Rheumatology/MSK Flashcards
What is primary biliary cirrhosis?
Pruritis, xanthomas, anti-mitochondrial Ab; seen in females
What is primary sclerosing cholangitis?
P-ANCA Ab, bike duct inflammation, onion skinning, IBD
What is type I autoimmune hepatitis?
Anti-smooth mm. Ab; seen in young women
What is type II autoimmune hepatitis?
Anti-LKM Ab
What is bullous pemphigoid?
Anti-hemidesmosome Ab, subepithelial skin bullae
What is celiac sprue?
Anti-gliaden Ab (can’t eat wheat/ bread products = steatorrhea) assoc. w/ dermatitis herpetifomis
What Ab is assoc. w/ CREST Syndrome?
Anti-centromere Ab
What is dermatitis herpeteformis?
Vesicles on anterior thigh, Anti-BMZ Ab, Anti-endomysial Ab
What is dermatomyositis?
Anti-jo-1 Ab; Myositis with a rash; Assoc. w/ occult malignancy
What are symptoms of T1DM?
Polyuria, polydipsia, wt. loss, Anti-islet cell Ab, anti-GAD Ab, post-infection, DKA
What is drug Induced lupus(and causative drugs)?
Anti-histone-Ab;
Drugs: Hydralazine Isoniazid Phenytoin Penicillamine Procainamide Ethosuximide
What is gastritis type A?
Anti-parties cell, an strophic gastritis adenocarcinoma
What is goodpasture’s?
Anti-GBM Ag, attacks the lungs and kidneys, can progress to RPGN and death
What is Graves’ disease?
Anti-TSHr Ab, hyperthyroid exopthalmos, pretibial myxedema
What is Hashimotos?
Anti-microsomal Ab/anti-TPO, hypothyroid
What is ITP (immune thrombocytopenic purpura)?
Anti-platelet Ab, anti-GP IIB/IIIA Ab
What is MCTD (mixed connective tissue disease)?
Anti-RNP Ab
What is mononucleosis?
Heterophile Ab positive; teenager w/ sore throat, lymphadenopathy, splenomegaly, “kissing disease”
What is MPGN type II?
Anti-C3 convertase Ab= C3 nephritic factor
What is paroxysmal hemolysis?
Donate landsteiner Ab; bleed when cold
What is pemphigus vulgaris?
Anti-desmosome Ab (skin sloughs off when touched) starts in oral mucosa
What is pernicious anemia?
Anti-IF Ab, via. B12 deficiency = megaloblastic anemia
What is polyarteritis nodosa?
P-ANCA Ab; attacks gut, kidneys and nervous system; assoc. w/ Hep. B infection. There is no pulmonary environment
What is post-strep. GN?
ASO Ab, Nephritic w/ complement deposition; after 3 weeks post-infection
What is RA?
Rheumatoid factor present pain and swelling, worse in the morning, anti-citrullinated peptide protein Ab’s
What is scleroderma?
Anti-Scl70 Ab (anti-Topol), fibrosis, tight skin, masked faces
What is Sjogrens?
Anti-SSA Ab, dry eyes, dry mouth, arthritis
What is SLE?
Anti-dsDNA; Anti-Smith, Anti-cardiolipin Ab.
Malar rash, photosensitivity, oral ulcers, RF positive, VDRL positive but not infected, FTA-ABS to confirm
What is SLE Cerebritis?
Anti-neuronal Ab; Anti-ribosomal Ab
What is Vitiligo?
Anti-melanocyte Ab; white patches on skin
What is warm hemolysis?
Anti-Rh Ab; bleeds at body temperature
What is Wegner’s?
c-ANCA Ab; attacks ENT, Lungs, and kidney
What is HSP?
IgA Disease - 2 or 3 days post-common cold or GI infection. Leads to Berger’s
What is Berger’s?
IgA disease, 2 weeks post vaccination; serum sickness
What is Alport’s?
IgA disease; 2 weeks after diarrhea, HSP and polio
Where is CK-MB found?
Heart
Where is CK-MM found?
Muscle
Where is CK-MB found?
Brain
Why should you wait 30 mins after a meal before swimming?
All blood is shunted to GI for digestion, digestion depletes ATP stores; No ATP = no muscle movement
How does neurogenic muscle disease present?
Distal weakness and fasciculations
How does myopathy muscle disease present?
Proximal weakness and pain
What is a light chain composed of?
Actin
What is a heavy chain composed of?
Myosin
What band of sarcomere does not change length?
The A band
Where are T-tubules located?
Cardiac mm: at the z-line
Skeletal mm: at the A-I junction
What is duchenne’s muscular dystrophy?
Caused by a dystrophin frame shift; defective Dystrophin patient will have a Gower sign and calf pseudohypertrophy
What is Becker Muscular Dystrophy?
Dystrophin Missense; milder form of DMD
Symptoms present after 5yo
What is seen with Myotonic Dystrophy?
Bird’s beak Face; can’t let go when shaking hands
What is Myasthenic Syndrome/Lambert-Eaton?
Patients will tell you that they get stronger as the day goes by; stronger with EMG (electromyography)
Assoc. w/ small cell CA
What is Myasthenia Gravis?
Anti-ACh post-synaptic Ab; PT ~20-30yo, weaker as day goes on (dysarthria, ptosis, dysphagia)
Periotic exacerbations get stronger w/ Edrophonium
Weaker with EMG (electromyography); must rule out thymoma
What is MS?
Production of Anti-myelin Ab
MC in 20-40yo women, vision disturbances, spasticity (UMNs), decreased sensation, symptoms wax and wane - each MS attack gets worse
What is Metachromatic Leukodystrophy?
Arylsulfatase A deficiency; a child who presents similar to MS
What is ataxia telangiectasia?
IgA deficiency; PT has spider veins
What do you see in Friedrick’s Ataxia?
Retinitis pigmentosa, scoliosis
What is adrenal leukodystrophy?
Carnitine acyltransferase (CAT-1), defective adrenal failure (XR); long-chain FA stuck in cytoplasm
What is Guillain-Barre?
Ab’s damage multiple peripheral nerves (acute inflammatory polyneuropathy); patients present with ascending paralysis 2 weeks post-UTI
What is ALS?
Descending paralysis seen in middle aged men with fasciculations; no sensory problems
What is Werdnig-Hoffman?
Fasciculations in newborn due to failure of anterior horns to develop
What is polio?
Asymmetric fasciculations in kids; presents 2 weeks post- gastroenteritis
What is choreoathetosis?
Dance-like movements; wringing of hands, quivering/unsteady voice
What is Atonic Cerebral Palsy?
No mm. Tone - floppy
