Term
| What is the McMurrays test used to evaluate? |
|
Definition
|
|
Term
| What is a very common MOI in meniscal tears? |
|
Definition
| twisting action exerted on the knee joint while the foot is still in a weight-bearing position. |
|
|
Term
| Differentiate between the swelling observed with a meniscal tear and ligament tear |
|
Definition
| effusions associated with meniscal injuries accumulate over hours in contrast to ligamentous injuries, in which hemorrhage causes immediate swelling. Thus, the knee swelling and pain associated with meniscal tears are typically worse the day after the injury. |
|
|
Term
| What joints are often affected in OA of the hands? |
|
Definition
|
|
Term
| What are three hand deformities commonly seen in pt's with RA? |
|
Definition
Boutonniere deformity (PIP) of the fingers
swan neck deformity (DIP) of the fingers
z deformity of the thumb |
|
|
Term
| What is gamekeepers thumb and what physical exam findings would make you think this is the dx |
|
Definition
| ulnar collateral ligament is ruptured causing laxity when moving the thumb into abduction |
|
|
Term
| what are the first and second line treatments for acute gout attack? |
|
Definition
first: NSAIDs
second: Colchicine (reserved for pts who cant take NSAIDs or corticosteroids, and due to its side effects it is not first line) |
|
|
Term
| a child has the most severe genu valgum at about what age |
|
Definition
| age 3-4, and this requires no tx |
|
|
Term
| what type of splint should be used for a possible scaphoid fracture |
|
Definition
|
|
Term
| what type of fx causes the dinner fork deformity of the wrist |
|
Definition
|
|
Term
| what gait is associated with bilateral spastic paresis of the legs? |
|
Definition
|
|
Term
| what gait is associated with a foot drop, often secondary to lower neuron disease? The patient drags his foot, or lifts the knee high and slaps the foot against the ground. This gait may be unilateral or bilateral. |
|
Definition
|
|
Term
| What gait is unsteady and wide-based. The feet are thrown forward, out, and then down. There is a distinct 2-slap sound, secondary to the heel striking first, then the forefoot. This is associated with polyneuropathy or posterior column damage. |
|
Definition
|
|
Term
| what gait is staggering, unsteady, and wide-based. The patient has difficulty with turns, and cannot stand steady when feet are together and eyes closed (Romberg's sign). |
|
Definition
|
|
Term
| a benign cartilaginous tumor nearly always found in the spine and in the epiphysis of long bones. They represent approximately 1% of all bone tumors. These tumors are usually well-defined, radiolucent lesions that have a thin area of sclerotic material that ranges in size from 1 to 4 cm. They may also contain small calcifications. These tumors are seen most often in people between the ages of 10 and 30 years. The majority of cases are seen in children and young adults between the ages of 5 and 25 years. The mean age is about 20 years |
|
Definition
|
|
Term
| describe the salter harris fx grading systems (I-V) |
|
Definition
Type I is a transverse fracture through the growth plate
Type II the fracture lies above the growth plate, sparing the epiphysis.
Type III is a fracture through the growth plate and epiphysis, sparing the metaphysis.
Type IV is a fracture through all 3 elements of the bone, the growth plate, metaphysis, and epiphysis.
Type V is a compression fracture of the growth plate (resulting in a decrease in the perceived space between the epiphysis and diaphysis on X-ray). |
|
|
Term
|
Definition
| the inability to completely abduct the thigh to the surface of the examining table when hip and knee are flexed, the major sign of hip dislocation or subluxation |
|
|
Term
| what is trendelenburgs sign |
|
Definition
| is positive in persons with congenital hip dislocation and pelvis abnormality. When the person stands on the affected leg, the opposite (normal) gluteal fold falls. This test is almost impossible to do on an infant. |
|
|
Term
| In a baby with a dislocated hip would there be increased or decreased skin folds on the affected side? |
|
Definition
|
|
Term
| In a baby with a dislocated hip, will the affected leg look longer or shorter when he/she is held supine with legs flexed? |
|
Definition
|
|
Term
| name two drugs appropriate for the tx of smooth muscle spasm pain (as in IBS) |
|
Definition
|
|
Term
| you have a pt with constant pelvic pain, which is because of soft tissue involvement with inflammation and compression pain... name two appropriate tx regimens |
|
Definition
| morphine and steroids OR ibuprofen |
|
|
Term
| you have a pt with striated muscle spasm pain (as in a tension HA), name two meds you could use to tx this type of pain |
|
Definition
| cyclobenzaprine or diazepam |
|
|
Term
| ixodes scapularis is another name for..... |
|
Definition
|
|
Term
|
Definition
| prepatellar bursitis- this bursa is located on the anterior patella between the patella and the skin |
|
|
Term
| what class of drugs is used to treat myasthenia gravis, name two. what can be a side effect of using these drugs, and what is the antedote? |
|
Definition
cholinesterase inhibitors- neostigmine and pyridostigmine
-cholinergic crisis which is tx by propmt withdrawal of cholinesterase inhibitors |
|
|
Term
|
Definition
deformity that is due to the rupture of the extensor tendon at the base of the dorsal distal phalanx of any digit of the hand. Patients will report pain dorsally at the DIP joint with the inability to actively extend the DIP joint.
-swan neck deformity can be due to chronic mallet finger |
|
|
Term
| what is the etiological agent in lyme disease and what is the transmitting organism |
|
Definition
| Borrelia burgdorferi , the etiological agent, is transmitted by Ixodes spp. ticks |
|
|
Term
| what is the most common arthropathy among adults, particularly in the elderly? |
|
Definition
|
|
Term
| What is the basic pathophysiology of OA |
|
Definition
| articular cartilage loss accompanied by increasing thickness and sclerosis of the subchondral bone plate---> outgrowth of osteophytes at joint margin---->stretching of articular capsule----> weakness of the muscles bridging the joint |
|
|
Term
| give some common signs and symptoms of OA |
|
Definition
-morning stiffness in AM lessing last than 30 m
-increasing pain with increasing joint usage
-asymmetric involvement
-NO SYSTEMIC S/SX |
|
|
Term
| what are the MC joints of the hands affected by OA? other joints? |
|
Definition
-DIP (heberdens nodes) and PIP (bouchards nodes)
-hips, knees, spine |
|
|
Term
| what is the max dose of APAP per day? |
|
Definition
|
|
Term
| what is the usual progression of tx for an OA pt |
|
Definition
| APAP--NSAIDs/voltaran gel---steroid injections (>Q3-6 months)--simvisc (only covered after failing steroid injections)---total joint replacement |
|
|
Term
| describe the anatomy of a joint affected with RA |
|
Definition
high synovium to cartilage ratio
pannus (hyperplastic synovial tissue) formation erodes cartilage, subchondral bone, articular capsule, tendons, and ligaments |
|
|
Term
| what are the most common joints affected with RA? If what joint is affected is the Dx of RA unlikely? |
|
Definition
wrists, MCP, and PIP
-DIP are RARELY almost NEVER involved |
|
|
Term
| What are some common signs and sx of RA |
|
Definition
-morning stiffness lasting greater than 1 hr that gets better as the day goes on
-arthritis and soft tissue swelling
-symmetric distribution |
|
|
Term
| what sex is more commonly affected by RA |
|
Definition
|
|
Term
| what are two extraarticular manifestations that are pretty pathognomonic for RA (skin and lung...) |
|
Definition
-rheumatoid nodules are pathognomonic
-pleural effusions with pleural fluid very low in glucose |
|
|
Term
| Give the three most common hand joint deformities seen in RA |
|
Definition
-ulnar deviation of the MCPs
-boutonniere deformities of the PIP where PIP is flexed and DIP is hyperextended
-swan neck deformtity: MCP flexed, PIP hyperextended, DIP flexed |
|
|
Term
| what does aspiration of an RA joint tell you |
|
Definition
| it quantifies inflammation and excludes gout and septic arthritis |
|
|
Term
| what lab tests are useful in dx of RA |
|
Definition
-CRP and ESR are elevated
-RF is elevated 80% of the time, but often not in early disease |
|
|
Term
| what is the general treatment for RA |
|
Definition
NSAIDs and DMARD (usually methotrexate) started immediately
-PO corticosteroids can be used if NSAIDs not helping |
|
|
Term
|
Definition
| triad of RA, neutropenia, and splenomegaly |
|
|
Term
| what is still's disease associated with? |
|
Definition
|
|
Term
| what is the anatomical distribution of a septic arthritis usually? what are the MC affected joints |
|
Definition
often only affects one joint
MC knee THEN hip, shoulder, ankle, wrist |
|
|
Term
| what is the MC pathogen of septric joint? what other pathogen needs to be considered in certain population? |
|
Definition
s. aureus
-n. gonorrhea in a young sexually active pt |
|
|
Term
| what will the synovial fluid of a septic joint look like (color, wbc, PMN %, cx results) |
|
Definition
green yellow
>50,000 WBC
75% or greater PMN
positive cx |
|
|
Term
| which joint affected by septic arthritis definitely needs arthrotomy and arthrocentesis |
|
Definition
|
|
Term
| what is the tx of septic joint |
|
Definition
| IV abx followed by PO for 7-10 days |
|
|
Term
| the pencil in cup deformity seen on xrays of the hand is common with what type of arthritis? what part of the phalanx is generally deformed? |
|
Definition
psoriatic arthritis
proximal phalanx |
|
|
Term
| in a pt with psoriatic arthritis give the lab results for ESR, CBC, uric acid, and RF |
|
Definition
esr= elevated
CBC= normocytic normochromic anemia
uric acid= hyperuricemia
RF= normal |
|
|
Term
| what is the tx for psoriatic arthritis? |
|
Definition
NSAIDs if mild
methotrexate |
|
|
Term
| What is the classic triad of Rieter Syndrome? Zarbocks describes a tetrad, what is the 4th component? |
|
Definition
-urethritis (non-gonococcal)
-conjunctivitis
-arthritis
*mucosal ulcers (painless and shallow) |
|
|
Term
| what genotype is associated with reactive arthritis in 50-80% of patients |
|
Definition
|
|
Term
| Reactive arthritis is usually preceded by what how many days before onset of arthritis? what are the most common organisms? |
|
Definition
enteric or urethral infection, 1-4 weeks before
-GU: chlamydia and ureaplasma
-GI: shigella, salmonella, yersinia, campylobacter |
|
|
Term
| describe the arthritis of reactive arthritis |
|
Definition
usually affects large joints below the waist
asymmetric
oligoarticular
new joints may become involved sequentially
joints are painful, less mobile, and have effusions |
|
|
Term
| what would a CBC, ESR, and CRP show in a pt with reactive arthritis. what are two other tests that should be ordered? |
|
Definition
cbc- anemia
-ESR and CRP would be elevated
-order joint fluid analysis and HIV test |
|
|
Term
| what is the first line medication for reactive arthritis, 2nd line |
|
Definition
|
|
Term
| what is another name for reactive arthritis |
|
Definition
| rieter syndrome- more likely used if the classic triad is present |
|
|
Term
| At what age should women be screened by DEXA scan for osteoporosis? |
|
Definition
65 and post menopausal
*studies do not show evidence of a positive benefit for screening men |
|
|
Term
| what is the most common site of an osteoporotic fracture? |
|
Definition
|
|
Term
| what is the recommended calcium supplementation for osteoporosis prevention and or treatment |
|
Definition
|
|
Term
| what are the first line treatment options for osteoporosis? 2nd line? 3rd line? last line? other tx fails? |
|
Definition
1st line: bisphosponates
2nd line: boniva (ibandronate)
3rd line: raloxifene (SERM)
last line: calcitonin
failure: terparatide (PTH analog) |
|
|
Term
| what causes PTH to be secreted? |
|
Definition
| hypocalcemia.. so high PTH means that calcium is being drawn out of bones |
|
|
Term
| why does hyperthyroidism sometimes cause osteoporosis? |
|
Definition
| its associated with accelerated bone remodeling, reduced bone density, and as much as a 25% increase in serum calcium levels |
|
|
Term
| where is ALP found besides the biliary tract? |
|
Definition
| bone, so high levels are seen in growing children, metastatic osteoblastic activity, and bone breakdown |
|
|
Term
| What are the ways osteomyelitis can come about? |
|
Definition
-hematogenous
-contiguous spread from adjacent soft tissues and joints
-direct inoculation of infection into bone as a result of trauma a/o surgery |
|
|
Term
| When an osteomyelitis is spread via hematogenous seeding it is usually (mono microbial/polymicrobial) in nature. What about if its spread via contiguous/direct routes? |
|
Definition
monomicrobial
polymicrobial |
|
|
Term
| Name the three top organisms that cause osteomyelitis |
|
Definition
s. aureus
coag negative staph
aerobic gram negative bacilli |
|
|
Term
| what is pathognomic sign on PE of a chronic osteomyelitis |
|
Definition
|
|
Term
| In a patient with a diabetic foot ulcer, if either of what two symptoms are seen is osteomyelitis so likely that no further non-invasive evaluations need to be conducted |
|
Definition
>2x2 cm in size
palpable bone |
|
|
Term
| What is the reference standard for diagnosis of osteomyelitis |
|
Definition
| isolation from a bone biopsy sample obtained via sterile technique, together with histologic findings of inflammation and osteonecrosis |
|
|
Term
| what is the best radiological study for osteomyelitis? |
|
Definition
|
|
Term
| What is the form of osteomyelitis that manifests as TB of the vertebral bodies? |
|
Definition
|
|
Term
| Name some RFs for osteomyelitis |
|
Definition
Open Fracture!
diabetes
IV drug use
vascular insufficiency |
|
|
Term
| How long should IV abx be implemented in osteomyelitis? Name the top two abx used |
|
Definition
4-6 weeks
-Penicillin ase resistant penicillin (Oxacillin)
-Ist gen cephalosporin (Cefazolin) |
|
|
Term
| What joints of the hand are commonly affected by OA? |
|
Definition
-distal PIP: heberdens nodes
-proximal PIP: bouchards nodes |
|
|
Term
| housemaid's knee is bursitis of what? |
|
Definition
|
|
Term
| what is the MC organism assoc with osteomyelitis? How about osteomyelitis in a patient with sickle cell disease? |
|
Definition
|
|
Term
| What are the primary carcinomas that MC spread to the bone? |
|
Definition
| prostate, breast, thyroid, lung, kidney |
|
|
Term
| What is the ideal tx of an open fracture? |
|
Definition
| Refer to ortho and within 4-8 hours of injury pt is in OR getting derided and irrigated followed by IV abx |
|
|
Term
| What are the 5 types of Salter Harris Fractures? |
|
Definition
1: straight through the epiphyseal plate
2: through the epiphysis into the metaphysis
3: Through the epiphysis and the articular surface
4: Through the epiphysis and metaphysics
5: Crushed epiphyseal plate |
|
|
Term
| What is a torus fracture and what is the tx |
|
Definition
| -when the bone bucks due to a compression injury. Can be one side of the cortex or both sides buckling. Also called a buckle fx. Tx is 4-6 weeks in a cast |
|
|
Term
| What is a green stick fracture. Tx> |
|
Definition
When bowing causes a break in one side of the cortex
Tx is cast if the angulation is less than 15 degrees, if greater than 15 degrees they need referral to ortho |
|
|
Term
| What is the MC dislocations of the shoulder and the hip? |
|
Definition
anterior dislocation of the shoulder
posterior dislocation of the hip |
|
|
Term
|
Definition
| stretch of a terminal extensor tendon which is treated with extensor splinting x 6 weeks |
|
|
Term
| What ligament is MC associated with an ankle sprain? |
|
Definition
| ATL (anterior talofibular ligament) |
|
|
Term
| What is the tx of a shoulder dislocation |
|
Definition
| immobilization by a sling and swatch (valpaeu's sling) |
|
|
Term
| what injuries need to be checked in a pt with a clavicle fracture? what is the tx? |
|
Definition
brachial plexus injuries (pain, weakness, reflex, sensory abnormalities)
figure of eight sling x 4-6 weeks |
|
|
Term
| Which nerve needs to be checked for injury in a humeral shaft fracture |
|
Definition
|
|
Term
| what is the initial splint used in a humeral shaft fx? |
|
Definition
|
|
Term
| What artery needs to be checked for damage in a supracondylar humerus fx? Why is this so important? |
|
Definition
| Brachial artery bc it is the most spastic artery in the body and can lead to Volkmann's ischemic contractures |
|
|
Term
| what is kienbocks disease? |
|
Definition
| osteonecrosis of the lunate |
|
|
Term
| What are tinels and phalens signs? Assoc with what condition |
|
Definition
Carpal Tunnel
Tinels is tingling with percussion over the volar aspect of the wrist
Phalens is tingling after flexing both wrists for >1 min |
|
|
Term
| What type of splint is used in the initial treatment of carpal tunnel? |
|
Definition
|
|
Term
| what organism is specific to the human mouth and is often associated with human bites? |
|
Definition
|
|
Term
|
Definition
fracture of the distal radius with dorsal angulation
silver fork deformity |
|
|
Term
|
Definition
| distal radius fracture with volar angulation |
|
|
Term
| what is gamekeepers thumb, signs, tx |
|
Definition
| sprain or tear of the ulnar collateral ligament of the thumb, inability to pinch strongly, thumb spica cast or surg depending on degree of rupture |
|
|
Term
|
Definition
| lateral epicondylitis, pain with lifting object esp when arm is pronated |
|
|
Term
| what is golfers elbow, baseball elbow? sx? |
|
Definition
| medial epicondylitis, pain with resisted pronation or flexion of the wrist |
|
|
Term
| what is nursemaids elbow? |
|
Definition
| subluxation of the radial head |
|
|
Term
| what is the MC fx carpal bone? |
|
Definition
|
|
Term
| WHat are the sx of a scaphoid fracture? |
|
Definition
| pain over the anatomical snuff box |
|
|
Term
| What is dequervains disease? Test to dx? tx? |
|
Definition
-stenosing tenosynovitis involving the abductor pollicis longus and extensor pollicis longus
-Finkelsteins test when pt puts thumb into palm and then ulnar flexes wrist will cause pain
-THumb spica splint |
|
|
Term
| Describe the pain felt in sciatica? |
|
Definition
| pain felt in the buttock, posterior thigh, and posterolateral aspect of the leg around the lateral malleolus to the lateral dorsum of the foot and the entire sole |
|
|
Term
| Radiographs of the spine are not necessary when Hx and PE show no sign of a serious condition. What are the red flags? |
|
Definition
| fever, weight loss, morning stiffness, hx of IV drug or steroid use, trauma, hx of cancer, saddle anesthesia, loss of anal sphincter tone, or major motor weakness |
|
|
Term
| What is the MC curve of scoliosis? What is the least common and spinal cord pathology needs to be ruled out if present? |
|
Definition
Right thoracic curve is MC
Left thoracic curve is RARE |
|
|
Term
| What is Schuermans disease? |
|
Definition
|
|
Term
| What is the mc extra pulmonary location of TB after the lymph nodes? |
|
Definition
|
|
Term
| WHat is the brace used to tx scoliosis with a curve greater than 60 degrees |
|
Definition
|
|
Term
| what PE move will relieve the pain in spinal stenosis |
|
Definition
|
|
Term
| What is ankylosing spondylitis? what extraarticular manifestations are seen? on xray> |
|
Definition
-seronegative spondyloarthropathy that progresses to fusion of the vertebrae
-uveitis, cardiac abnormalities, and interstitial lung disease
-bamboo spine |
|
|
Term
| WHat is caudal equina? s/sx? Tx? |
|
Definition
-major disk herniation that compresses several nerve roots, usually L4-L5 level
-loss of bowel bladder function, saddle anesthesia, leg pain, numbness, paralysis
-SURGICAL EMERGENCY IMMEDIATE REFERRAL |
|
|
Term
| what is the name of the disease that manifests as aseptic necrosis of the hip in children |
|
Definition
| legg calves perches disease |
|
|
Term
| What may be seen on lateral films of a patient with aseptic necrosis? |
|
Definition
|
|
Term
| what is slipped capital femoral epiphysis (SCFE) |
|
Definition
| weakening of the epiphyseal plate of the femur resulting in displacement of the femoral head |
|
|
Term
| s/sx of a meniscal tear? tests? tx? |
|
Definition
-joint pain along the joint line (usually medial), locking (inability to fully extend the knee), giving way, trouble with squatting or walking up/down steps
-McMurray and Apleys test
-NSAIDS and PT, then surg for sx unresponsive to conservative tx |
|
|
Term
| what is osgood schlotters disease? |
|
Definition
| apophysitis of the tibial tubercle caused by trauma or overuse |
|
|
Term
| what causes cruciate injuries? s/sx? tx? |
|
Definition
-excessive pivotal force during running jumping cutting
-hearing a pop and complaining of knee instability, hemarthrosis develops quickly
-Lachmans test is most sensitive
-conservative then surg if under 40 who are unresponsive |
|
|
Term
| When will a patient with achilles tendonitis complain of pain on exam, test to rule out rupture? |
|
Definition
passive dorsiflexion and resisted plantar flexion
thompsons test |
|
|
Term
| in a person with hallux valgus, a valgus deformity of greater than how many degrees is considered abnormal? |
|
Definition
|
|
Term
| What is a mortons neuroma? What is the consequence of surgical repair? |
|
Definition
traction of the interdigital nerve against the transverse metatarsal ligament
third and fourth toes will be chronically numb |
|
|
Term
| plantar fasciitis? s/sx? tx? |
|
Definition
-microtears in the plantar fascia (usually in runners or obese)
-pain with the first few steps of the morning and heel pain at night
-conservative tx, surgery if severe |
|
|
Term
| What is a monteggia fx? Galeazzi fx? |
|
Definition
-prox ulnar fx with dislocated radial head
-prox ulnar fx with displaced distal radial ulnar joint at the wrist |
|
|
Term
| Name three drugs that are often used in the tx of fibromyalgia |
|
Definition
| Pregabalin (lyrica), amitriptyline (elavil), fluoxetine (prozac) |
|
|
Term
| Joint fluid analysis of a patient with gout reveals? |
|
Definition
| uric acid crystals that are needle/rod shaped and negatively birefringent, incr WBC |
|
|
Term
|
Definition
-NSAIDs (indomethacin) number 1 for acute
-colchicine is back up for an acute attack if pt can't take NSAIDs, has lots of side effects (diarrhea)
-Allopurinal for prophylaxis |
|
|
Term
| What is pseudo gout? What will be found on synovial fluid analysis? Tx? |
|
Definition
-calcium pyrophosphate dehydrate disease
- rhomboid shaped positively birefringent crystals
-Same as Gout, NSAIDs, colchicine, steroids if necessary |
|
|
Term
| Juvenile RA is similar to adult RA, but what are some characteristics that define it? |
|
Definition
| -Higher fever, pink maculopapular rash in the evenings, pericarditis and valvulitis more common, hepatomegaly and splenomegaly more common, Uveitis is more common and these pt's must est. care with an ophthalmologist |
|
|
Term
| What is polyarteritis nodosa? What other diseases is it assoc with? |
|
Definition
-small and med. artery inflammation (skin, kidney, peripheral nerves, muscle, gut)
-HEP b and HEP C, sogrens, RA, HIV, varicella |
|
|
Term
| S/sx of polyarteritis nodosa? |
|
Definition
-fever, anorexia, weight loss, fatigue, abd pain, arthralgias, HTN, 3rd CN damge
-SKIN: palpable purport and lived reticularis |
|
|
Term
| How is polyarteritis nodosa Dx? |
|
Definition
| Gold standard is biopsy and the characteristic finding is LEUKOCYTIC INFILTRATE |
|
|
Term
| What is the tx of polyarteritis nodosa? |
|
Definition
steroids (prednisone)
cyclophosphamide/methotrexate etc if necessary |
|
|
Term
|
Definition
| a disease of striated muscle affected the PROXIMAL muscles of the limbs, neck and pharynx |
|
|
Term
| What are some labs that are characteristic of polymyositis |
|
Definition
-incr aldolase and CPK
-ANTI jo1 AB! |
|
|
Term
| What skin finding are assoc with polymyositis? |
|
Definition
-Dermatomyositis: Malar and helitrope type rashes
*Guttrons papules: flat topped purple lesions usually seen over MCP and interphalangeal joints (assoc. with anti jo 1 ab) |
|
|
Term
|
Definition
-Prednisone, methotrexate
-PT! |
|
|
Term
| What should be excluded in all pts with polymyositis? |
|
Definition
| common neoplasms (skin, lung, breast, prostate) |
|
|
Term
| What is the pathophys of polyarteritis nodosa? |
|
Definition
| PMN invasion of all layers and fibrinoid necrosis plus resulting intimal proliferation lead to reduced intimal area, which results in ischemia, infarction, and aneurysms |
|
|
Term
| what are the s/sx of polymyalgia rheumatica |
|
Definition
| -proximal, bulateral, symmertrical muscle pain/stiffness/weakness that is present more in the morning or after periods of inactivity. Can have assoc. fatigue, anorexia, weight loss, depression |
|
|
Term
| If a patient is dx with polymyalgia rheumatic, what definitely needs to be R/O |
|
Definition
| giant cell arteritis!!!! often presents with PR and will cause blindness if not treated |
|
|
Term
| What labs should you order in a pt who may have polymyalgia rheumatic? |
|
Definition
| -ESR (incr), CPK (NL- will differentiate from polymyositis), then R/O with TSH, ANA, CBC, LFTs, Renal Fxn, Muscle Bx, and EMG will ALL BE NORMAL! |
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|
Term
| WHat is the tx for polymyalgia rheumatic? |
|
Definition
-Alone: prednisone 15-20 mg QD
-with temporal arteritis: 40-60 mg prednisone QD |
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|
Term
|
Definition
| splenmegaly, neutropenia, RA |
|
|
Term
| What are some common extraarticular manifestations of RA? |
|
Definition
-malaise, anorexia, weight loss, fever
-RHEUMATOID SKIN NODULES!!!
-plueral effusion (low complement and low glucose)
-pericarditis, effusion, cardiac nodules
-scleritis, dry eyes
-Felty syndrome
-anemia of chronic disease |
|
|
Term
|
Definition
-Slceroderma findings
_Calcinosis, Raynauds, Esophageal disease, Sclerodactyly, Telangiectasis |
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|
Term
|
Definition
| evaluates tear secretion by holding filter paper in the lower eyelid. less than 5mm in 5 min is positive. testing for sogrens |
|
|
Term
| What is the pathognomnic testing and findings for sogrens |
|
Definition
| minor salivary gland bx will show lymphocytic infiltration with secondary degeneration, necrosis, fibrosis, and atrophy |
|
|
Term
| what antibodies are ALWAYS present in drug induced lupus |
|
Definition
|
|
Term
| What is the most sensitive test for lupus? Most specific? |
|
Definition
Anti ANA
specific: Anti- sm and anti-ds DNA |
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