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54 Cards in this Set
- Front
- Back
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Fibromyalgia
definition |
-a chronic noninflammatory soft tissue pain disorder
-greater than 3 months duration -widespread musculoskeletal pain -excess tenderness in at least 11 of 18 points |
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Fibromyalgia
epi |
-more common in females
-common age range 30-60 |
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Fibromyalgia
etiology |
-combo of nervous system dysfunction, genetics, mood and anxiety
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Fibromyalgia
signs and symptoms |
-chronic, non resting sleep
-pain increased with stress -pain improved with mild physical activity -generalized fatigue -absence of joint involvement |
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gout
definition |
-deposition of uric crystals and usually associated with hyperuricemia
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gout
epi |
-more common in men
-average age is 50 -after age 65, equally found in women and men |
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gout
etiology |
-serum urate concentration more than 6.8
-decreased uric acid excretion by kidneys tophi: deposition of uric acid crystals in a joint |
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gout
signs and symptoms |
-warmth, swelling and erythema of the affected joint
-extreme pain within 8-12 hours -may have fever, chills and malaise |
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gout
diagnosis |
-synovial fluid analysis
-needle shaped uric acid crystals |
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juvenile idiopathic arthritis
definition |
group of disorder that cause chronic arthritis in children
-significant cause of both short term and long term disability -autoimmune |
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juvenile idiopathic arthritis
epi |
-relatively common
-age of onset less than 16 years old -affects more girls than boys |
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juvenile idiopathic arthritis
etiology |
idiopathic
-can be caused by environment and genetic combo |
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juvenile idiopathic arthritis
signs and symptoms |
-joint swelling, pain and stiffness
-worse in the morning or after sleeping -commonly affects the hands and feet as well as the knees -may have rash and high fever as well if systemic |
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juvenile idiopathic arthritis
diagnostics |
-ESR, CRP, CBC
ANA and RF to rule out other causes |
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juvenile idiopathic arthritis
treatment |
NSAIDS
may need methotrexate if NSAIDS don't work |
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Lyme disease
definition |
-disease caused by Borrelia burgdorferi
-insect bite in the wood |
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Lyme disease
epi |
-more common in 5-14 and 45-54 year olds
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Lyme disease
early symptoms |
-HA, fever, fatigue and joint aches
-classic sign -- erythema migrans *circular rash this rash occurs in 90% of patients but only a small percentage turn to a bullseye rash |
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Lyme disease
1st stage |
-begins days to a month after tick bite
-fever, myalgia rash (wel defined border) |
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Lyme disease
2nd stage |
-occurs weeks to months after
-meningitis, cranial nerve palsy, radiculopathy and carditis |
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Lyme disease
3rd stage |
-presents months to years after initial infection
-monoarthritis or oligoarthritis usually with prominent effusion |
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Lyme disease
diagnosis |
-can be made clinically or confirmed through western blot
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Lyme disease
treatment |
-doxycycline!
or beta lactams or 2nd/3rd gen cephalosporin |
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osteoarthritis
definition |
-degenerative joint disease that has degeneration of articular cartilage and the hypertrophy of bone at the joint margin
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osteoarthritis
risk factos |
-female sex
-genetics -obesity -past trauma -advancing age |
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osteoarthritis
etiology |
-injuries such as ACL
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osteoarthritis
symptoms |
-joint pain, worse with activity especially after a period of rest
-morning stiffness forless than 30 minutes -joint locking -joint instability -hard time with ADLs |
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osteoarthritis
PE |
-heberden (distal) and bouchard (proximal) nodes
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osteoarthritis
imaging |
-joint space narrowing
-subchondral cysts -osteophyte formation -bony sclerosis -arthrocentesis can be done as well |
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osteoarthritis
treatment |
NSAIDs
-can have joint replacement if bad enough |
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polymyalgia rheumatic
definition |
bilateral, symmetric muscle pain and stiffness, mainly in the neck, shoulder and pelvic girdle
-pain and stiffness worse in the morning and get better throughout the day |
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polymyalgia rheumatic
disease features |
-synovitis of large joints
-tenpsynovium and bursa |
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polymyalgia rheumatic
epi |
-people over the age of 50
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polymyalgia rheumatic
info |
-about 50% of patients will have giant cell arteritis
-symptoms should last at least 2 weeks |
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polymyalgia rheumatic
clinical features |
--morning stiffness
-difficulty with ADLs -weight loss, anorexia, general malaise, depression, low grade fever -if giant cell: HA, visual changes, jaw claudication, scalp tenderness |
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polymyalgia rheumatic
diagnostics |
-ESR over 30
-CRP elevated -CBC; normocytic normochromic |
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polymyalgia rheumatic
treatment |
-no cure
-glucocorticosteriods to help with controlling symptoms -prednisone |
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polymyositis
definition |
-systemic connective tissue disease that is characterized by inflammatory and degenerative changes in symmetrical proximal muscles
-can sometimes have a rash, if heliotropic rash present, called dermatomyositis |
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polymyositis
epi |
5-15 or 40-60
more common in females |
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polymyositis
etiology |
-unknown by possible genetic cause or viral factors
-risk factors: Fx of autoimmune disease |
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polymyositis
signs and symptoms |
-proximal muscle weakness especially when standing up from chair
-muscle stiffness -joint pain/swelling -dysphagia -dyspnea -rash |
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polymyositis
diagnostics |
-Creatine kinase and aldolase-elevated
-increased LDH -muscle biopsy |
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polymyositis
treatment |
prednisone
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reactive arthritis
definition |
-inflammatory polyarthritis usually preceded by GI or GU infection 1-4 weeks prior
-diagnosis is clinical |
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reactive arthritis
epi |
-whites
-people with HLA-B27 gene -family history |
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reactive arthritis
etiology- |
-shigella, Yersinia, salmonella, campylobacter
-chlamydia or HIV |
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reactive arthritis
signs and symptoms |
-acute oligoarthritis
-urethritis -dactylitis-sausage digits -conjunctivitis -circinate balanitis (characteristic lesion on glans penis) |
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reactive arthritis
treatmetn |
-indomethacin
-treat STI if they have it |
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rheumatic fever
definition |
-systemic, immune-mediated disease that is caused by group S streptococci
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rheumatic fever
epi |
-most commonly between 5-15
-very rare under 3 |
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rheumatic fever
symptoms |
-fever
-migratory polyarthritis -carditis |
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rheumatic fever
diagnostic criteria |
-jones criteria
-major: carditis -minor; fever, arthralgia -GAS from strep test -NEED two major, one minor and evidence of GAS infection |
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rheumatic fever
diagnostics |
-throat culture
-antistreptolysin O (ASO) titer |
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rheumatic fever
treatment |
-penicillin PO for 10 days or Erythromycin PO for 10
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