Rheumatology
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45 questions
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| AM pain/stiffnes > 30 mi for at least 6 wk, fatigue, wt loss, anorexia, fever Affects bilateral small joint MCP and PIP. Rheumatoid nodule, knee involvment , C spine subluxation' | What are the sx and sign of Rheumatoid Arthritis? |
| Anti CCP, sed rate, CRP, RF, CBC and CMP Xray of involved joint (RF may be - initially, can take up to 2 years to show) | How do you dx RA? |
| RA, splenomegaly and neutropenia | What is Felty Syndrome? |
| Block activity of TNF. Work best when given along with MTX. Halt and heal erosive changes. | How do Biologics work? |
| Infection, esp. reactivation of TB. Screen all pt with PPD and CXR. Hep B and C Vaccinate for pneumococcal, Zoster, Flu, Hep B. | What are the side effects of Biologics? |
| Retinopathy: Check eye exam yearly Renal: Check renal function. | What are the SE of Hydroxycholoquine. |
| Bone marrow depression: Check CBC Oligospermia and liver dz. | What are the SE of Sulfasalazine? |
| Hands: DIP ( Heberdon's node) and PIP ( Bouchard nodes) Spine, hips, knees. | Which joints are most affected in OA? |
| Joint space narrowing, osteophytes, subchondral bone sclerosis, and pseudocyst. | What are the xray findings in OA? |
| Tylenol, Topical analgesics: Capsasin, DMSO, Methsalycilate, Voltaren, Mucopolysaccaride injection. and Exercise. | What is the treatment of OA? |
| Joint swelling 50% initially in first MTP joint ( Podagra) Swelling may extend beyond foot and involve lower leg. | What are the sx of gout? |
| NSAIDS : Naproxen 500 mg bid Indomethacin 50 mg tid x 5-7 days. Steroid in Elderly: Prednisone 30-50 mg x 7-10 days. | How do you treat acute gout? |
| Poly arthritis of the hands, knees and wrist. | What is pseudo gout? |
| Calcium pyrophosphate crystals, Causes chonedrocalcinosis, calcium in the cartilage on xray. | What causes Pseudogout? |
| Joint aspiration showing rhomboid positive bifringence. | How do you dx pseudo gout? |
| Hemochromatosis and hyperparathyroid. Cause increase in phosphate and trauma causes precipitation of crystals. | What conditions predispose to pseudo gout? |
| Intra articular steroid injection, NSAIDS, Oral steroid. | How do you treat pseudo gout? |
| Non inflammatory disorder related to neurotransmitter dysfunction. Centralized pain disorder with pain amplification. | Fibromyalgia: What causes it? |
| Mutifocal pain, sleep disturbance and memory problems. Joint and proximal muscle tenderness. Points no longer checked. | What are the symptoms of fibromyalga? |
| Worse: Humid weather, stress , poor sleep Better: Dry hot weather, relaxation and sleep. | What makes fibromyalgia worse and better? |
| Anxiety, depression, migraine, IBS, PMS, non cardiac CP, restless leg, dysmenorrhea, RA, Lupus. | What are associated conditions with fibromyalgia? |
| Hypothyroid, chronic fatigue, and myofacial pain. WU: Check: CBC sed rate RF, TSK and CPK. | What is the DDX of fibromyalgia? |
| Ankylosing spondylitis Reiters syndrome Psoriatic Artharitis Inflamatory bowel disease | What are the seronegative spondyloarthorpathies |
| Xray: SI fusion, Bamboo spine Labs: HLAB27, CRP elevation, Clinical: Schober test,, pain over SI joint and achilles tendon insertion. | How do you diagnose AS? |
| NSAIDS, DMARDS, and Biologics, intra- articular steroid injection, PT | How do you treat AS? |
| Arthritis with infection elsewhere in the body. Findings: Sausage digits, Urethritis, conjunctivitis, asymmetric arthritis, skin discoloration of feet. | What is Reiters syndrome? |
| Chlamydia, Ureaplasma, Salmonella, Shigella, Campy and c. diff. | What causes Reiters? |
| Nail pitting, oonycholysis, sausage digits, and severe resorptive degeneration of joint. | What are the hallmarks of Psoriatic Arthritis? |
| Anti-ds DNA and anti-SM Ab Anticardiolipin and lupus anticoagulants are associateed with thrombosis and fetal loss | How do you diagnose Lupus? |
| NSAIDS and Antimalarial ( hydroxychloroquine) effective for rash and artharitis Steroid for organ involvement. Azathioprine and cyclophosphamide for renal and CNS disease | How do you treat Lupus? |
| Stiffness in bilateral shoulder girlds and hand swelling Associated with temporal artharitis in 20% | PMR sx? |
| Thought to be post infectious, accompainieed by immunologic disturbance and depression. Causing hypothalamic dysfunction. No dx test | What causes chronic fatigue? |
| NSAIDS for pain TCA for mood and sleep Venlafaxine low dose CBT and exercise | How do you treat chronic fatigue? |