Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
What is Rheumatoid Arthritis?
|
1) Autoimmune, HLA-DR4
2) Symmetric inflammatory arthritis: knees, feet, MCP, PIP |
|
What is the pathology of RA?
|
Leukocyte infiltration into joint. Synovium hypertrophies into joint, eroding cartilage and bone.
|
|
What are the si/sx of RA?
|
1) Symmetric arthritis in > 3 joint areas
2) SubQ nodules 3) Fever & wt. loss 4) Serositis 5) Anemia of chronic disease 6) Elevated ESR |
|
What is Rheumatoid Factor?
|
IgM anti-IgG, not specific but present in > 70% of RA patients
|
|
What is the treatment for RA?
|
Methotrexate, NSAIDs, TNF antagonists
|
|
How do you Dx SLE?
|
D= discoid macular rash
O= oral ulcers P= photosensitivity A= arthritis M= malar rash I= immunologic criteria N= neurologic E= ESR high R= renal disease A= ANA + S= serositis H= hematologic problems |
|
How do you Tx SLE?
|
NSAIDs, prednisone, cyclophosphamide
|
|
What is the classic triad of Sjogren's syndrome?
|
1) Dry eyes
2) Dry mouth 3) Inflammatory arthritis |
|
What is Behcet's syndrome?
|
Multisystem inflammatory disorder that chronically recurs. Painful genital and oral ulcers, can also see vasculitis and arthritis.
|
|
What are the Seronegative Spondyloarthropathies?
|
1) Osteoarthritis
2) Ankylosing spondylitis 3) Reiter's syndrome 4) Psoriatic arthritis |
|
How is Osteoarthritis different from Rheumatoid Arthritis?
|
1) Caused by wear & tear, not autoimmune/inflammation
2) See osteophytes (Heberden's nodes, Bouchard's nodes) 3) Asymmetric joint involvement 4) Affects older patient population |
|
What do you find in Ankylosing Spondylitis?
|
1) HLA-B27
2) Sacroiliitis 3) "Bamboo spine" |
|
What do you find in Reiter's Syndrome?
|
1) Uveitis, conjunctivitis
2) Urtethritis 3) Arthritis 4) also HLA-B27 |
|
What do you find in Psoriatic Arthritis?
|
1) Nail-pitting
2) DIP involvement 3) Occurs in 10% of patients with psoriasis *recall psoriasis is epidermal hyperplasia with red plaques and white scaling |
|
What is the CREST syndrome in Scleroderma?
|
C= calcinosis
R= Raynaud's E= esophagitis S= sclerodactyly T= telangiectasis |
|
What do you see in Sarcoidosis?
|
1) Diffuse systemic disorder which might be infectious or autoimmune
2) Fevers, chills, night sweats, wt. loss, cough, dyspnea, arthralgia, blurry vision (uveitis) 3) BILATERAL HILAR adenopathy on chest x-ray |
|
How do you Dx Sarcoidosis?
|
Clinical, but if find noncaseating granulomas on Bx is highly suggestive if nothing else explains it
|
|
Why are patients with Sarcoidosis often have nephrolithiasis?
|
Granulomas secrete 1-a-hydroxylase which inc. production of VitD --> hypercalcemia
|
|
How do you Tx Sarcoidosis?
|
Prednisone (1st line), but 50% patients remit so only Tx if in danger
|
|
What is Gout?
|
Monoarticular arthritis due to uric acid crystal deposits in joint
|
|
What do you see in Sarcoidosis?
|
1) Diffuse systemic disorder which might be infectious or autoimmune
2) Fevers, chills, night sweats, wt. loss, cough, dyspnea, arthralgia, blurry vision (uveitis) 3) BILATERAL HILAR adenopathy on chest x-ray |
|
How do you Dx Sarcoidosis?
|
Clinical, but if find noncaseating granulomas on Bx is highly suggestive if nothing else explains it
|
|
Why are patients with Sarcoidosis often have nephrolithiasis?
|
Granulomas secrete 1-a-hydroxylase which inc. production of VitD --> hypercalcemia
|
|
How do you Tx Sarcoidosis?
|
Prednisone (1st line), but 50% patients remit so only Tx if in danger
|
|
What is Gout?
|
Monoarticular arthritis due to uric acid crystal deposits in joint
|
|
What are si/sx of Gout?
|
Often podagra (big toe), overlying skin erythema can mimic cellulitis. NEEDLE-SHAPED negatively birefringentcrstals!
|
|
What are some causes of urate overproduction in Gout?
|
1) PRPP synthetase hyperactivity: make a lot of purines --> lots of urate
2) HGPRTase deficiency (aka Lesch Nyan): no salvage purines --> lots of urate |
|
What are some causes of urate underexcretion in Gout?
|
1) Renal disease
2) Drugs: low-dose aspirin, diuretics, alcohol |
|
Acute Tx and Maintenance Tx of Gout?
|
Acute: colchicine, NSAIDs (but not aspirin)
Long term: allopurinol (for overproducers), probenecid (for underexcreters) |
|
What is Pseudogout?
|
Calcium pyrophosphate dihydrate crystals in joints, also in old ppl. Can be secondary to hyperparathyroid, Wilson's, diabetes, hemochromatosis. Positively birefringent rhomboid crystals!
|