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pance rheumatology
| Question | Answer |
|---|---|
| wetting of <5mm of filter paper placed in lower eyelid for 5 min is positive; RF, ANA, ESR inc'd; RA, SLE, polymyositis, scleroderma; autoimmune | Schirmer's test for Sjogren's |
| hyperplastic synovial tissue may erode cartilage, subchondral bone, articular capsule and ligaments; swan-neck and boutonniere deformities; claw toes, hallux valgus | rheumatoid arthritis |
| systemic sclerosis; ANA; monitor BP; initial complaint is Raynaud's | scleroderma |
| syndrome seen in subset of patients w/scleroderma | CREST (calcinosis, Raynaud's, esophageal dysmotility, sclerodactyl, telangiectasias) |
| elev'd ESR, RBC casts, proteinuria, low serum albumin; palpable purpura and livedo reticularis; small and medium artery inflammation, involves skin, kidney, peripheral nerves, muscle and gut | polyarteritis nodosa |
| high doses of prednisone-initial; cytotoxic drugs and immunotherapy may be used | tx polyarteritis nodosa |
| pt rsponds quickly to low-dose corticosteroid therapy; usually req'd for 2 years | tx polymyalgia rheumatica |
| stiffness most severe in morning bilateral/symmetrical, neck, shoulder, pelvic girdles accompanied by constitutional symptoms, depression; ESR markedly elev'd | polymyalgia rheumatica |
| inflammatory dz of striated mm; insidious, painless, proximal mm weakness, dysphagia, skin rash sim to SLE, polyarthralgias, muscle atrophy; joints, lungs, heart and GI affected; muscle bx; high-dose steroids, MTX, azathioprine | polymyositis |
| high dose steroids (taper w/improvement) NSAIDs, antimalarials, immunosuppressives w/glomerulonephritis | SLE tx for CNS and renal involvement |
| NSAIDs, hydroxychloroquine 200mg qd or bid; low dose corticosteroids | SLE tx mild |
| antibodies to Smith antigen, CMP (creatinine), CBC, ESR, serum complement, DNA, ANA | SLE dx |
| arthralgias and symmetrical nonerosive arthritis; predominantly affects small joints of hand, wrist, knees | MSK features SLE |
| malar/discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal/neurologic/hematologic/immunologic d/o's | SLE sx's |
| calcium pyrophosphate (positive birefringent crystals, fine linear calcifications in cartilage (knee, wrist, elbow); NSAIDs and intra-articular steroid injections | pseudogout |
| negatively birefringent urate crystals; serum uric acid level >8 mg/dL; ankles, knees, feetgout | gout |
| chalky deposits of urate crystals | tophi |
| dactylitis (sausage digits), painful oral ulcers, penile lesions (balanitis circinata) ulcers on extremities, palms and soles; plantar heel pain; metatarsal head erosion or calcaneal periostitis; d/t STD (chlamydia) or gastroenteritis | Reiter's syndrome |
| seronegative arthritis, predominantly affecting men; triad of urethritis, conjunctivitis and oligoarthritis | def of Reiter's syndrome |
| NSAIDs and PT most beneficial, MTX and hydroxychloroquine used 2nd line if systemic; monitor for growth abnormalities or nutritional deficiencies; STS and osteoporosis; tendency for uveitis; receding chin; involves >5 joints | juvenile RA |
| rash elicited by scratching | Koebner's phenomenon |
| spiking fevers, myalgias, polyarthralgias, maculopapular rash w/central clearing appears in evening; splenomegaly, pericarditis | systemic juvenile RA |
| rheumatoid vasculitis (ischemic ulcers and periph neuropathy), pericarditis, pulmonary disease (pleural effusions, fibrosing alveolitis, nodules) | systemic RA |
Created by:
548rad