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Rheumatoid > Systemic Inflammation Rheumatic Disorders > Flashcards

Systemic Inflammation Rheumatic Disorders Flashcards

1
Q

Cigarette smoking is the best documented environmental risk factor for what systemic inflammation rheumatic disorder?

A

Rheumatoid Arthritis

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2
Q

What is the peak onset for Rheumatoid Arthritis?

A

35 and 75 years old

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3
Q

Rhematoid Arthritis continues to result in SUBSTANTIAL morbidity for most patients primarily related to what?

A

increased cardiovascular burden

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4
Q

Rheumatoid arthritis typically spares what?

A

Spares the thoracolumbar spine and DIP joints

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5
Q

What is the pathogenesis of rheumatoid arthritis?

A

Synovial hyperplasia
Chronic inflammation
Pathological immune response

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6
Q

What are the key features in rheumatoid arthritis?

A

Symptoms >6 weeks duration
Palpable synovial swelling – tender, boggy feeling
Fatigue is profound
Symmetrical and polyarticular (>3 joints)
Stiffness – will be stiff for a long period of time in the morning, will take awhile to get going

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7
Q

What is the most characteristic feature of rheumatoid arthritis?

A

joint destruction

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8
Q

What is the most frequent extra-articular manifestation of rheumatoid arthritis?

A

nodules

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9
Q

Felty’s Syndrome triad consists of what?

A

leukopenia
Splenomegaly
Erosive deforming RA

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10
Q

What is an extremely rare manifestation of RA

A

renal involvement

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11
Q

What lab finding is very specific for RA?

A

anti-CCP (Anti-cyclic citrullinated peptide)

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12
Q

Chronic connective tissue disorder characterized by immune-mediated destruction of exocrine glands

A

Sjogren’s Syndrome

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13
Q

What condition is a well recognized extra-articular manifestation of Rheumatoid Arthritis

A

Sjogren’s Syndrome

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14
Q

Which condition is associated with 33-44x increased risk for lymphoma?

A

Sjogren’s Syndrome

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15
Q

What are two tests used in Sjogren’s Syndrome?

A

Schirmer-I test or Rose Bengal Score

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16
Q

Joint inflammation <17 years old

A

Juvenile Arthritis

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17
Q

What antibodies are associated with Sjorgen syndrome?

A

Type A (anti-RO-SS-A) in 60%
Type B (Anti-LA-SS-B) in 30%

18
Q

What is the most common rheumatic disease?

A

Juvenile Arthritis

19
Q

What are the three main types of JRA (based on onset)?

A

Systemic onset
Pauciarticular
Polyarticular

20
Q

What is the key factor in systemic onset juvenile arthritis?

A

fever (Quotidian)

21
Q

Describe a Quotidian fever

A

> 39 degrees
Intermittent
Daily or twice daily fever

22
Q

What sign/symptom are you likely to see in Pauciarticular type juvenile arthritis?

A

Uveitis

23
Q

Which type is most likely to end up with adult rheumatoid arthritis?

A

Polyarticular juvenile arthritis

24
Q

In Psoriatic Arthritis, which manifestation typically comes first?

A

Psoriasis precedes arthritis - 67%

25
Q

Which disease process presents as destructive, erosive polyarthritis affecting the hands and feet

A

Psoriatic Arthritis

26
Q

You may see “telescoping of digits” or “pencil in a cup” lesion in what disease process?

A

Psoriatic Arthritis

27
Q

What disease process is described below?
Primarily affects boys 8 years and older
Affects large joints of lower extremities
Heel pain and achilles tendinitis
Sacroilitis – 90% of cases

A

Enthesitis Related Arthritis

28
Q

Which disease process is described below:
Autoimmune multisystem disease
More common in females 9:1
Peak age 15-25
Major late cause of a death is cardiovascular disease

A

Systemic Lupus Erythematosus

29
Q

What are the four different types of Systemic Lupus Erythematosus?

A

Discoid
Subacute cutaneous
Drug induced
Systemic

30
Q

What is a major late cause of death in SLE?

A

cardiovascular disease

31
Q

Name some features of SLE

A

Jaccoud’s arthropathy
Malar rash
Hair is thin and fragile
Nephritis
Raynaud’s phenomenon
Photosensitive skin eruptions
Serositis
Pneumonitis
Myocarditis
Miscarriages

32
Q

Which type of SLE is limited to the skin?

A

Discoid

33
Q

Which type of SLE will you see a prominent, widespread
non-scarring skin lesions with marked photosensitivity, gets worse with sun exposure, and CNS and renal involvement rare

A

Subacute cutaneous

34
Q

Which type of SLE will you get a lupus-like reaction after taking a drug/medication?

A

Drug Induced

35
Q

What is a common medication you will see that causes drug induced SLE?

A

Procainamide

36
Q

Malar rash and Interarticular dermatitis are likely to indicate which disease?

A

Systemic Lupus

37
Q

Which two lab findings are specific for SLE?

A

Anti-ds DNA
Anti-Sm

38
Q

What is a common lab finding in SLE but is not specific?

A

ANA

39
Q

A history of thrombosis in a patient thought to be otherwise at low
risk of such an event often prompts the search for what disease?

A

Antiphospholipid Syndrome

40
Q

Name three common presentations for Antiphospholipid Syndrome?

A

A history of thrombosis in a patient thought to be otherwise at low
risk
Recurrent spontaneous abortions
Refractory thrombocytopenia

41
Q

What is Catastrophic APL syndrome?

A

Refers to the fulminant organ failure from widespread thromboses

Rheumatoid (6 decks)

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