Week 9 - Rheumatology And Connective Tissue Disorders Flashcards
Sx of ankylosising spondylitis
Constant Pain and Stiffness in the low back >3 months
Morning stiffness >30 minutes improved with exercise, not with rest. Alternating buttock pain. Awakening in 2nd half of the night d/t pain
Age <40 yo
Insidious onset
What gene is associated with ankylosising spondylitis?
HLA-B27
Dx of Ankylosing spondilytis
Physical exam including Schober’s test and Respiratory excursion (normal for both is at least 5 cm)
X-rays
HLA B27
What is a CT disorder characterized by recurring mouth and genital ulcers, uveitis and arthritis?
Behçet’s disease
Sx of Behçet’s disease
Mouth ulcers Skin lesions Sores on genitals Uveitis Joint swelling Inflammation
What tests make Dx of Behçet’s disease
None.
Signs and symptoms
An inflammatory CT disorder that affects skin, muscles, joints, esophagus, lungs, and heart
Purple or dark red rash may occur anywhere
Calcinosis
Dermatomyositis
Dermatomyositis Sx
Dark red or purple skin rash Dysphagia Fatigue Fever Muscle pain, weakness Unintentional weight loss
Dx of Dermatomyositis
None. Signs and symptoms.
Causes of fibromyalgia
Not known, but possibly:
Serotonin deficiency
Hypometabolism
Sx of fibromyalgia
Fatigue Stiffness Headache Sleep disturbance Anxiety Coldness Exercise intolerance Dysmenorrhea
How to Dx fibromyalgia
Symptoms and Abnormal tenderness at 11 or more of 18 specific anatomical tender point sites
Increased ____ can cause gout
Uric acid
Elevated uric acid levels due to
Increased uric acid
Not eliminating uric acid
Or both: overproduction and underexcretion of uric acid
Primary gout is __% of all cases of gout
90%
Causes of secondary gout
Diuretics
Low-dose aspirin
Sx of gout
Pain and inflammation in one joint, fever and chills
50% big toe
Causes of juvenile rheumatoid arthritis
Not known. Thought to be autoimmune
Sx of juvenile rheumatoid arthritis
Inflammation in joint
Limping
Sudden high fever
Rash that comes and goes with fever
Dx for juvenile rheumatoid arthritis
Physical exam Blood tests: - rH factor - ESR - ANA - CBC - HLA B27
Primary vs secondary osteoarthritis
Primary - old age
Secondary - obesity, trauma, surgery, congenital malformations in joint structure/function, etc.
What is a persistent inflammatory muscle disease that causes weakness of muscles
Polymyositis
Causes of polymyositis
Unknown, possibly autoimmune
Sx of polymyositis
Progressive mm weakness Dysphagia Difficulty speaking Mild joint or mm tenderness Fatigue Shortness of breath
Dx of polymyositis
MRI
Electromyography
Muscle biopsy
Blood tests - increased CK and aldolase suggest muscle damage
Chronic inflammatory condition affecting the entire body, esp synovial membranes of joints
Rheumatoid arthritis
What deformities are named in the hand with Rheumatoid arthritis?
Boutonnière deformity
Swan neck deformity
Dx of Rheumatoid arthritis
RF factor in serum
Radiograph
Buildup of scarlike tissue int he skin
Scleroderma
Causes of scleroderma
Unknown. Autoimmune? Build up of collagen in the skin
Sx of scleroderma
Skin hardening and tightening
Raynaud’s phenomenon
Acid reflux
Dx scleroderma
Blood tests
Biopsies of skin
Breathing tests, CT lungs, echocardiogram of the heart
An autoimmune disorder in which the glands that produce tears and saliva are destroyed
Sjogren syndrome
- dry mouth, dry eyes
Primary vs secondary sjogren syndrome
1˚ is without other AI disorder
2˚ is with other AI disorder e.g. Rheumatoid arthritis, lupus, etc.
Sx for sjogren syndrome
Dry eyes, mouth
Itching eyes
Dysphagia, loss of sense of taste, problems speaking
Fatigue
Dx sjogren syndrome
Physical exam
ANA test
RH factor
AI disease that leads to long-term inflammation that affects skin, joints, kidneys, brain, other organs
Systemic lupus erythematosus
Characteristic sign of SLE
Butterfly rash on the face
Sx of SLE
Chest pain with deep breath Fatigue Hair loss Mouth sores *butterfly rash*
Dx SLE
Antibody tests, ANA panel
CBC
Chest xray
General term for inflammation of blood vessels
Vasculitis
Dx vasculitis
Biopsy of involved tissue
