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21 Cards in this Set
- Front
- Back
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Gout clinical manifestations?
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Sudden onset of first MTP joint pain and recurrent. Chronic hyperuricemia –> tophi, CRF (HTN, DM, AS)
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What is the diagnostic finding of gout?
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Monosodium urate crystals in joint
Negative birefringent yellow, parallel to polarizing scope axis |
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What are the tx for gout?
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NSAIDs
Colchicine Steroids (systemic or intraarticular |
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Calcium Pyrophosphate Dihydrate, (CPPD) is deposited in in the synovium and cartilage
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Pseudogout
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Pseudogout asspcoated with
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hyperPTH, hypoT, hemochromatosis, Wilson’s
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Pseudogout diagnosis
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Chondrocalcinosis on x–ray
Positively birefringent crystals |
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Lyme disease rheumatologic manifestations
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Arthralgias without arthritis
Intermittent arthritis Chronic arthritis |
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Erythema migrans
Primary and secondary lesions Lymphocytic meningitis* Cranial neuritis* Radiculoneuropathy* |
Garin–Bujadoux–Bannwarth syndrome
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Increase B cell activation
Autoreactive antibody production Decrease suppressor cells, increased helper cells Direct Ab attack on tissues as well as immune complex formation |
Systemic Lupus Erythematosus (SLE) most common in black and women.
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Which drugs cause SLE?
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Estrogen, procainamide, hydralazine, INH, THN blockers, interferon
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What other conditions can cause SLE?
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HLA risk
Complement deficiencies: C1q, C2, C4 |
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By far the most common manifestation with people with lupus is
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polyarticular arthritis which starts acutely but then progresses it to chronic.
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An africa american women with arthrititis and signs of Malar rash, photosensitivy especially in people of color can show
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SLE. Arthritis #1 sign of SLE.
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Oral/nasal ulcers are very common among in SLE and serositis when you test them they come back
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pleuritis and pericarditis they are clean with no infection
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Neurological symptoms indicating SLE
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35 year woman (usually seisures occur young age) and psychosis (usually happen after 50).
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The most common lab finding of lupus is
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anti nuclear antibody positive and and it is for anti-dsDNA then it tells you they have lupus.
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Ab to native DNA, correlates with disease activity, nephritis
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Anti–dsDNA in SLE
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Ab to denatured DNA, no correlation with disease activity
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Anti–ssDNA in SLE
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SLE can also be diagnosed if Anti-smith antibody found. What is the Smith antigen?
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nuclear non–histone proteins called small nuclear ribonucleoprotein particles (sn RNPs, spliceosomes)
-more common in AFRICA AMERICAN -May be + when dsDNA antibody is (-) |
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Bind to U1–RNP. Splices heterogenous nuclear RNA into mRNA
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Anti–RNP
when found alone indicates mixed connective tissue disease. |
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If an antihistone antibody is found without dsDNA or smith antibody then this means there is
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drug–induced
SLE. |
