Rheum Study

Front 1

Inflammatory Arthritis cardinal signs

Back 1

swelling
warmth
erythema
tenderness
loss of function

Front 2

what physical exam suggests pain is referred?

Back 2

full, painless ROM

Front 3

when is synovial fluid analysis recommended

Back 3

monoarticular swelling

Front 4

when should ana, anca be sent?

Back 4

when something suspected, not to screen

Front 5

what wbc counts are important in synovial fluid?

Back 5

> 2000 = inflammatory
> 50000 = infection

Front 6

What PEX differs in inflammatory vs. noninflammatory?

Back 6

Inflam: joint inflammation- warmth, erythema, soft tissue swelling, effusion

Noninflam: bony prolif

Front 7

Morning stiffness differences in inflam vs. noninflam

Back 7

inflam > 1 hr

Front 8

systemic symptoms in inflam vs. noninflam?

Back 8

inflam: low grade fever, fatigue, rash

Front 9

what are XR findings in inflam vs. noninflam arthritis?

Back 9

inflam: erosions, periostitis, joint-space narrowing

non inflam: osteophytes, subchondral sclerosis

Front 10

Bacterial Joint Infection Patter

Back 10

asymmetric, monoarticular

Front 11

Gout joint pattern

Back 11

asymmetric, monoarticular

Front 12

diseases associated with AVNs

Back 12

coticosteroids, alcoholsims, vasculitis, sickle cell disease, trauma

Front 13

Reiter Syndrome

Back 13

arthritis, conjunctivitis, urethritis

Front 14

arthritis and sarcoid

Back 14

rare, but can present as monoarticular ankle arthritis.
Lofgren syndrome- arthrisis, erythema nodosum, hilar lad

Front 15

what is indicated if synovial fluid is not inflammatory

Back 15

structural abnormality, avn, internal derangement, osteoarthritis

Front 16

infectious causes of polyarticular arthritis

Back 16

heb b, c, lyme disease, endocarditis, acute rheumatic fever, parvo, hiv, ebv, rubella

Front 17

Noninfectious causes of polyarticular arthritis

Back 17

RA, SLE, MCTD, gout,

Front 18

seronegative spondyloarthropathies

Back 18

sarcoid, serum sickness, wegener, polyarteritis nodosa, microscopic polyangitis

uncommon: Still disease, Behcet disease, pelapsing polychondritis, whipple

Front 19

what presents as symmetric arthritis?

Back 19

RA, SLE, viral infections

Front 20

what area does RA not affect?

Back 20

spine, DIPs

Front 21

What Dermatologic Lesions are in Arthritis?

Back 21

Photosensitiviy, malar, discoid rashes are seen in SLE

Gottron papules over the metacarpophalangeal region, shwl sign over upper back and shoulders, v-neck on chest are seen in dermatomyositis

Cracked skin over the radial surfaces of the fingers and thenar eminency suggests antisynthetase syndrome assoc with polymyositis

Psoriasis is associated with arthritis in 30%, can see nail pitting

RF- erythema marginatum
Lyme Disease- Erythema Chronicum migrans

Erythema Nodosum- sarcoid, enteropathic arthritis, Behcets

Pyoderma gangrenosum- enteropathic arthritis

Palpable purpura adn livedo reticularis- vasculitis
leukoocytoclastic vasculitis may manifest as palpable purpura and may be associated with RA, SL, Sjogrens or relapsing polychondritis.

Keratoderma Blennorrhagicum and Circinate Balanitis are seen in reactive arthritis. Evanescent Salmon-colored rashes are seen in adult-onset still disease

Front 22

fever and arthritis

Back 22

polyarticular crystalline arthropathies, sle, vasculitis, infectious arthritis, and adult-onset still disease. fever is not a common feature of RA and should trigger a serach for infection.

Front 23

eye disease and arthritis

Back 23

photophobia and a painful eye are associated with sclertitis and anterior uveitis but not conjunctivitis

conjunctivitis can occur in reactive arthritis

wegener granulomatosis, ra, relapsing polychondritis is associated with scleritis

uveitis is seen with lyme disease, SLE, sarcoid, and Behcet disease

Front 24

lung disease and arthritis

Back 24

ILD in RA, Sclerosis, polymyositis/dermatomyositis. Ankylosing spondylitis associated with upper lobe pulm fibrosis. Cavitary lung disease is a feature of wegener granulomatosis.

Microscopic polyangiitis and SLE are seen to have PAH

Sarcoid can affect anything

Front 25

diarrhea and arthritis

Back 25

IBD is the only uniform diagnsosi

whipple, celiac sometimes can have reactive arthritis

Front 26

SEs of MTX

Back 26

stomatitis, nausea, diarrhea
give folic acid with it
can cause Hepatotox
contraindications: liver disease

Front 27

Hydroxychloroquine in rheumatoid disease

Back 27

used in RA, SLE,
take s3-6 months
don't use with renal/hepatic insufficiency
macular toxicity is a severe side effect, but unlikely.
cat c

Front 28

Sulfasalazine in Rheumatic disease

Back 28

monitor for neutropenia and liver disase
can have nausea or abd pain
contraindicated i G6PD, sulfa allergy. Can use in pregnancy

Front 29

Leflunomide

Back 29

can be used w/ MTX, as effective in RA
SEs: Diarrhea, Nausea, hair loss.
Teratogentic. Must undergo cholestyramine elimination.
measure LFTs monthly

Front 30

azathioprine in rheumatoid

Back 30

aza is good for sle, systemic vasculitis
CBCs, LFTs to monitor
pts w/ genitc deficiency of thiopurine mt can get toxicity
can cause hypersensitivity

Front 31

cyclophosphamide

Back 31

treats lupus nephritis, systemic vasculitis, and wegener's
Daily oral is more potent but causes toxicity
SEs: Hemorrhagic cystitis, cytopenias, bladder cancer, leukemia

need cbcs, u/as

Front 32

mycophenolate mofetil

Back 32

treats lupus nephritis
teratogenic

Front 33

cyclosporine

Back 33

used in RA
can cause renal toxicity