Uworld Rheum Flashcards
Effect of steroids on hip?
Avascular necrosis
Bahcet’s syndrome? Complications?
Erythema nodosum, recurrent oral and genital ulcers
Aortic aneurysms and alveolar hemorrhage
Part of spine affected in RA? Complications?
Cervical spine. Can cause subluxation or spinal compression.
Evidence of pseudogout on X-ray?
Chrondocalcinosis
Viral arthritis versus rheumatic arthritis?
Acute onset of symptoms, morning symptoms lasting <30 minutes, lack of joint swelling
Fibromyalgia diagnosis depends on?
Tenderness in 11/18 trigger sites
Rheumatic arthritis increases risk of developing?
Osteopenia and osteoporosis due to disease, steroids, female sex, inability to weight bear
Baker cyst associated with what disease?
Rheumatoid arthritis
Cervical spondylosis Sx? X-ray findings?
Chronic neck pain, limited neck rotation and lateral bending, osteophyte induced radiculopathy, sensory abnormalities,
Bony spurs and sclerotic facet joints
Signs of catheter induced atheroembolism?
Blue toe syndrome – cyanotic and painful toes with intact pulses
Organ dysfunction, livedo reticulatus
Signs of vertebral osteomyelitis?
- Tenderness to gentle percussion
- No relief with rest
- ESR>100
Enthesitis? Associated with?
Inflammation at site of tendons/ ligament attachment. Associated with arthropathies.
Systemic diseases with oral ulcers?
Lupus, crohn’s and behcet’s
Episcleritis associated with what diseases?
RA and IBD
Pain with pulling, pushing or lifting arm above shoulder with:
1) no improvement with lidocaine
2) with improvement with lidocaine
1) Rotator cuff tear
2) rotator cuff tendonitis/impingement
avascular necrosis can be complications of?
Corticosteroids, trauma, lupus, sickle cell
X-rays of joints affected by chronic gout show?
Punched-out erosions with overhanging cortical bone
Consider fibromyalgia when?
- Woman ages 20 to 55
- Normal ESR
- Diffuse musculoskeletal pain or weakness without joint swelling
Myasthenia gravis versus Lambert-Eaton versus dermatomyositis: involved sites? Clinical features?
Postsynaptic ACh Receptor versus presynaptic Ca channels versus muscle fiber injury
Myasthenia gravis versus Lambert-Eaton versus dermatomyositis: All three can present as? Clinical features?
All three can present as paraneoplastic syndrome
Fluctuating muscle weakness (ocular, bulbar, facial, neck)
Proximal muscle weakness, autonomic dysfunction, cranial nerve involvement, no deep tendon reflexes
Symmetric and proximal muscle weakness, interstitial lung disease, esophageal dismotility, skin findings
Felty syndrome?
Rheumatoid Arthritis, splenomegaly, granulocytopenia
Whipple’s disease symptoms?
Diarrhea, weight loss, migratory arthritis, low-grade fever, Lymphadenopathy
Treatment of fibromyalgia?
Tricyclics and exercise
Lumbar spinal stenosis – symptoms?
Low back pain, difficulty walking. Pain is worse with standing and walking uphill.
Symptoms of subacromial bursitis?
Pain with internal rotation and flexion shoulder with no signs deltoid atrophy
Caused by repetitive overhead motions (tennis players)
Can make a diagnosis of polymyalgia rheumatica if? Treatment?
Age >50
Pain in neck, shoulders, pelvis
Morning stiffness lasting >1 hour
ESR >40
Low dose prednisone
Causes splenomegaly and pruritis with hot baths? Mechanism?
Polycythemia vera. Histamine release from increased basophils
Bone pain caused by metastasis versus bone pain caused by degenerative disease?
Constant and worse at night versus exacerbated by exercise and relieved by rest
Dermatomyositis is associated with?
Ovarian, breast, lung cancers
Inflammatory diseases associated with aortic aneurysms?
- Vasculities - Takayasu and Giant cell arteritis
- ankylosing spondyloarthropathies
- rheumatoid arthritis
- Behcet syndrome
Inflammatory diseases associated with Alveolar hemorrhage?
- Goodpasture’s
- Wegner’s
- Chrug-Strauss
- Behcet syndrome
- Antiphospholipid antibody syndrome
Inflammatory diseases associated with carpal tunnel syndrome?
Rheumatoid arthritis, sarcoidosis, amyloidosis
Causes of Erythema nodosum?
Most common: recent streptococcal infection
- Sarcoidosis
- TV/histoplasmosis
- IBD
Pain of spinal stenosis vs herniated disk vs spinal cord compression vs ankylosing spondylitis
(Pain worse/better when? Leg raise test?)
Worse with standing (spinal extension), leg raise negative
Vs
Worse when sitting and positive leg raise
Vs
Paralysis, incontinence and hyperreflexia
Vs
Symptoms improve with exercise and no leg pain
Treatment for antiphospholipid antibody syndrome In a pregnant female?
Low molecular weight heparin
