Chapter 6

Front 1

diagnosis of SLE

Back 1

positive ANA screening test: sensitive but not specific
2. anti ds DNA and anti SM ab:sepcfic not sensitive
3. anti ssDNA
4. antihistone Ab
5. SSA and SSB associated with sjobren: subacute cutaneous sle, neonatal lupus
6. anticardiolipin and lupus anticoagulatn

Front 2

treatment for SLE

Back 2

avoid sun, NSAIDS, systemic steroids for severe manifestation
HYDROXYCHLOROQUINE-for constitutional, cutaneous and articular manifestations
CYCLOPHOSPHAMIADE-for active glomerulonephritis

Front 3

scleroderma diagnosis

Back 3

1. anticentromere antibody: specific for limited form
2. antitopoisomerase I: ver specific for diffuse from
3. barring swallow and pulmonary function test for complications

Front 4

scleroderma treatmetn

Back 4

NSAIDS
no effective cure

Front 5

Sjogren diagnosis

Back 5

ANA present in 95% of patietns
2. SSA AND SSB in 40%
3. increased ESR, normocytic normochromic anemia, leukopenia
4. SCHIRMIR TEST: filter paper inserted in ee to measure lacrimal gland output
5. salivary gland biopsy!
THINK SJOGREN AND SCHIRMIR

Front 6

treatment for sjogren

Back 6

pilocarpine or cevimeline
artificial tears for ees
good oral hgene
nsaids, steorids for arthralgia

Front 7

Rheumatoid arthritis defintiion

Back 7

a chronic inflammatory autoimmune disease involving the SYNOVIUM OF joints

Front 8

rheumatoid arhthiris involve all joints EXCEPT

Back 8

DIP (
rude not dear)

Front 9

rheumatoid arhtits morning stiffness or night

Back 9

morning stiffness that improves as day progresses

Front 10

diagnosis of rheumatoid arthritis

Back 10

1. RF
2. Anti citrulinated pepti
ded (ACPA)
3. ESR, CRP
4. radiographs-juxtaarticulr bone mass near finger joints, NARROWING OF JOINT SPACE, BON EROSIONS

Front 11

treatment of rheumatoid arhritis

Back 11

1. exercise
2. NSAIDS drug of choice, corticosteroids if NSAIDS not good
3. DMARDS: reduce morbiti and mortality, slow progression of disease, have slow onset of action
METHOTREXATE IS BEST DMARD
4. surgery: synovectomy or joint repalcemnt surgery

Front 12

gout diagnosis

Back 12

1. joint aspiration and synovial fluid analysis: needle shaped and negatively birefringent urate crystals
2. radiographs revelal punched ut erosions with an overhanging rim of cortical bone

Front 13

treatmetnT FOR GOUT

Back 13

1. acute gout: nsaids, cochicine, corticosteorids (oral prednisone)
2. prophylactic therapy: wiatu ntil 2 acute gouty attacks first. allopuronl or
PROPENACID

Front 14

how descide between probenecid or allopurinol

Back 14

if 24 hour urine uric acid <800 mg/day this means undersecretion of urate so do uricosuric durgs such as probenecid

Front 15

diagnosis of psudogout

Back 15

1. weakly positive birefringent rod shaped and rhomboid cyrstals
2. radiographs-chondrocalcinosis

Front 16

treatment of psudogout

Back 16

similar to out-nsaids, cholchinien, intraarticular steroids injections
total joint repalcemnt if symptoms debilitating

Front 17

polymyoositis and dermatomyosistis diagnoss

Back 17

1.CK level is significantly elevated
2. LDH, aldolase, AST, ALT ELEVATED
3. ana
4. ANTI O1 ANTIBODIES
5. ANTISIGNAL RECOGNITION PARTICLE
6. emg-abnormal in 90%
7. muscle biosy shows inflammation and muscle fiber fibrosis
DERMATOMSOSTIS-PERIVASUCLAR NAD PERIMYSIAL
POLYMOSITS-Endomsial

Front 18

treatment of dermato and polmyositis

Back 18

1. corticosteorids until symptoms improve then taper slowl
2. methotrexate, cyclophosmaide, chlorambucil (immnosuppreive)
3. PT

Front 19

polymyalgia Rheumatica clinical feature

Back 19

hip and sholder muscle pain bilaterala-often begins aprutpy
2. joint sweeling in knees wrist sor hands
3

Front 20

treatment of polymyalgia rheumatica

Back 20

esr >50
cincal diagnosis

Front 21

treatment of polymyalgia rhematica

Back 21

corticosteroids then taper after 6 weeks

Front 22

fibromyalgia diagnosis

Back 22

11/18 tenderpoints
efore confirming rule out: myofaiscal, rheumatoid, polymyalgia rhematica, ankllsing spondylitis,chornic fatige sdnorme, lyme disease, hypothyroidism, depression and somatization disorder, etc

Front 23

treatment for fibromyalgia

Back 23

SSRI and TCA
cognitive bheavoiral therapy, exercise

Front 24

ankylosing spondylitis is asocated with

Back 24

acute antieor uveitits or iridocyclitis

Front 25

diagnosis of ankylosing spondylitis

Back 25

1. plain film mrior ct of lumbar psine and pelvis
2. ESR elevated

Front 26

treatment for ankylsing spondylits

Back 26

1. NSAID
2. anti-tnf meciation
3. PT
4. surgery

Front 27

REITER SYNDOMRE HAS WHAT CLINCAL FEATURES

Back 27

asmitci arthits
genticurinae
faitue

Front 28

REITER sndomre diangosis

Back 28

send synovial fluid for analysi

Front 29

treatment of reiter

Back 29

NSAIDS first line
if no response try SULFASALZINE

Front 30

psoriatic arthriti features and treatmetn

Back 30

asympmetirc and polyarticulara, upper extremites invovlened
intial treamnet is NSAIDS

Front 31

temporal arteries diangosis

Back 31

esr
biopsy of temporal artery

Front 32

TREATMENT of temporal arteritis

Back 32

1. high dose steorids-predinose-early to prevent blindness
2. follow up on ESR elevesl
3. visual loss in one ye may be temporary or permant

Front 33

takayasu arteritis treatmetn

Back 33

steroids
treat htn

Front 34

churg strass syndrome diagnosi

Back 34

p-anca
PROGNISIS I5 YEAR SURVIVAL OF 25% but steroid inc it to 50%

Front 35

wegners granulomatosis diagnosis

Back 35

c-anca
esr elevated
open lung biopsy conifmrs

Front 36

treatment for wegners

Back 36

cyclophosmaid and corticosteroids

Front 37

polyarteritis nodosa diagnosis

Back 37

PANCA AND ESR

Front 38

treatment for polyartiis nodosa

Back 38

corticosteroids

Front 39

behcet sdrome diagnosis and treatmetn

Back 39

diagnosis: biopsy of inovled tissue
treatment: steroids

Front 40

Buergers disease

Back 40

smoke cessation