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Rheumatology – Aweso
Random rheum questions
| Question | Answer |
|---|---|
| apple green birefringent with congo red | amyloid deposition |
| what is the predictor for CVS disease in RA? | homocysteine levels |
| Treatment for CPPD | NSAIDs and intra-articular joint injections |
| PPX for CPPD | standing NSAIDs |
| Leading cause of CPPD in US (1st and 2nd) | hemachromatosis and hyperPTH |
| If you have CPPD, what should you screen patients for? (4) | 1/ hemachromatosis, 2/ hyper PTH, 3/ hypothyroid, 4/ gout |
| hip and shoulder girdle stiffness and pain | PMR |
| Fever of unknown origin and fatigue in someone >50yo - what to do? | need to r/o giant cell arteritis, temporal biopsy; need to image the great vessels with CT chest / MRA chest to diagnose if temporal biopsy negative |
| how to diagnose polyarteritis nodosa | Kidney and mesenteric angiography |
| hypertension, abdominal pain, kidney dysfunction, or mononeuritis multiplex | polyarteritis nodosa |
| Morning stiffness lasting more than 1 hour and a synovial fluid leukocyte count greater than 5000/µL (5.0 × 109/L) are associated with | inflammatory arthritis - RA |
| aching in the shoulders, neck, and hip girdle region; fatigue; and malaise that develop over weeks to months | PMR |
| flowing osteophytes along the anterolateral aspect of at least four contiguous vertebral bodies. - He has neck and low back pain and limited mobility throughout the spine. This patient is male, obese, and has diabetes mellitus | diffuse idiopathic skeletal hyperostosis (DISH) |
| calcification of the enthesis regions (where the tendons or ligaments insert into bone) and the spinal ligaments | diffuse idiopathic skeletal hyperostosis (DISH) |
| vertical bridging syndesmophytes | ankylosing spondylitis |
| sacroilitis | + in ankylosing spondylitis, NOT in DISH |
| ankylosing spondylitis associated with what findings | uveitis, aortitis, sacroilitis, syphilis |
| criteria for diagnosing antiphospholipid syndrome | venous or arterial thromboembolism or pregnancy morbidity (>=3 1st trim miscarriages or 1 fetal death) and + labs (dilute Russell viper venom time, anticardiolipin antibody assay, β2 glycoprotein I antibody assay) on at least 2 occasions 12 weeks apart. |
| How to treat Kawasaki disease | intravenous immune globulin and salicylates --> steroids if refractory (Kawasaki presents in kids and immunosuppressed |
| recurrent 12- to 72-hour episodes of fever with serositis (most commonly abdominal or pleural), synovitis (most often monoarticular and affecting the lower extremities), and erysipeloid rash, neutrophilic leukocytosis - how to treat? | familial mediterranean fever, tx with colchicine |
| high ferritin, fever (less than 4h, peaks in early evening), rash (evanescent, salmon-colored, not painful, and appears on the trunk and proximal extremities), joint pain, and serositis (usually pleuritis or pericarditis) - what dx? | Adult-onset Stills |
| acute digital ischemia in the setting of limited cutaneous systemic sclerosis - how to tx | warm ambient environment, prompt attention to pain control to decrease sympathetic vasoconstriction, and institution of vasodilating therapy, preferably with a prostacyclin analogue such as epoprostenol |
| preventing recurrences of digital ulcers in patients with severe Raynaud phenomenon - what drug | bosentan |
| scleroderma renal crisis - how to tx | enalapril |
| positive lupus anticoagulant, moderate- to high-titer anticardiolipin antibodies | ALP Syndrome |
| thrombocytopenia; hx recurrent pregnancy loss; livedo reticularis; a murmur consistent with mitral regurgitation; and elevated serum creatinine level, proteinuria, and noninflammatory urine sediment suggestive of microangiopathic kidney insufficiency | ALP Syndrome |
| how to treat alveolitis in diffuse cutaneous systemic sclerosis | Cyclophosphamide |
| how to treat symmetric synovitis involving the peripheral joints, tendon sheath inflammation, or (less commonly) a mild inflammatory myopathy in diffuse cutaneous systemic sclerosis with sx's of RA | methotrexate |
| Anti–Jo-1 antibodies | highly specific for the inflammatory myopathies and are associated with an increased risk for interstitial lung disease. |
| typical osteoarthritis features, along with chondrocalcinosis, in locations atypical for osteoarthritis such as the metacarpophalangeal joints | calcium pyrophosphate (CPP) arthropathy |
| How do you treat ankylosing spondylitis that has not responded to NSAIDs | Eternacept, TNF alpha Ab |
| How to treat ankylosing spondylitis with recurrent iritis or inflammatory bowel disease | either infliximab or adalimumab, preferably over etanercept |
| How long do you treat a patient with ankylosing spondylosis with NSAIDs before you consider calling it a treatment failure? | If the patient does not adequately respond to a minimum of two different trials of NSAIDs used at least 4 weeks total, Then eternacept if no axial dz or iritis. If axial or iritis, then adalimumab. |
| H |
Created by:
christinapham
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