Lisa Rheum 2 - Laughing/medstudy

Front 1

what's next step in dx dermatomyositis?

Back 1

get CK level

Front 2

tx of kawasaki? and what's primary concern? and what labs are abnl w/ it?

Back 2

IVIG and ASA;
- coronary artery disease; hi plt; otehr APR: CRP, ESR: alpha 1 anti trypsin high x 4-6 wks

Front 3

chills, fevers, hypotension w/ sepsis like picture after lyme disease: what's cause?

Back 3

Jarisch-herxheimer reaction: result of lysis of organism and release of endotoxin

Front 4

what are major criteria of Marfan's?

Back 4

dilatation and dissection of ascending aorta
2. lumbosacral dural ectasia
3. ectopia lentis
4. four skelatal manifestions;
NOT MVP

Front 5

what happens early diz vs late diz in lyme?

Back 5

early: erythema chornicum migrans rash (bullseye) at site of tick bite; flue-like sx
late: CAN: carditis, arthritis (pauciarticular; large jionts, esp knee), neuro signs

Front 6

How tell difference b/w JRA and acute leukemia?

Back 6

JRA: Am stiffness, spiking fevers, rashes; > 6 wks
-acute leukemia: pm awakeneings; pains at night; doesn't involve a joint; acutely

Front 7

pt w/ vague joint pains, got MMR vaccine; what's most likely explanaion for joint aches? other causes?

Back 7

MMR post infectious arthritis from rubella component; esp in post pubertal femaile;
other bugs: salmonella, yersinia, campylobacter

Front 8

how dx of Rheumatic fever?

Back 8

Joints
2 major or 1 minor :
Major: Joints (poly arthritis) Migratory! , Carditis
Nodules
Erythema marginatum: red, diffusee
syndenhams chorea

Minor: PR prolongation; APR (esr, crp), arthralgia, F

Front 9

tx of Rheumatic fever?

Back 9

1) pcn - eliminate grp A strep
2) aleviate sx
3) proyphax to prevent recurrence

Front 10

noncaseating granulomas, b/l peribronchial infiltrates on cXR; AA; wt loss, fatigue, hilar adenopathy,
-hi Ca, hypercalcuiria; reanl diz, eye diz

Back 10

sarcoidosis

Front 11

what' smost specific lupus test?
most sensitive?

Back 11

specifici ? anti-SM
most sensitive? ANA

Front 12

signs of active renal diz in lupus?

Back 12

C3,4, and CH50

Front 13

8 yo F w/ acute abd pain ~ N/V, decreased appetitis; preceding week: abd pain; arthralgia, arthritis in both knees; Nl CBC, ESR, and urine w/ red/white blood cells;
dx?

Back 13

HSP ~ palpable maculopapular lesions on LE

Front 14

3 yo w R knee pain, swelling, had F, bloody diarrhea 3 wks bprior; PE: arthritis in R knee, B/L injection of conjunctiva; what abnl labs?

Back 14

Dx: reactive arthritis (Reiter's): ~ shigella, salmonelly, yersinia or chlamydia infection: include conjunctivitis, uveitis, arthritis, dysuria
- ; abnl: WBC on UA: neg urine cx

Front 15

9 yo F w/ b/l knee and left wrist pain, swelling x 8 wks; stiff joints, decresaed activity; knee effusions, tender; What's dx and will ANA, RF be positive?
-what other associations?

Back 15

pauciarticluar/oligoarticular JRA; + ANA ~ uveitis;
** most common cause of JRA !!
< 5 med joints-large joints are involved;
pks: 1-3, 8-12 yo; regular slit lamp adivsed;
vs: polyarticular (has a -/+ RF; teenage girls, but RF+ ~ poor prognosis)

Front 16

8 yo M w swelling and pain of L knee x 2 wks w/ suddent onset of abd pain; Nl CBC, lytes, renal function, Nl UA, ESR 45; urine + blood, protein, no longer any evidence of arthritis or arthralgi of L knee, but now - R ankle edematous, tender upon range of Motion; tender, colicky abd : + heme stools;
-what's dx, how dx?

Back 16

HSP: will also have red purple palpable purpura on LE

Front 17

What GI complications ~ HSP?

Back 17

intussusception

Front 18

15 yo F w/ 10 wk h/o fatigue, malaise, low appetite, intermittent F /co intermittent pain, swelling in writsts, fingers, L knee, ankle that are getting worse, cause interference w/ acitivities of daily living;
-whats dx and what labs ~ poor prognosis and subsequent develpment of functional disabilities?

Back 18

JRA: polyarticular
+ RF ~ worse prognosis!!, esp in older kids; --> destructive changes in cervical spine increased risk of atlantoaxial subluxation and pain
-also presence of rheumatoid nodules ~ poorer overlal prognosis

Front 19

+ ANA in JRA is ~ with what?

Back 19

uveitis

Front 20

6 yo boy w/ 2 wk h/o daily T spikes /co CP, joint pain, intermittent rash on trunk, thighs, looks ill, F; pericardial friction rub, cervical AD, HPSNM, mulitple warm swollen joints; what's dx and what's ~ poor long term prognosis

Back 20

JRA; polyarthritis ~ worse prognosis than oligo/pauciarticular JRA
-oligo have better prognosis that poly

Front 21

Anykylosing spondylitis ~ ? JRA and will present w/ what kind of clinical finding in spine? what labs +?

Back 21

oligoarthritis and ethesitis or pain in areas where tendon/ligament attache to bone
-Loss of mobility in the lumbosacral spine
+ HLA B27

Front 22

how do you differentiate AS from psoriatic arthiritis?

Back 22

Psoriatirc arthritis ~ females who have asymmetric oligoarthritis affecting both large and small joints as well as nail pitting

Front 23

what kind of arthritis do SLE patients have?

Back 23

nonerosive, reducible, involves tendons; vs rhematoid arthritis has erosive arthritis (erosions on x-ray)

Front 24

17 yo w SLE c/o SOB, CP, Pain on right side, worse on deep breathing; vitals except: P 128, RR 30, A-a gradient : 30 (nL < 20); what's dx?

Back 24

Pulmonary embolism ** abnl A-a gradient; SLE pts hypercoaguable; CXR ~ nl w/ atelectasis or small infiltrate like pattern

Front 25

which joints are involved in psoriatic arthritis?
- how dx?
-More common in females or males?

Back 25

DIP: distal interphalangeal joints;
DX: psoriasis AND arthritis OR
-arthritis at at least 2 of: dactylitis, nail findings, and/or FHH of psoriasis in 1st degree relative
-more common in Females

Front 26

10 yo F w/ fatigue, low appetitis, weakness, periorbital violaceous heliotrope rash can have what kind of depostis in muscle, faascia, subcutatneous tissue?
-what kind of muscle weakenss/pattern?

Back 26

calcium depositis; dermatomyositis: calcinosis;
-proximal M. weakness; + gowers sign;

Front 27

10 yo boy w/ HA, fever, rash 2 wks after camping, has annular targetlike rash w/ central clearing; whats dx?
-how long does it take develop?

Back 27

Lyme, infected tick must be attached to skin for at least 36-48 hrs before significant risk of developing condition;
-good prognosis, arthritis-hallmark of late diz;
DX: ELISA, Western

Front 28

7 yo w/ SOB, nunpruritic rash, painful migratory arthritis, 2 wks prior had F, sore throat, truncal macular rash, now w/ 3/6 loud holosystolic M at apex, axilla; whats dx?
-how dx? and what's tx?

Back 28

acute Rheumatic F;
-2 major (JONES: joints-migratory polyarthritis, carditis, nodules, E. marginatum, syndehams chorea) OR
-1 Major + 1 Minor: F, arthralgia, ESR, leukocotisis;
-many have High ASO
-Tx: acute: PCN (strep infx) + NSAIDs or steroids - for inflammation

Front 29

12 yo boy w/ severe arthritis of hips, sacroiliac joints; + HLA B 27, DX?

Back 29

late onset pauciarticular JRA ~ ankylosing spondylitis; vs
-early onset JRA - female, 1-5 yo, high risk of uveitis (w/ + ANA), don't have involvement of sacoiliac joints

Front 30

14 yo F w/ + HLA B27 w /abd pain, chronic diarrhea, what's dx?

Back 30

arthritis of IBD