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12 Cards in this Set
- Front
- Back
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Polymyalgia rheumatica 1. key feature 2. associated with 3. time course |
1. pain (and stiffness) 2. temporal arteritis 3. self-limited, lasts 1-3 years |
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PMR history features |
1. difficulty getting up stairs 2. difficulty getting up from chairs 3. difficulty combing hair 4. pain worse in morning |
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GCA features |
1. scalp pain 2. jaw claudication 3. scalp tenderness |
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PMR Clinical features 1. distribution 2. labs |
1. proximal muscles - shoulders and upper arms, hip girdle and thighs 2. raised ESR |
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PMR treatment |
PO prednisone - taper to lowest dose to which patient responds |
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SLE 1. pathophysiology 2. labs 3. classic presentation 4. skin changes 5. serosa 6. joints 7. kidneys 8. haematological |
1. Genetic predispostion. Triggers include agents that induce cell damage, revealing nuclear antigens. Antigen-antibody complexes deposit in vessel walls of many organs initiating local inflammatory response 2. ANA 3. fever, rash and joint pain in women of childbearing age 4. malar rash, photosensitivity, discoid rash 5. pericarditis, pleuritis 6. arthritis in 2 or more joints 7. renal disorders 8. anemia, thromboctytopenia, leukopenia |
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Rheumatoid arthritis 1. definition 2. joints involved 3. common presentation 4. extra articular features - skin - eyes - heart - lungs |
1. chronic, symmetrical synovitis of peripheral joints 2. PIP, MCP, wrist, elbow, shoulder, c-spine, MTP, ankle, knee 3. morning stiffness, symmetrical joint involvement, initially involves small joints of hands and feet, constitutional symptoms (e.g. fatigue) 4. - rheumatoid nodules, ulcers - scelritis, episcleritis - pericarditis, myocarditis, valvular defects - pulmonary fibrosis, pleural effusion, pleuritis |
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RA cont 5. Investigations 6. treatment |
5. bloods - RF, anti CCP, anemia of chronic disease, raised platelets, ESR and CRP. X-rays show osteopenia and erosions. 6. DMAs (e.g. methotrexate) and biologics. NSAIDs for pain. |
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Methotrexate side effects |
methotrexate is cytotoxic therefore causes: 1. ulcerative stomatitis 2. hepatoxicity 3. haematological - leukopenia (increased infection risk) 4. pulmonary fibrosis |
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Gout 1. commonly affected joints 2. investigations 3. treatment |
1. 1st MTP, ankle, knee, DIPs 2. joint aspirate 3. NSAIDs, corticosteroids, allopurinol long term |
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Joint pain differentials 1. articular a. inflammatory b. degenerative 2. non-articular a. localised b. generalised |
1. a) seropostive (RA, SLE), seronegative (reactive, psoriatic), crystal (gout, pseudo-gout), infectious (septic) b) OA 2. a) bursitis, tendonitis, muscular b) generalised - PMR, fibromyalgia |
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Polymyositis 1. hallmark 2. other features 3. diagnosis 4. treatment 5. cause |
1. weakness and wasting in proximal muscles, no neurological features as disease of muscle only. 2. esophageal dysmotility, ILD, cardiac conduction abnormalities 3. elevated CK, nerve conduction studies, muscle biopsy 4. steriods 5. as yet unidentified autoantibody |
