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Clin Med III > Rheumatology Review > Flashcards

Rheumatology Review Flashcards

1
Q

First line treatment for OA

A

Acetaminophen

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2
Q

Acetaminophen “safe dose” per day

A

4g/day

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3
Q

HLA antigens associated with SLE

A

HLA-B8
HLA-DR2
HLA-DR3

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4
Q

On what chromosome are non-MHC genetic mutations found in SLE patients?

A

16

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5
Q

HLA antigens associated with RA

A

HLA-DR4

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6
Q

On what chromosome are non-MHC genetic mutations found in RA patients?

A

Chromosome 3 and some others

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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)

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8
Q

Antibody specific for RA

A

Anti-CCP

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9
Q

Antibodies specific for SLE

A

Anti-DS DNA

Anti-SM

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10
Q

Lab findings for SLE

A 
Anti-DS DNA
Anti-Sm
ANA (Anti-nuclear antibody)
Decreased serum complement
RF
mixed cryoglobulins
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11
Q

Physical deformations associated with SLE that looks like RA

A

Jaccoud’s Arthropathy

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12
Q

What lab finding would you look for if drug-induced SLE is suspected?

A

ANA specific to anti-histone

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13
Q

Unifying laboratory abnormality in the four types of SLE

A

Circulating ANA

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14
Q

SLE antibody that has the strongest clinical association with nephritis

A

Anti-ds DNA

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15
Q

24-yo female presents with fever, weight loss, malaise, a rash, and painful, swollen joints. Diagnosis?

A

SLE

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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
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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
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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
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19
Q

Punctate and linear densities in articular hyaline or fibrocartilaginous tissue is almost diagnostic for what?

A

CPPD (calcium pyrophosphate dihydrate) crystal deposition

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20
Q

Drug to give under-excretors (gout patients)

A

Probenecid

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21
Q

Drug to give uric acid over-producers

A

Allopurinol

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22
Q

Probenecid and Allopurinol are given until serum urate levels reach what?

A

< 6 mg/dL

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23
Q

Drug that directly reduces uric acid quickly

A

Pegloticase

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24
Q

Antibody-mediated immune response involving microangiopathy of muscle capillaries

A

Dermatomyositis

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25
Q

Cell-mediated immune response directed against antigens on muscle fibers

A

Polymyositis

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26
Q

Pathology involving:

  • Mantle/shawl-patterned rash
  • periungual capillary changes
  • livedo reticularis
  • heliotrope eyelids
  • Gottron’s papules
A

Dermatomyositis or Polymyositis

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27
Q

Most sensitive and specific marker of muscle destruction

A

Creatinine Kinase

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28
Q

Antibodies associated with polymyositis

A

cytoplasmic antibodies

Jo-1 antibodies

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29
Q

antibodies associated with dermatomyositis

A

cytoplasmic antibodies

Anti-Mi-2 antibodies

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30
Q

First line treatment for dermatomyositis/polymyositis

A

Prednisone

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31
Q

Pathology involving proximal muscle weakness

A

DM/PM

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32
Q

Dermatomyositis/Polymyositis “Badness”

A

-Weakness of the pharynx and upper esophageal muscles

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33
Q

Felty’s Syndrome triad

A
  • leukopenia (usually a neutropenia_
  • splenomegaly
  • deforming RA
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34
Q

Pathology involving leukopenia, splenomegaly, deforming RA

A

Felty’s syndrome

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35
Q

Scleroderma’s most common initial complaint

A

Dysphagia

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36
Q

Pathology involving:
-Raynaud’s phenomenon, edema in fingers and hands, skin tightening and thickening, arthralgias, muscle weakness, tight/thin lips, xerostomia, xerophthalmia

A

Scleroderma

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37
Q

What should you think when you have a cold, pregnant, tight-lipped, dehydrated female with microhematuria

A
  • Scleroderma patient in renal crisis

- Put on ACE inhibitor

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38
Q

CREST syndrome accompanies what?

A

Scleroderma

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39
Q

Antibody specific for scleroderma

A

Anti-topoisomerase 1

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40
Q

CREST syndrome

A
  • Calcinosis
  • Raynaud’s
  • Esophageal dysmotility
  • Sclerodactyly
  • Telangiectasias
41
Q

Vasculitis of small and medium arteries

A

Polyarteritis nodosa

42
Q

Peripheral neuropathy caused by polyarteritis nodosa

A

Mononeuritis multiplex

43
Q

Group of genetically distinct connective tissue disorders characterized by excessive stretchability and fragility of the skin

A

Ehlers-Danlos Syndrome

44
Q

Soft, fleshy nodules seen in areas of trauma in patients with Ehlers-Danlos Syndrome

A

Molluscum pseudotumors

45
Q

Hard, subcutaneous nodules that become calcified in patients with Ehlers-Danlos Syndrome

A

Spheroids

46
Q

Any joint disease of the vertebral column

A

Spondyloarthropathy

47
Q

“I can’t see, I can’t pee, I can’t climb a tree”

A

Reactive arthritis (Reiter’s Syndrome)

48
Q

“I can’t climb a tree”

A
  • Caused by DISH (Forestier’s disease)

- This is calcification of the anterior longitudinal ligament

49
Q

“I can’t pee”

A
  • circinate balantitis

- urethritis/cervicitis

50
Q

“I can’t see”

A
  • conjunctivitis

- uveitis (unilateral)

51
Q

Pathology involving:

-Arthralgias, myalgias, pleurisy, fever, with a high ANA titer specific to histones

A

Drug-induced lupus

52
Q

Most common cause of inflammatory back pain in young adults

A

Ankylosing Spondylitis

53
Q

Chronic inflammatory disease of the SI joints and spine

A

Ankylosing spondylitis

54
Q

“Pulseless disease”

A

Takayasu’s arteritis

55
Q

Pathology involving:
-claudication of extremities, decreased brachial pulse, BP difference between arms, bruits over subclavian arteries or aorta

A

Takayasu’s arteritis

56
Q

How do you diagnose Takayasu’s arteritis?

A

Angiogram

57
Q

Chronic disorder characterized by immune-mediated destruction of exocrine glands

A

Sjogren Syndrome

58
Q

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?

A

Sicca Syndrome

59
Q

Good study to do if unsure if xerostomia caused by Sjogren syndrome

A

Lip biopsy

60
Q

Nodes at the DIP

A

Heberden’s

61
Q

Nodes at the PIP

A

Bouchard’s

62
Q

Cancer of the white blood cells characterized by excess lymphoblasts

A

Acute lymphoblastic leukemia

63
Q

Pathology associated with:

-Fever, rash, hepatosplenomagaly, lymphadenopathy, rash

A

Systemic JIA

64
Q

Pathology associated with Quotidian fever

A

Systemic JIA

65
Q

Fever associated with systemic JIA

A

Quotidian fever

66
Q

Arthritis in 5 or more joints for more than 16 weeks in a patient <16yo

A

Polyarticular JIA

67
Q

Arthritis in 4 or fewer joints for more than 16 weeks in a patient <16yo

A

Oligo/Pauciarthritis JI

68
Q

What tool must we use to examine oligoarthritis JIA patients and why?

A

Slit lamp to check for uveitis

69
Q

Best predictor of fracture in osteoporotic patient

A

Bone mineral density

70
Q

Preferred method of measurement of bone mineral density

A

DEXA scan

71
Q

Pathology involving:

  • Necrotizing granulomas of the upper airway
  • bilateral pneumoitis
  • chronic sinusitis
  • mucosal ulceration of the nasopharynx
  • renal disease
A

Wegner’s granulomatosis

72
Q

Pathology involving necrotizing granulomatous vasculitis

A

Wegner’s granulomatosis

73
Q

Serologic finding specific for Wegner’s granulomatosis

A

c-ANCA (cytoplasmic ANCA)

74
Q

Treatment for Wegner’s granulomatosis

A

Cyclophasophamide plus Prednisone

75
Q

Pathology consisting of small vessel vasculitis, extra-vascular granulomas, and hypereosinophilia

A

Churg-Strauss Syndrome

76
Q

Vasculitis that affects the large arterial branches of the aorta

A

Giant cell/temporal arteritis

77
Q

Small ophthalmic arteries affected by temporal arteritis

A
  • ophthalmic artery
  • posterior ciliary arteries
  • central artery of the retina
78
Q

Chromosome with Marfan mutation

A

15

79
Q

Spinal arthritis that also involves inflammation of the intestinal wall

A

Enteropathic arthritis

80
Q

Arthritis or periarticular inflammation that waxes and wanes

A

Palindromic Rheumatism

81
Q

Warning signs of cast complications

A
  • The Four P’s:

- Pain, Pallor, Poikilothermia, Parasthesia/Paralysis

82
Q

SNRI approved for treating Fibromyalgia

A

Milnacipran

83
Q

Antidepressant approved for treating Fibromyalgia

A

Pregabelin

84
Q

Cast/splint used for finger sprains or fractures

A

Finger splint

85
Q

Cast/splint used for tendon injuries of the hand

A

Bulky hand dressing

86
Q

Cast/splint used for 4th and 5th metacarpal injuries

A

Ulnar gutter splint

87
Q

Cast/splint used for carpal tunnel or wrist sprain

A

Volar splint

88
Q

Cast/splint used for 1st metacarpal fracture

A

Thumb spicca splint

89
Q

Cast/splint used for scaphoid fracture

A

Thumb spicca splint

90
Q

Cast/splint used for distal radius fracture or wrist soft tissue injuries

A

Sugar tong splint

91
Q

Cast/splint used for radial head fracture

A

Posterior elbow splint

92
Q

Cast/splint used for Ankle sprains or nondisplaced fractures

A

Yoke (Stirrup) Splint

93
Q

Cast/splint used for tibia/fibula fractures

A

Long Posterior leg splint

94
Q

Cast/splint used for femoral shaft fractures

A

long posterior leg splint

95
Q

Cast/splint used for ankle injuries

A

Short posterior leg splint

96
Q

Cast/splint used for MT fractures

A

Short posterior leg splint

97
Q

Cast/splint used for 1st and 2nd degree knee sprains

A

Knee splint

98
Q

Bulky temporary dressing that allows for swelling

A

Robert Jones dressing

Clin Med III (4 decks)

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