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10 Cards in this Set
- Front
- Back
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Clinical characteristics of Buerger's disease
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Claudication and pain at rest; can be Raynaud-like reaction to cold
PEDAL or INSTEP claudication is particularly characteristic migratory thrombophlebitis gangrene of toes or fingers, esp. following trauma |
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How do you diagnose Buerger's disease?
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Diagnosis of exclusion:
rule out atherosclerosis (lipid panel, arteriogram) emboli (echo) autoimmune dz (ESR, CRP, RF, ANA) hypercoag state (PT, PTT) diabetes (blood glucose) |
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What is treatment of Buerger's dz?
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smoking cessation
CCBs or pentoxifylline Iloprost (IV prostaglandin) treat cellulitis with abx treat phlebitis with NSAIDs amputation when all else fails |
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What three areas are affected by Wegener's granulomatosis?
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nasal/sinus/oral ulcers (chronic sinusitis, epistaxis, saddle-nose)
pulmonary (nodules, cavitation, fixed infiltrate on Xray) kidneys (microhematuria or RBC casts) |
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New onset otitis media in an adult, think ?
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Wegener's
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What are the three main pulmonary-renal syndromes?
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Wegener's granulomatosis
Goodpasture's disease SLE |
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What is the treatment for Wegener's?
What is a complication of the regimen? |
oral prednisone 1 mg/kg/day, for 1-2 months then taper
+ oral cyclophosphamide 2 mg/kg/day for ONE YEAR consider Bactrim prophylaxis against Pneumocystis carinii and recurrent sinus infection complication: leukopenia |
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What are the clinical/physical exam features of Churg-Strauss syndrome?
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sinuses: rhinitis, polyps
pulmonary: asthma, shifting infiltrates, sometimes nodular; effusions; pulmonary hemorrhage MONONEURITIS MULTIPLEX but rarely CNS involvement GI: gastrointestinal pain, bloody diarrhea skin: subQ nodules, petchiae, purpura, skin infarction (during late vasculitis phase) other organ involvement (renal, cardiac, prostate) is uncommon/rare |
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What is the treatment for Churg-Strauss?
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high dose prednisone, 60 mg/day
Add cyclophosphamide if severe |
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What lab findings are diagnostic of Churg-Strauss?
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p-ANCA +
eosionphilic necrotizing granulomas on biopsy eosinophilia (10%) |
