Rheumatology Flashcards
Features of prosthetic joint infection
Immunosuppressed + Elevated ESR + pain, warmth, effusion, fever
Imaging finding for prosthetic joint infection
Periprosthetic lucency on radiograph
Biopsy of microscopic polyangiitis (MPA)
- Nongranulomatous *necrotizing
* Pauci immune
Clinical features of microscopic polyangiitis
*kidney involvement + palpable purpura
Labs for microscopic polyangitis
Positive p-ANCA
labs for GPA + biopsy
c-ANCA + granulomatous
IgA vasculitis (HSP) biopsy
immune complexes identified on biopsy
Thromboangiitis obliterans clinical features
Inflammation of vessels in upper and lower limbs, leading to reduced pulses and gangrenous ulcers + smoker
Diffuse idiopathic skeletal hyperostosis on imaging
Bridging ossification of spinal ligaments
Workup after radiologic diagnosis of AS
Don’t test for HLA-B27 antigen, low specificity and diagnosis is clinical + radiographic
WBC count in septic arthritis
> 50K
Treatment of severe tophaceous gout not responding to febuxostat
Pegloticase
Workup of reactive arthritis
Chlamydia urine NAAT (most common agent causing urethritis)
Ankylosing spondylitis diagnosis
- clinical + radiographic (inflammatory back pain + sacroillitis on imaging)
- Not HLA-B27
Gastric antral vascular ectasia (GAVE) clinical features
- proliferation of blood vessels typically in antrum of stomach
- looks like watermelon stripes on endoscopy
What is a dielafoy lesion?
Submucosal arterioles that protrude through the mucosa and cause hemorrhage
Treatment of acute gout refractory to steroids
Il-1 inhibitors (Anakinra or canakinumab)
Antisynthetase syndrome clinical features
ILD + Dermatomyositis or polymyositis
Raynaud’s
Inflammatory arthritis
Positive antibody in anti-synthetase syndrome
anti-Jo-1 (an anti synthetase antibody)
Cause of GI involvement in patients with systemic sclerosis
Small intestinal bacterial overgrowth (SIBO0
Felty syndrome clinical features
long standing RA + neutropenia + splenomegaly
Lyme arthritis clinical features
Large effusion + stiffness + minimal pain
IgG4-related disease clinical features
- Organomegaly
- diffuse fibrosis
- Multiorgan failure
Germ cell tumor presentation
- Bulky RP or mediastinal lymphadenopathy
- testicular mass may not always be present
Management of knee OA in patients with RA
- topical NSAIDs
Management of GCA
- high-dose prednisone BEFORE biopsy
Inclusion body myositis clinical features
- inflammatory myopathy involving proximal and distal muscles + symmetric + insidious onset
Initial management of sjogren syndrome
- artificial tears + sugar free candies
disseminated gonorrhea features
Tenosynovitis + dermatitis + polyarthralgia + fever/chills
Antibodies positive in GPA
Proteinase 3
Treatment of relapsed GPA
Rituximab
IMPT side effects to know with lyrica
- peripheral edema
- dizziness
- weight gain
Treatment of primary angiitis of the CNS
Cyclophosphamide
Primary angiitis clinical features
Vasculitis of CNS + granulomas
joint involvement in RA
symmetric involving small joints of hands and feet
Management of OA in patients with NSAID contraindications
Duloxetine
When topical NSAIDs are beneficial
patients with isolated joint involvement
Adult-onset Still disease clinical features
- spiking fever
- evanescent salmon-colored rash on the trunk and extremities
- arthritis
- lymphadenopathy
- HSM with elevated liver enzymes
Lab feature of adult still disease
Extremely high ferritin level
Long term treatment of IBD-associated arthritis
Adalimumab
Infliximab
psoriatic arthritis clinical features
- psoriatic rash
- nailbed pitting
antibody used to diagnose an SLE flare
dsDNA (also elevated ESR + low complement support)
Antibody associated with immune-mediated necrotizing myopathy
Anti-HMG Co-A reductase antibodies
Workup of suspected sjogren syndrome if serology is negative
Lip biopsy