysis]

leukocytes 10,000 - 20,000
Negative culture

A

gonococcal arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

[diagnosis]

soft tissue swelling, joint space widening, displacement of tissue planes by the distended capsule

A

septic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the empiric DOC for patients with non-gonococcal arthritis?

A

Cefotaxime or ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the empiric DOC for patients with gonococcal arthritis?

A

Ceftiraxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

[diagnosis]

young adult, fever, chills,rash, articular symptoms

A

disseminated gonococcal arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

[diagnose]

22F fatigue, malaise, fever 10 days, swelling hands and ankles, chest pain on deep inspiration

PE: raised erythema on the skin, hand, and ankle joints swelling

A

Dx: SLE
Initial diagnostic test: ANA
Most specific test: anti dsDNA or Anti-Sm
Correlates disease activity: anti-dsDNA

Maintstay tx for life-threatening SLE: systemic glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

[Classification of LN]

LM: normal
IF: mesangial immune deposits

A

Class I: minimal messangial

74
Q

[Classification of LN]

LM: purely messangial hypercellularity or mesangial matrix expansion
IF: subendothelial deposits

A

Class II: mesangial proliferative

Tx: High dose steroids

75
Q

[Classification of LN]

GN < 50%

A

Class III: Focal

Tx: cyclophosphamide

76
Q

[Classification of LN]

GN > 50%

A

Class IV: Diffuse

Tx: cyclophosphamide

77
Q

[Classification of LN]

Global or segmental subepithelial immune deposits

A

Class V: Membranous

Tx: cyclophosphamide

78
Q

[Classification of LN]

> 90% without residual activity

A

Class VI: Advanced sclerotic

Tx: cyclophosphamide

79
Q

Signs and symptoms of SLE

A

BOSS BRAS

Brain - psychosis
Oral ulvers
Skin - butterfly rash, discoid rash
Synovitis

Blood - hemolytic anemia
Renal - hematuria, proteinuria, RBC cast,
Alopecia
Serology

80
Q

What are the serologic picture of lupus flare?

A

Increase anti-dsDNA

Low complement levels

81
Q

[treatment of SLE]

non-life threatening SLE, QOL no acceptable

A

conservative management + low dose glucocorticoids

consider: belimumab

82
Q

[treatment of SLE]

life threatening SLE, unresponsive to high dose glucocorticoids and mycophenolate mofetil

A

Give: belimumab, rituximab, calcineurin inhibitors

83
Q

[treatment of SLE]

life threatening SLE, unresponsive to high dose glucocorticoids and cyclophosphamide

A

Give: belimumab, rituximab, calcineurin inhibitors

84
Q

[treatment of SLE]

how long will you give cyclophosphamide?

A

not more than 6 months

85
Q

[name the serologic marker of SLE]

best for screening mtest

86
Q

[name the serologic marker of SLE]

best for disease activity

A

anti-dsDNA

87
Q

[name the serologic marker of SLE]

Specific for SLE

88
Q

[name the serologic marker of SLE]

associated with Sicca Syndrome

A

Anti-RO (SS-A)

89
Q

[name the serologic marker of SLE]

drug-induced lupus

A

antihistone

90
Q

[name the serologic marker of SLE]

clotting, fetal loss, thrombocytopenia

A

antiphospholipid

91
Q

[name the serologic marker of SLE]

useful in distinguishing lupus cerebritis and steroid-induced psychosis

A

antiribosomal P

92
Q

[Treatment of SLE]

Drugs for SLE relapse?

A
  1. Cyclophosphamide
  2. Azathioprine
  3. Mycophenolate mofetil
93
Q

[Treatment of SLE]

Between cyclophosphamide and MMofetil, diarrhea is more common in

A

Mycophenolate mofetil

94
Q

[Treatment of SLE]

Between cyclophosphamide and MMofetil, nausea is more common in

A

cyclophosphamide

95
Q

[Treatment of SLE]

DOC for SLE in pregnancy

A
  1. Hydroxychlorquine

2. Prednisone or prednisolone

96
Q

Drugs that cause drug-induced lupus

A
  1. Procainamide
  2. Hydralazine
  3. Propylthiouracil
  4. Lithium
  5. Phenytoin
  6. Isoniazid
  7. Nitrofurantoin
  8. Sulfasalazine
  9. Statine
97
Q

What is the target INR for SLE with APAS

98
Q

What is the target INR for SLE with recurring clots

99
Q

most common acute rash of SLE

A

butterflu rash

100
Q

leading cause of mortality on the first decade in SLE

A

nephritis and infection

101
Q

Intermittent polyarthritis in SLE are commonly seen in what areas of the body

A

Hands
Wrists
Knees

102
Q

most common chronic dermatitis in SLE

A

discoid rash

103
Q

most common diffuse CNS lupus

A

cognitive dysfunction

104
Q

most common pulmonary manifestation of SLE

105
Q

most common cardiac manifestation of SLE

A

pericarditis

106
Q

most serious cardiac manifestion in SLE

A
  1. myocarditis

2. Liebman-sacks endocarditis

107
Q

most common endocardial involvement in SLE

A
  1. Mitral valve

2. Aortic valve

108
Q

most common hematologic manifestation of SLE

A

Anemia (normo, normo)

109
Q

most common MSK manifestation of SLE

A

Arthralgia/myalgia

110
Q

most common cutaneous manifestation

A

photosensitivity

111
Q

Mainstay treatment for non-life threatening SLE

A

Analgesics

Antimalarials

112
Q

Lupus Nephritis with worst prognosis

A

crescentic lupus nephritis

113
Q

[diagnosis]

fever, disabling joing pain, previous history of sore throat, small painless lumps on his elbows and pink macules with clear center on his chest

A

Dx: ARF
Best treatment: aspirin
Secondary prophylaxis: benzathine penicillin G

114
Q

What is the valvular damage that is a hallmark of rheumatic carditis

A
  1. Mitral valve
115
Q

[Jones Criteria]

Initial ARF

A

2 major OR

1 major plus 2 minor

116
Q

[Jones Criteria]

recurrent ARF

A

2 major OR
1 major plus 2 minor OR
3 minor

117
Q

[Jones Criteria]

Major criteria

A 
J - oint polyarthalgia
O - heart, carditis
N - odules
E - erythema marginatum
S - sc nodules
118
Q

[Jones Criteria]

Minor criteria, low risk population

A

Fever > = 38.5
ESR >= 60mm
CRP >= 3mg/dL
Polyarthralgia

119
Q

[Jones Criteria]

Minor criteria, moderate to high risk population

A

Fever > = 38
ESR >= 30mm
CRP >= 3mg/dL
Monoarthralgia

120
Q

[Skin lesions]

evanescent macular rash
central clearing
serpiginous edge
migrates
non-pruritic
A

Erythema marginatum

121
Q

[Skin lesion]

annular patch
central erythema
bulls eye appearance
expands

A

erythema migrans

122
Q

[Skin lesions]

erythematous plaque
central vesicle
target or iris
pruritic

A

erythema multiforme

123
Q

[diagnose]

first degree AV block + evanescent migrating rash

A

Rheumatic fever

124
Q

[diagnose]

expanding bulls eye rash + complete heart block + tick bite

A

Lyme disease = Borrelia burgdorferi

125
Q

[diagnose]

multiple target-appearing plaque + drug exposure

A

erythema multiforme

126
Q

[Secondary prevention of RF]

RF without carditis

A

5 years after last attack OR until 21 year old

127
Q

[Secondary prevention of RF]

RF with carditis but no residual valvular disease

A

10 years after last attack OR

until 21 years old

128
Q

[Secondary prevention of RF]

RF with carditis and persistent residual valvular disease

A

10 years after last attack OR until 40 years old

129
Q

What is the most accurate test to diagnose Sjogren Syndrome

A

Labial biopsy

130
Q

Sjogren syndrome is associated with what renal abnormality?

A

renal tubular acidosis

131
Q

What serologic markers are associated with Sjogren Syndrome

A

Anti-Ro/SSA

Anti-La/SSB

132
Q

What drugs are useful to increase tear secretion (for Sjogren Syndrome)

A

Pilocarpine

Cevimeline

133
Q

[diagnosis]

woman, thickened skin, tight fingers, reynaud phenomenon or digital pitting scars, arthralgia, interstitial lung disease, acid reflux, dysphagia

A

Scleroderma/systemic sclerosis

134
Q

Also called limited scleroderma

A

CREST syndrome

135
Q

What are the components of CREST syndrome

A 
Calcinosis cutis
Reynaud's phenomenon
Esophageal dysmotility
Sclerodactyl
Telangiectasia
136
Q

[diagnosis]

20F abdominal pain, joint pain, palpable rashes on the buttocks up to the legs

polyarthalgia without frank arthritis

A

Dx: HSP
Pathophysio: small vessel vasculitis due to immune-complex deposition
Most often seen immune complexes: IgA

137
Q

What is the skin biopsy finding in HSP?

A

Leukocytoclastic vasculitis with IgA and C3 deposition by IF

138
Q

[Diagnosis]

23F, right arm claudication, malaise, fever, arthralgia, right brachial and radial pulse are absent

A

Dx: Takayasu arteritis
Pathophysio: Inflammation and stenosis of medium/large sized arteries

139
Q

Most commonly affected artery in Takayasu arteritis?

A

subclavian

140
Q

Manifestation when common carotid artery is involved in Takayasu Arteritis?

A

Syncope, TIA, Visual changes, stroke

141
Q

What is the most common pattern of takayasu arteritis in arteriography?

A

Irregular vessel walls

stenosis, aneurysm, occlusion

142
Q

[diagnose]

20F dyspnea and rashes 30 mins after IV penicillin.

PE: (+) generalized pruritic urticaria and wheezing on auscultation

A

Dx: anaphylaxis

Initial step: administration of epinephrine 0.3-0.5mL 1:1000 SC or IM

143
Q

Which adrenoceptor does epinephrine act to dilate bronchial smooth muscle?

A

beta 2 adrenoceptor

144
Q

what is the most common presentation of anaphylaxis?

145
Q

Angioedema resulting in death by mechanical obstruction is commonly located in ___

A

epiglottis and larynx

146
Q

Aside from histamine, this eicosanoid contributes to hypotension in anaphylaxis

147
Q

[diagnose]

21 M, two day history of well circumscribed wheals with erythematous raised borders and blanched centers after exposure to pollen

A

Dx: Acute urticaria

148
Q

What is the cut off duration for acute and chronic urticaria?

A
  1. Acute < 6 weeks

2. Chronic > 6 weeks

149
Q

[Difference of urticaria and angioedema]

superfical dermis involvement, well-circumscribed wheals, blanched centers, <24 hours, pruritic, frequentl migrates, no bruising or scarring

150
Q

[Difference of urticaria and angioedema]

deeper dermis and subcutaneous, dramatic swelling, painful than pruritus

A

angioedema

151
Q

Cite examples of sedating H1 antihistamines

A
  1. Chlorpheniramine

2. Diphenhydramine

152
Q

Cite examples of non-sedating H2 antagonist

A
  1. Loratidine
  2. Desloratidine
  3. Fexofenadine
153
Q

most common sites of urticaria

A

extremities and face

154
Q

most common site of angioededma

A

periorbital and lips

155
Q

[diagnosis]

22M, on and off sneezing, runny nose and nasal congestion in the morning, history of atopic dermatitis and food allergy

A

Dx: allergic rhinitis

Next step: identify offending allergen by confirming with skin test or serum assay

156
Q

What is the most potent drug for the treatment of rhinitis?

A

intranasal corticosteroids (high dose)

157
Q

What are the hallmarks of allergic rhinitis?

A
  1. Sneezing
  2. Rhinorhea
  3. Obstruction of nasal passages
  4. Pharyngeal itching
  5. Lacrimation
158
Q

What is the skin biopsy finding in HSP?

A

Leukocytoclastic vasculitis with IgA and C3 deposition by IF

159
Q

[Diagnosis]

23F, right arm claudication, malaise, fever, arthralgia, right brachial and radial pulse are absent

A

Dx: Takayasu arteritis
Pathophysio: Inflammation and stenosis of medium/large sized arteries

160
Q

Most commonly affected artery in Takayasu arteritis?

A

subclavian

161
Q

Manifestation when common carotid artery is involved in Takayasu Arteritis?

A

Syncope, TIA, Visual changes, stroke

162
Q

What is the most common pattern of takayasu arteritis in arteriography?

A

Irregular vessel walls

stenosis, aneurysm, occlusion

163
Q

[diagnose]

20F dyspnea and rashes 30 mins after IV penicillin.

PE: (+) generalized pruritic urticaria and wheezing on auscultation

A

Dx: anaphylaxis

Initial step: administration of epinephrine 0.3-0.5mL 1:1000 SC or IM

164
Q

Which adrenoceptor does epinephrine act to dilate bronchial smooth muscle?

A

beta 2 adrenoceptor

165
Q

what is the most common presentation of anaphylaxis?

166
Q

Angioedema resulting in death by mechanical obstruction is commonly located in ___

A

epiglottis and larynx

167
Q

Aside from histamine, this eicosanoid contributes to hypotension in anaphylaxis

168
Q

[diagnose]

21 M, two day history of well circumscribed wheals with erythematous raised borders and blanched centers after exposure to pollen

A

Dx: Acute urticaria

169
Q

What is the cut off duration for acute and chronic urticaria?

A
  1. Acute < 6 weeks

2. Chronic > 6 weeks

170
Q

[Difference of urticaria and angioedema]

superfical dermis involvement, well-circumscribed wheals, blanched centers, <24 hours, pruritic, frequentl migrates, no bruising or scarring

171
Q

[Difference of urticaria and angioedema]

deeper dermis and subcutaneous, dramatic swelling, painful than pruritus

A

angioedema

172
Q

Cite examples of sedating H1 antihistamines

A
  1. Chlorpheniramine

2. Diphenhydramine

173
Q

Cite examples of non-sedating H2 antagonist

A
  1. Loratidine
  2. Desloratidine
  3. Fexofenadine
174
Q

most common sites of urticaria

A

extremities and face

175
Q

most common site of angioededma

A

periorbital and lips

176
Q

[diagnosis]

22M, on and off sneezing, runny nose and nasal congestion in the morning, history of atopic dermatitis and food allergy

A

Dx: allergic rhinitis

Next step: identify offending allergen by confirming with skin test or serum assay

177
Q

What is the most potent drug for the treatment of rhinitis?

A

intranasal corticosteroids (high dose)

178
Q

What are the hallmarks of allergic rhinitis?

A
  1. Sneezing
  2. Rhinorhea
  3. Obstruction of nasal passages
  4. Pharyngeal itching
  5. Lacrimation
179
Q

Most cases of chronic urticaria are

A

idiopathic

180
Q

What are the components of sclerodermal renal crisis in patients with systemic sclerosis?

A
  1. BOV
  2. Severe headache
  3. Chest pain
181
Q

Histocompatibility complex associated with ankylosing spondylitis

Internal Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions