Rheum Step 3

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pszurnicki
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307436
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Rheum Step 3
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2015-09-07 00:18:02
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Rheum Step
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Rheum Step 3
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  1. Ra diagnosis criteria
    • 4
    • Multiple small joint synovitis
    • >6 weeks
    • ESR and CRP
    • anti-CCP, and RF
  2. Characteristic finding of RA on pleural effusion tap
    low glucose
  3. rx for RA
    DMARD and Nsaids
  4. MTX failing for RA, next step?
    add anti-tnf
  5. which DMARD requires yearly optho exam
    hydroxychlroroqine
  6. moa of abatacept
    t cell activation inhibition
  7. moa of anakinra
    IL-1 inhibitor
  8. Toclizumab moa
    IL-6
  9. Leflunomaide moa
    pyrimidine antagonist
  10. side effects of gold salts
    nephrotic syndrome
  11. HLA-b37 diseases
    • psoriasis
    • ankylosing spondylitis
    • IBD
    • Reactive arthiritis
  12. characteristic of seronegative spondyloarthropathies
    • hla b27
    • spine predilection
    • SI involvement
    • negative for RF
  13. best initial test for as?
    most accurate
    • Xray
    • MRI
  14. rx for AS
    nsaids, anti-tnf, sulfasalazine
  15. rx for reiters
    nsaids
  16. Joint involvement of RA vs OA
    • RA-proxima
    • OA-distal
  17. best initial rx for psoriatic arthriis
    if not effective
    • nsaids
    • MTX or anti-tnf
  18. feltys syndrome
    • RA
    • Neutropenia and splenomegaly
  19. junvenile ra
    • salmon colored rash
    • polyarthritis
    • lad
    • mylagia
  20. Dx of juvenile rA
    rx
    • negative Ana and rf
    • high ferritin level, wbc
    • nsaids, steroids, mtx, anti-tnf
  21. most specific test for whipple disease
    biopsy of colon showing pas positive organism
  22. bouteniere, heberson nodes are found where?
    bouchards
    • OA
    • RA
  23. wbc count in OA, RA,and infected joint
    • OA<2k
    • RA 5-50k
    • Infected >50K
  24. best initial test for OA?
    what should be ordered
    xray

    ANA, RF,anti-ccp,  ESR
  25. best 2 tests for disease flare up in sle
    complement and anti-ds dna
  26. rash in sle rx
    severe disease relapse when steroids stop
    nephritis
    • hydroxychloroquine
    • belimumab, aza, cylophosphamide
    • mycophenolate and steoids
  27. drugs causing lupus
    drug induced lupus vs regular sle
    hydralazine, inh, procainamide

    complement, anti-ds dna is normal and no renal or cns involvement
  28. sjogren dx
    lip biopsy
  29. rx for sjogrens?
    • pilocarpine systemic
    • cevimeline
  30. scleroderma associated lung fibrosis treated with
    cyclophosphamide
  31. dx of scleroderma diffuse?
    crest
    • scl-70
    • anti-centromere antibodies
  32. crest involves wht
    • calcinosis of fingers
    • rayunaudas phenomenon
    • esphageal
    • sclerodactyly
    • Telagienctasia
    • pulmonary HTN
  33. Eosinophilic fascitis dx
    rx
    • thickened orange pau skin worse with exercise- but no other involvement , DX with high eosinophills
    • steroids
  34. polymyositis and dermatomyositis findings
    order what else
    • high ck, aldolase, abnormal EMG
    • ana and LFT
  35. anti-joe antibodies confer what increased risk
    most serious complication of DM
    • ILD
    • malignancy
  36. RX for polymyosists and dermatomysosis
    steroids
  37. rx for fibromyalgia
    duloxetine, amitryptilline, milnacipran, pregabalin, exercise
  38. side effects of mtx
    liver and lung fibrosis
  39. best initial test for pan
    most accurate
    • angiography of abdominal bv
    • biopsy of skin, muscle or sural nerve
  40. hep b causes what vasculitis
    hep b
  41. rx for pan
    prednisone and cyclophosphamide
  42. upper and lower resp involvement and renal
    wegeners c-anca
  43. test for takayasu
    mra
  44. pathergy
    sterile skin abscess
  45. behcet disease
    • oral, genital ulcers
    • ocular involvement
  46. when is rasburicase use?
    when allopurinol is not enough
  47. gout vs pseudogout and crystals
    • gout-negative
    • pseduogount-positive birefringent
  48. joint fluid test
    • cell count
    • culture
    • crystal
    • protein
    • uric acid level
  49. febuxostat is used when
    when allopurinol is not tolerated
  50. when is colchicine used
    when nsaids and steroids cannot be used
  51. when are probenecid and sulfinpyrazone used in gout?
    never
  52. pseudogout is seen with what diseases
    • hemochromatosis
    • hyperparathyroidism
    • hypothyroidism
    • acromegalyy
  53. rx for septic joint
    ceftriaxone and vanco
  54. what bugs are covered in septic arthritis
    strepto and staphylococci and GNR
  55. pagets gives what type of bone lesions
    osteolytic and osteoblastic
  56. best initial test for pagets
    alp
  57. what is ordered for pagets disease
    • urinary hydroxyproline
    • serum calcium and phosphate and bone scan
  58. rx for pagests
    bisphosphonates and calcitonin
  59. dx of bakers cyst?
    rx
    • r/o dvt with ultrasound
    • nsaids or steroids
  60. difference between tarsal tunnel syndrome and plantar fascitis
    plantar fascitis is better with use, stretching and
  61. motor neuroma
    ternderness between 3rd and 4th metatarsal heads

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