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MS 5 RA and Lupus
RA and Lupus
| Question | Answer |
|---|---|
| Which glomerular dz would you suspect most in a pt with the following findings?: MC nephrotic syndrome in children | minimal change dz |
| Which glomerular dz would you suspect most in a pt with the following findings?: MC nephrotic syndrome in adults | FSGS |
| Which glomerular dz would you suspect most in a pt with the following findings?: Kimmelstiel-Wilson lesions (nodular glomerulosclerosis) | Diabetic nephropathy |
| Which glomerular dz would you suspect most in a pt with the following findings?: LM: crescent formation in the glomeruli | Crescenteric/RPGN |
| Which glomerular dz would you suspect most in a pt with the following findings?: LM: segmental sclerosis and hyalinosis | FSGS |
| Which glomerular dz would you suspect most in a pt with the following findings?: anti-GBM Ab, hematuria, hemoptysis | Goodpastures |
| Which glomerular dz would you suspect most in a pt with the following findings?: positive ANCA | crescenteric/RPGN |
| Which glomerular dz would you suspect most in a pt with the following findings?: nephrotic syndrome a/w hep B | membranoproliferative GN |
| Which glomerular dz would you suspect most in a pt with the following findings?: nephrotic syndrome a/w HIV | FSGS |
| Positive p-ANCA is a/w what conditions? | Pauci-immune GN, microscopic polyangitis, Churg-Strauss, UC, and PSC |
| A husband asks that his wife (your pt) not be told about her recently-discovered lung cancer. What should you do? | Have an open-ended conversation about why he doesn't want you to tell her. Ultimatley, though, your responsibility is to the pt who has a right to know her dx. |
| How long must you have sx of RA to be dx? | 6 weeks |
| What is the mainstay of tx for RA? | NSAIDs (high dose) + steroids. Can also add DMARDs. |
| Name 3 major DMARDs (disease-modifying anti-rheumatic drugs) | sulfasalazine, hydroxychloroquine, and MTX. Can also use anti-TNF drugs, cyclosporines, or leflunomide. |
| What disease should you include in your differential with arthropathy of the following joints?: DIP and PIP | OA |
| What disease should you include in your differential with arthropathy of the following joints?: PIP and MCP (but not DIP) | Rhematoid Arthritis (remember R.A.D.S.= in Rheumatoid Arthritis, Dip is Spared) |
| What disease should you include in your differential with arthropathy of the following joints?: isolated MCP joints (squred off bone ends and hook-like osteophytes of the MCPs) | Hemochromatosis |
| What are the deformities of the hand a/w RA? | Swan neck: DIP flexed with hyperextended PIP. Boutoniere's: PIP flexed, DIP extended. Also ulnar deviation and MCP hypertrophy |
| What factors tend to elicit joint pain and stiffness in RA? What factors tend to relieve pain/stiffness? How does this differ from the pattern seen in OA? | RA: morning stiffness, improves with use. OA: stiffness/pain that worsens throughout day and is improved with rest. |
| What disease is a/w each of the following serologic markers?: anti-histone Ab | drug-induced lupus |
| What disease is a/w each of the following serologic markers?: rheumatoid factor | RA |
| What disease is a/w each of the following serologic markers?: anti-dsDNA Ab | SLE |
| What disease is a/w each of the following serologic markers?: anti-Sm Ab | SLE |
| What disease is a/w each of the following serologic markers?: HLA-DR4 | RA |
| What disease is a/w each of the following serologic markers?: anti-mitochondrial Ab | PBC |
| What are the 4 skin findings that are diagnostic criteria for SLE? | Discoid rash, malar rash, photosens, and painless oral ulcers |
| What disease is a/w each of the following serologic markers?: Name 7 non-skin diagnostic criteria for SLE | Non-erosive arthritis in at least 2 joints, serositis (pleuritis or pericarditis), + ANA, renal dz, neuro (seizures, psychosis), hemat d/o (anemia, leukopenia), and immune d/o (dsDNA, anti-smith, anti-phospholipid, false + VDRL) |
| Which drugs cause a lupus-like syndrome? | SHIPP: Sulfasalazine, Hydralazine, INH, Phenytoin, and Procainamide |
Created by:
sarah3148
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