Rheumatology Review Flashcards
1
Q
First line treatment for OA
A
Acetaminophen
2
Q
Acetaminophen “safe dose” per day
A
4g/day
3
Q
HLA antigens associated with SLE
A
HLA-B8
HLA-DR2
HLA-DR3
4
Q
On what chromosome are non-MHC genetic mutations found in SLE patients?
A
16
5
Q
HLA antigens associated with RA
A
HLA-DR4
6
Q
On what chromosome are non-MHC genetic mutations found in RA patients?
A
Chromosome 3 and some others
7
Q
Although rheumatoid factor is present in RA patients, what other serological component is more specific for RA?
A
Anti-cyclic citrullinated peptide (Anti-CCP)
8
Q
Antibody specific for RA
A
Anti-CCP
9
Q
Antibodies specific for SLE
A
Anti-DS DNA
Anti-SM
10
Q
Lab findings for SLE
A
Anti-DS DNA Anti-Sm ANA (Anti-nuclear antibody) Decreased serum complement RF mixed cryoglobulins
11
Q
Physical deformations associated with SLE that looks like RA
A
Jaccoud’s Arthropathy
12
Q
What lab finding would you look for if drug-induced SLE is suspected?
A
ANA specific to anti-histone
13
Q
Unifying laboratory abnormality in the four types of SLE
A
Circulating ANA
14
Q
SLE antibody that has the strongest clinical association with nephritis
A
Anti-ds DNA
15
Q
24-yo female presents with fever, weight loss, malaise, a rash, and painful, swollen joints. Diagnosis?
A
SLE
16
Q
11 SLE diagnostic criteria
A
- malar rash
- discoid rash
- photosensitivity
- Oral ulcers
- arthritis
- serositis
- renal disorder
- neurologic dissorder
- hematologic disorder
- immunologic disorder
- ANA
17
Q
Infliximab
A
- biologic DMARD
- monoclonal antibody that binds directly to TNF, preventing the binding to receptor cells and the initiation of inflammatory signals
- binds soluble and membrane-bound TNF
18
Q
Etanercept
A
- biologic DMARD
- soluble receptor that mimics the TNF receptors found on our immune cells
- Binds TNF extracellularly, preventing it from binding to receptor cells and initiating inflammatory signals
- binds only soluble TNF
19
Q
Punctate and linear densities in articular hyaline or fibrocartilaginous tissue is almost diagnostic for what?
A
CPPD (calcium pyrophosphate dihydrate) crystal deposition
20
Q
Drug to give under-excretors (gout patients)
A
Probenecid
21
Q
Drug to give uric acid over-producers
A
Allopurinol
22
Q
Probenecid and Allopurinol are given until serum urate levels reach what?
A
< 6 mg/dL
23
Q
Drug that directly reduces uric acid quickly
A
Pegloticase
24
Q
Antibody-mediated immune response involving microangiopathy of muscle capillaries
A
Dermatomyositis
25
Cell-mediated immune response directed against antigens on muscle fibers
Polymyositis
26
Pathology involving:
- Mantle/shawl-patterned rash
- periungual capillary changes
- livedo reticularis
- heliotrope eyelids
- Gottron's papules
Dermatomyositis or Polymyositis
27
Most sensitive and specific marker of muscle destruction
Creatinine Kinase
28
Antibodies associated with polymyositis
cytoplasmic antibodies
| Jo-1 antibodies
29
antibodies associated with dermatomyositis
cytoplasmic antibodies
| Anti-Mi-2 antibodies
30
First line treatment for dermatomyositis/polymyositis
Prednisone
31
Pathology involving proximal muscle weakness
DM/PM
32
Dermatomyositis/Polymyositis "Badness"
-Weakness of the pharynx and upper esophageal muscles
33
Felty's Syndrome triad
- leukopenia (usually a neutropenia_
- splenomegaly
- deforming RA
34
Pathology involving leukopenia, splenomegaly, deforming RA
Felty's syndrome
35
Scleroderma's most common initial complaint
Dysphagia
36
Pathology involving:
-Raynaud's phenomenon, edema in fingers and hands, skin tightening and thickening, arthralgias, muscle weakness, tight/thin lips, xerostomia, xerophthalmia
Scleroderma
37
What should you think when you have a cold, pregnant, tight-lipped, dehydrated female with microhematuria
- Scleroderma patient in renal crisis
| - Put on ACE inhibitor
38
CREST syndrome accompanies what?
Scleroderma
39
Antibody specific for scleroderma
Anti-topoisomerase 1
40
CREST syndrome
- Calcinosis
- Raynaud's
- Esophageal dysmotility
- Sclerodactyly
- Telangiectasias
41
Vasculitis of small and medium arteries
Polyarteritis nodosa
42
Peripheral neuropathy caused by polyarteritis nodosa
Mononeuritis multiplex
43
Group of genetically distinct connective tissue disorders characterized by excessive stretchability and fragility of the skin
Ehlers-Danlos Syndrome
44
Soft, fleshy nodules seen in areas of trauma in patients with Ehlers-Danlos Syndrome
Molluscum pseudotumors
45
Hard, subcutaneous nodules that become calcified in patients with Ehlers-Danlos Syndrome
Spheroids
46
Any joint disease of the vertebral column
Spondyloarthropathy
47
"I can't see, I can't pee, I can't climb a tree"
Reactive arthritis (Reiter's Syndrome)
48
"I can't climb a tree"
- Caused by DISH (Forestier's disease)
| - This is calcification of the anterior longitudinal ligament
49
"I can't pee"
- circinate balantitis
| - urethritis/cervicitis
50
"I can't see"
- conjunctivitis
| - uveitis (unilateral)
51
Pathology involving:
| -Arthralgias, myalgias, pleurisy, fever, with a high ANA titer specific to histones
Drug-induced lupus
52
Most common cause of inflammatory back pain in young adults
Ankylosing Spondylitis
53
Chronic inflammatory disease of the SI joints and spine
Ankylosing spondylitis
54
"Pulseless disease"
Takayasu's arteritis
55
Pathology involving:
-claudication of extremities, decreased brachial pulse, BP difference between arms, bruits over subclavian arteries or aorta
Takayasu's arteritis
56
How do you diagnose Takayasu's arteritis?
Angiogram
57
Chronic disorder characterized by immune-mediated destruction of exocrine glands
Sjogren Syndrome
58
Sjogren Syndrome requires a 2-combo of xerostomia, xerophalmia, and associated collagen tissue disease. What is it called if the patient only has one of the first 2?
Sicca Syndrome
59
Good study to do if unsure if xerostomia caused by Sjogren syndrome
Lip biopsy
60
Nodes at the DIP
Heberden's
61
Nodes at the PIP
Bouchard's
62
Cancer of the white blood cells characterized by excess lymphoblasts
Acute lymphoblastic leukemia
63
Pathology associated with:
| -Fever, rash, hepatosplenomagaly, lymphadenopathy, rash
Systemic JIA
64
Pathology associated with Quotidian fever
Systemic JIA
65
Fever associated with systemic JIA
Quotidian fever
66
Arthritis in 5 or more joints for more than 16 weeks in a patient <16yo
Polyarticular JIA
67
Arthritis in 4 or fewer joints for more than 16 weeks in a patient <16yo
Oligo/Pauciarthritis JI
68
What tool must we use to examine oligoarthritis JIA patients and why?
Slit lamp to check for uveitis
69
Best predictor of fracture in osteoporotic patient
Bone mineral density
70
Preferred method of measurement of bone mineral density
DEXA scan
71
Pathology involving:
- Necrotizing granulomas of the upper airway
- bilateral pneumoitis
- chronic sinusitis
- mucosal ulceration of the nasopharynx
- renal disease
Wegner's granulomatosis
72
Pathology involving necrotizing granulomatous vasculitis
Wegner's granulomatosis
73
Serologic finding specific for Wegner's granulomatosis
c-ANCA (cytoplasmic ANCA)
74
Treatment for Wegner's granulomatosis
Cyclophasophamide plus Prednisone
75
Pathology consisting of small vessel vasculitis, extra-vascular granulomas, and hypereosinophilia
Churg-Strauss Syndrome
76
Vasculitis that affects the large arterial branches of the aorta
Giant cell/temporal arteritis
77
Small ophthalmic arteries affected by temporal arteritis
- ophthalmic artery
- posterior ciliary arteries
- central artery of the retina
78
Chromosome with Marfan mutation
15
79
Spinal arthritis that also involves inflammation of the intestinal wall
Enteropathic arthritis
80
Arthritis or periarticular inflammation that waxes and wanes
Palindromic Rheumatism
81
Warning signs of cast complications
- The Four P's:
| - Pain, Pallor, Poikilothermia, Parasthesia/Paralysis
82
SNRI approved for treating Fibromyalgia
Milnacipran
83
Antidepressant approved for treating Fibromyalgia
Pregabelin
84
Cast/splint used for finger sprains or fractures
Finger splint
85
Cast/splint used for tendon injuries of the hand
Bulky hand dressing
86
Cast/splint used for 4th and 5th metacarpal injuries
Ulnar gutter splint
87
Cast/splint used for carpal tunnel or wrist sprain
Volar splint
88
Cast/splint used for 1st metacarpal fracture
Thumb spicca splint
89
Cast/splint used for scaphoid fracture
Thumb spicca splint
90
Cast/splint used for distal radius fracture or wrist soft tissue injuries
Sugar tong splint
91
Cast/splint used for radial head fracture
Posterior elbow splint
92
Cast/splint used for Ankle sprains or nondisplaced fractures
Yoke (Stirrup) Splint
93
Cast/splint used for tibia/fibula fractures
Long Posterior leg splint
94
Cast/splint used for femoral shaft fractures
long posterior leg splint
95
Cast/splint used for ankle injuries
Short posterior leg splint
96
Cast/splint used for MT fractures
Short posterior leg splint
97
Cast/splint used for 1st and 2nd degree knee sprains
Knee splint
98
Bulky temporary dressing that allows for swelling
Robert Jones dressing
