Rheumatology Flashcards
Recurrent episodes of periodic fevers every 3-5 days, serositis (peritonitis, less commonly pleuritis/pericarditis), joint pains, and erysipelas-like rash; family history of disorder. What is the patient’s likely ethnicity? Most likely complication of disorder?
Familial Mediterranean Fever
Mediterranean
Amyloidosis due to increase Acute Phase reactants during attacks.
True or false. Complex regional pain syndrome can be preceded by a traumatic trigger and lead to somatic changes in involved extremity (mottling, cool to touch, demineralization of bone).
True, requires multidisciplinary approach (PT/OT).
True or false. Kingella kingae is the most common cause of septic arthritis in kids <4 years of age.
False. Staph aureus is the most common cause in ANY age group of septic arthritis. K. kingae is more commonly seen in <4 years old, would add CTX to Vanc/clinda if suspect that.
Antibody(ies) most specific for SLE?
Anti-Smith, Anti-dsDNA
Antibodies for neonatal lupus?
Anti-Ro (SS-A) and Anti-La (SS-B) antibodies
Drug induced lupus antibodies?
Anti-histone antibodies
Most frequent cause of congenital heart block?
Neonatal Lupus, may also have associated cardiac structural anomalies (transposition and septal defects)
Lab abnormalities for SLE?
Anemia, thrombocytopenia, leukopenia, elevated transaminases
Factors that indicate worse prognosis in SLE?
Renal and neurological manifestations
Mixed Connective Tissue Disease antibody?
anti-U1 RNP
Calcium deposits in the muscle/skin can be seen in which rheumatologic condition?
Dermatomyositis
Anti-citrullinated protein antibodies are useful in the diagnosis of which condition?
Rheumatoid arthritis
Systemic JIA
Recurrent daily fevers, joint swelling, evanescent and salmon colored blanchable rash on trunk and proximal extremities that comes on with a fever and resolves on its own, may have serositis
Koebner phenomenon is related to which disorder? What is another name for this disease?
Cutaneous hypersensitivity following superficial trauma seen in sJIA aka Still’s disease.
Oligoarticular vs polyarticular JIA?
4 or less vs 5 or more joint involvement; need to check vision regularly with slit-lamp exam for oligo due to chronic uveitis (esp. if ANA+)
What is Hyperimmunoglobulin D syndrome? What lab finding is usually associated with this?
Starts in infancy, monthly episodes of fevers, non-erosive arthritis, abd pain, diarrhea, HSM, LAD, oral ulcers, macular rash that common occurs especially after vaccines; deficiency of MVK enzyme causing an increased production of IL-1;
elevated IgD
Psoriatic arthritis physical exam findings?
Dactylitis (swollen digits) and nail bed pitting, psoriatic scales on extensor surfaces, asymmetric oligoarticular or symmetrical polyarticular arthritis, enthesitis (Achilles tendonitis)
Infectious triggers for reactive arthritis?
Preceding GI (Salmonella, Shigella, E coli) or GU illnesses (gonorrhea/chlamydia)
Enthesitis of the Achilles tendon, dactylitis and arthritis can be a clinical presentation of which two rheumatologic conditions?
Reactive arthritis and psoriatric arthritis
What can help differentiate reactive arthritis and psoriatic arthritis?
Reactive arthritis– urethritis (UA +leukocytes), conjunctivitis
Psoriatic arthritis– pitting of nail beds
Onset in infancy of cyclic fevers, oral ulcers, neutropenia as low as ANC <200, may have family history of similar symptoms?
Cyclic neutropenic fever
Severe complication of sJIA? How does it present?
Macrophage Activation Syndrome, juxta-articular osteoporosis caused by hemophagocytosis by histiocytes
Painful sloughing ulceration commonly seen in children/adolescents with IBD?
Pyoderma gangrenosum
Enthesitis-related arthropathy is also known as?
Arthropathy seen with ankylosing spondylitis
HLA B-27 is positive in?
Ankylosing spondylitis and psoriatic sJIA
