Week4 6671/6611 Flashcards
Small, non palpable rash
Macule
Raised palpable rash
Papule
Rash contains pus
Pustule
Large palpable rash
Plaque
Rash- small with clear fluid
Vesicles
Allergic- raised edges, migratory
Urticaria
Allergic- watery edema
Angioedema
Thick swollen synovial membrane with granulation tissue (fibroblasts, myofibroblasts, and inflammatory cells)
Pannus
RA
Photo sensitivity can be caused by what meds?
Antibiotics
Diuretics
NSAIDS
Oral hypoglycemics
RA - joints?
Symmetrical
Multiple- usually 5 or more
Common:
Small joints first: MCP, PIP, MTP
As progresses…
Large joints: shoulders, elbows, knees, ankles
Unusual itching- skin disease screening
Liver disease
Renal disease
Elderly population
Dry skin
Specific RA deformities - hands
- Ulnar deviation
- Boutonnière deformity
Extensor tendon splits- PIP flex, DIP hyper-ext - Swan neck deformity
PIP hyper-ext , DIP flex
Baker cyst
Popliteal cyst
Synovial sac of knee bulges posteriorly
(RA)
Felty syndrome
RA, Splenomegaly, and Granulocytopenia
Risk of life threatening infections
ABCDE mole/lesion
Asymmetry Border Color Diameter Evolve
Atopic dermatitis/Eczema
Chronic inflammatory skin disease
Usually children, but can affect adults
Flexor surfaces most involved
Dry skin, erythema, oozing and crusting
Scaling often present in adults
Very itchy
Often associated w/ other allergic conditions such as asthma and food allergy
Herpes zoster
Very common rash
Often in elderly
UNILATERAL distribution is hallmark
Can be triggered by stress, immunocompromise, illness
“Dew drop on a rose petal”
Effective vaccination is available
Post herpetic neuralgia is a significant complication
Abscess
Treatment is always drainage
Antibiotics may be needed for surrounding cellulitis
MRSA is an increasing problem
Any lesion with obvious purulence/pus should be referred for incision and drainage
Post op infection-
Physical exam
Sinus tract to joint is a definite infection
Warmth, redness or swelling
Low grade fever
Limited ROM due to pain and swelling
Err on side of caution
Post op infections- history
Persistent pain and stiffness at site of arthroplasty is associated w/ infection >90% of patients
Acute onset w/ swelling, tenderness, drainage
Chronic infections show pain and more subtle symptoms- function deteriorates and pain worsens over time
Vascular exam
Pulse palpitation
Capillary refill
Edema
Turgor
Dermatomyositis
Idiopathic inflammatory myopathy w/ proximal skeletal muscle weakness and muscle inflammation
Pink cheeks, purple “violaceous” hue over eyelids, rash along elbows, knuckles and knees
Rash classically does NOT spare nasal labial fold
Similar to polymyositis- but polymyositis does not have skin changes
Good prognosis, rarely recurrent
SLE -
Epidemiology
African-American, Latino and Asian women
Women 9-10:1
Typical onset 15-45
Chronic inflammatory disease
Can affect virtually every organ
Develop large number of antinuclear antibodies
Common pattern: constitutional complaints w/ skin, MSK, mild hematologic, and serologic involvement
Avoid sunlight, smoking, stress. Get Regular exercise and prolonged rest
SLE- constitutional symptoms
Fatigue
Fever
Myalgia