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18 Cards in this Set
- Front
- Back
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T/F: oral corticosteroids have no place in the treatment of ankylosing spondylitis.
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true
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Ddx of sacroiliac joint abnormalities on xray.
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spondys
infection trauma: fracture, osteoarthritis dz: gout, hyperPTH, Paget's, paraplegia, cancer mets |
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What are the five signs of Bechet's?
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oral ulcers (97%), 3x in year
genital ulcers (80+%) eye lesions: uveitis, cells in vitreous on slit lamp, retinal vasculitis skin lesions: erythema nodosum, pseudofolliculitis, papular, pustular, acneform nodules PATHERGY: reaction to any needle stick |
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Where is Bechet's most common?
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"Marco Polo's Silk Route"
Japan, Turkey, Mediterranean basin |
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Aphthous ulcers are 70% idiopathic. What is the most common known cause?
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B12, folate, or iron deficiency
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Describe the arthritis seen with Bechet's.
Is Bechet's a thrombotic disease? |
About 50% of Bechet's patient develop signs of sx of point involvement, migratory, asymmetic, oligoarticular, mainly in knees, ankles, elbows, wrists.
Yes, in 1/4 of patients; at least that many have factor V Leiden mutation. |
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What is the drug of choice for severe CNS and ocular sx in Bechet's?
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chlorambucil; cyclosporine is second line.
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What is the treatment for Bechet's?
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skin lesions: colchicine, dapsone, thalidomide, levamisole, INF-alpha.
immunosuppressives: systemic corticosteroids azathioprine MTX tacrolimus |
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What are the main signs of relapsing polychondritis?
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recurrent chondritis of both auricles
chondritis of nasal cartilage inflammation of eyes, conjunctivitis, uveitis, episcleritis or scleritis CHONDRITIS OF TRACHEAL CARTILAGE (DANGEROUS) cochlear/vestibular damage, tinnitus, hearing loss |
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What diseases can cause saddle nose deformity?
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syphillis, Wegener's, relapsing polychrondritis (these might all have multifocal signs/sx); frostbite, midline granuloma (these would not)
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What labs would be seen in relapsing polychrondritis?
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ESR elevated
can be ass w hypothyroid check PFTs check echo for valvular heart dz |
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What is the tx of RPC?
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Glucocorticoids 20-60 mg/day
If refractory, DAPSONE, MTX, etc. try steroids, cyclophosphamide until controlled, then MTX for maintenance |
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What is the mnemonic for polymyalgia rheumatica symptoms?
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SECRET
Stiffness, pain Elderly >50, usually > 60 Caucasian, Constitutional symptoms Rheumatic (arthritic symptoms) ESR elevated > 40 Temporal arteriitis |
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What is the first area to be affected in PMR?
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shoulders
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T/F Synovitis and constitutional symptoms like weight loss are often seen in PMR.
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true; spiking fevers only seen in TA
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What labs are elevated besides ESR in PMR?
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LFTs can be
alk phos elevated in 1/3 of pts Gamma globulins can be elevated normochromic anemia is common however, renal function, UA and Cr will be normal; RF and ANA will be negative |
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What questions should be asked in history for a PMR/TA patient?
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vision loss
JAW CLAUDICATION SCALP TENDERNESS BRUITS AND DECREASED PULSATION IN ARTERIES OF NECK AND UE |
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Tx of PMR
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prednisone 15-20 mg/day should cause rapid resolution; if it doesn't, it's probably not PMR
Taper fairly quickly to 5 mg, may need extended tx; observe for one year |
