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46 Cards in this Set

  • Front
  • Back
Back pain malignancy Sx
– not relieved by lying down
– older than 50
– worsen’s at night
– more than 1 month
Spinal Stenosis
– leg cramping is worse at rest and with standing and walking
– if you suspect it, skip w-ray and get MRI
– improves w/ hip flexion
– can give epidural steroids or lamectomy if really bad
Anklysoing Spondylitis
– apophyseal joint arthritis
– Schober test is decreased flexion
– 3rd degree heart block
– only exercise can reverse it
– can try TNF-a inhibitors
Reiter’s syndrome causes
– Camp, Shigella, Salmonella
– Ureaplasma, Chlamydia
Dystrophen in DMD and BMD
– Absent vs. Abnormal protein
Fibromyalgia Tx
– antidepressants
– TENS, hydrotherapy etc.
– make sure to test of TSH and CK
Gout findings
– Rat bite bones
– hips and shoulders are spared
Causes of uricemia
– cyclosporine
– DI
– Lead
– Salicylates
Gout Tx
– Acute is NSAIDS and colchicines or steroids
– Maintenance is Allopurinol for overproduces or probenecid for undersecretors (do 24 hr urine level)
The myositis Dx
– increased Aldolase
– EMG shows fibrillations
– Bx shows fibers in varying stages of necrosis and regeneration
Myositis Tx
– high dose corticosteroids for 4-6 weeks, then taper
– Azathioprine or Methotrexate as adjuvant
– needs to be > 6 weeks
– Felty is spenomegaly and neutropenia
– fluid has decreased viscocity and increased WBC
– 1st line is methotrexate, hydroxyl or TNF a-inibitors
– 2nd line is penicillamine and cyclosporine
JRA types
– must last > 6 weeks
– Pauciarticular is asymectric on weight bearing w/ iriocyclitis and ANA
– Polyarticular is > 5 small joints
– Acute febrile has salmon rash and remises w/in 1 year
– NSAIDS or steroids
– ROM and strengthening
– methotrexate is 2nd line
Scleroderma Antibodies
– CREST is centromere
– Scl-70 is poor prognosis
Scleroderma Tx
– Steroids for acute and penicillamine for skin
– CCBs for Raynauds
– ACEI’s for renal
Neonatal SLE
– Anti-Ro antibodies
Drug induced SLE
– Cyclorpromazine
– Methyldopa
– Penicillamine
– Procainamide
– Quinidine
SLE Tx for refractory
– Steroids
– hydroxychloroquine
– cyclophaspamide
– azathioprine
Temproal Arteritis
– ESR > 100
– bx shows necrosis of the media, lymphocytes, plasma cells, and giant cells
– give high dose prednisone for 1-2 months
– increased ESR w/ anemia
– give low dose prednisone
– no weakness on exam
DDH signs
– Orrolani’s is abducting from midline
– Barlow is pressure on inner aspect
– Allis or Galezzi’s is knees unequal heights
– Less than 6 months is Pavlik harness (flexed and abducted)
– 6-15 months is Spica cast
– 15-24 months is open reduction
What do hip fractures look like?
– externally rotated and shortened
Shoulder dislocation nerves
– Anterior damages axillary
– posterior damages radial
Monteggia’s fracture
– Proximal ulna w/ subluxation of radial head
– ORIF of ulna and closed reduction of radial head
Galeazzi’s fracture
– fracture of radius w/ dislocation of distal radial/ulnar joint
– ORIF of radius and cast in supination for the joint
– limited ABduction and internal rotation
– can observe if full ROM
– if not, do osteotomy
– better if less than 5 years
– medial and posterior displacement
– hypothyroidism
– flexion leads to obligatory external rotation
– can’t bear weight until surgically stabilized
Osteosarcoma Tx
– Methotrexate
– doxorubicin
– cisplatin
– ifosfamide
Methotrexate SE’s
– it inhibits DFR and leads to macrocytic anemia
Relapsing polychondrits
– recurrent inflammation of cartilage and internal organs
OCP’s in SLE
– increases risk of thromboemoblism so avoid if active renal involvement
Stepwise OA tx
– Tylenol
– NSAIDS (or COX-2)
– weight reduction/exercise
Systemic Sarcoidosis Tx
– systemic steroids
Mixed essential cyroglobulinemia
– leukoclast vasculitis and IgM C3 deposits
– usually w/ HCV
Suprascapular neuropathy
– poor ADduction and external roatation
Lupus Nephritis
– from Anti-DsDNA Ab
Mixed connective tissue D/O
– anti-ribonuclear protein
– SLE/Scleroderma/myositis
Erythema nodosum tests
– Get CXR for sarcoid
– if bowel problems, SBFT
Reflex sympathetic dystrophy
– pain and swelling w/ vasomotor instability
– give prednisone
Atheromatous syndrome
– blue toes syndrome
– calf discomfort from small vessles
– livedo reticularis w/ mottled skin
Abs for Sjogrens, poly, and dermatomyositis
– SSA and SSB
– Jo1
De Quervian’s disease
– tendenitis of abductor policis longus under reinacular pulley
– Hyperparathyroidism
– Hemochromatosis