Wk 5 Rheumatology Flashcards
Osteoarthritis pathophys
progressive cartilage loss
Osteoarthritis progression
gradual progressive joint pain
New bone formation term
sclerosis
Sclerosis in joints
osteophyte
Radiologic findings of osteoarthritis
osteophytes
bone spurs at joints
unilateral cartilage degeneration
Physical exam findings of osteoarthritis
hard joints (bone spurs)
Hx findings osteoarthritis
morning stiffness < 30 min
Tx osteoarthritis
NSAIDs
analgesics
intra-articular steroid/hyaluronic acid injections
RA pathophys
chronic progressive autoimmune inflammatory arthritis
RA extra-articular manifestations
- sub-Q nodules
- pericarditis
- lung nodules
- interstitial fiborosis
- inflammatory eye disease
- vasculitis
Hx RA
morning stiffness > 1 hr
Physical exam findings RA
symmetrical swollen glossy joints
RA small joints
wrist
MCP
MTP
PIP
Osteoarthritis joints
DIP
PIP
knee
hip
RA large joints
ankle
elbow
knee
shoulder
RA severe physical findings
subluxation
ulnar deviation
RA severe radiological findings
bone degeneration
RA Tx
DMARDs (disease-modifying anti-rheumatic drugs)
Juvenile Idiopathic Arthritis (JIA) age group
≤ 16 y/o (be definition)
JIA Systemic Onset Sx
daily spiking fevers evanescent salmon-colored rash hepatosplenomegaly lymphadenopathy pericardial/pleural effusions leukocytosis
DDx in systemic onset JIA
LEUKEMIA
IT’S A CHILD ALWAYS THINK LEUKEMIA
okay not “always”
JIA polyarticular onset
5+ joints
RF+ subtype most severe, resembles RA
JIA oligoarticular onset
≤ 4 joints
most common
1-5 y/o
Test 95% sensitive for lupus
ANA (but nonspecific)
Tx for drug-induced lupus
DC drug
2 types of crystal induced arthritis
gout (monosodium urate)
pseudogout (calcium pyrophosphate dihydrate)
What is the most common cause of uric acid concentration elevation
decreased excretion
What is the second most common general cause of elevated serum uric acid
increased synthesis
What type of drug is usually associated with gout
thiazide diuretics
Definitive diagnosis of gout/pseudgout
joint aspiration/crystals
Tofi are present in what disease
gout
What makes up tofi
uric acid crystals
T/F uric acid levels may be normal during acute gout episode
T
First-line gout therapy
NSAIDs
What Rx is definitely NOT an appropriate first-line gout therapy but is appropriate for long-term gout uric acid level management?
allopurinal (PRPP pathway, xanthine oxidase inhibitor)
Chonrocalcinosis of the knee is most common in which condition
pseudogout
Pseudogout is often associated with which disease
hyperthyroidism (15%)
Ankylosing spondylitis
boney fusion of lumbar vertebrae
Ankylosing spondylitis, increase or decrease of pain w/ exercise
decrease
Psoriatic arthritis
DIP joints most affected
dactylitis/sausage toe
sacroiliitis
Reactive arthritis
GI bacterial infiltration, chlamydia, or gonnorhea
