Rheum-CM

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42 terms

DcSSc

sclerosing of internal organs

lcSSc

CREST syndrome

SSc sin scleroderma

organ involvement, peripheral autoantibodies, but no skin involvement

Pathogenesis of scleroderma

fibrosis
vascular injury
cellular & humoral immunity

overlap syndrome

skin changes of SSC + features of other rheumatic diseases (SLE, inflammatory myopathies)

antibody dx of dcSSc

anti-topoisomerase

antibody dx of lcSSc

anti-centromere

treating Raynaud's

d/c smoking
CCB
topical nitro
losartan

weakness

Idiopathic Inflammatory Myopathies
1. polymyositis
2. dermatomyositis
3. Inclusion Body Myositis
4. Anti-Synthatase Syndrome

heliotrope

Dermatomyositis:
red/purple rash on 1 or both eyelids

Gottron's sign

Dermatomyositis: pathognomic
slightly raised red, dusky red, purple rash over dorsal side of MCP, PIP, DIP

Gottron's Papules

Dermatomyositis:
macular rash over dorsal side of MCP, PIP, DIP

V sign

Dermatomyositis:
photosensitivity rash over anterior neck (similar to SLE)

shawl sign

Dermatomyositis:
macular rash over posterior shoulders, neck

disease which histologically resembles dermatomyositis but clinically resembles polymyositis

Anti-Synthetase Syndrome

Polymyositis pathology

CD8+ T cell
class I MHC expression on all muscle fibers

Dermatomyositis pathology

perivascular B cells & CD4+ T cells
Ig & complement deposition in capillaries

rheumatic manifestations of malignancy

vasculitis
polyarthritis
synovitis

rheumatic manifestations of hemochromatosis

symmetric athritis of MCP joints

rheumatic manifestations of hypothyroidism

large joints
joint effusion
ligament laxity
swelling stiffness

rheumatic manifestations of hyperthyroidism

shoulder joint arthritis
myopathy
osteoarthritis

rheumatic manifestations of sickle cells disease

knee arthritis preceeding crisis

rheumatic manifestations of hemophilia

hemarthrosis

SLE susceptibility genes

MHC class II polymorphisms
complement deficiencies

SLE characterized by autoantibodies to:

phospholipids
nuclear antigens
cell surface receptors

Heberden's Nodes

DIP (OA)

Bouchard Nodes

PIP (OA)

analgesic options for tx OA

acetaminophen
topical agents
opioids
tramadol

antiinflammatory options for tx OA

NSAIDs
Cox-2
steroids (PO or inj)

erythematous rash of LE that does not blanch

palpable purpura

disease in which 3 organs are always affectes

Wegners
-upper airway
-lungs
-kidneys

diagnostic criteria of antiphospholipid syndrome (clinical + lab)

1. preeclampsia
2. pregnancy loss
3. recurrent thrombosis
-anticardolipin ab, B2-glycoprotein antibodies, lupus anticoagulant, false + syphilis test

mixed CT d/o

overlap of scleroderma & SLE

Undifferentiated CT Dz

pt has many symptoms, fails to meet criteria for specific dx

palindromic rheumatism

episodic arthritis involving 1-7 joints which lasts only a few days

-not full blown RA

swan neck deformity

RA
flexed DIP
hyperextended PIP

boutonniere deformity

RA
flexed PIP
hyperextended DIP

RA complications

Felty Syndrome
baker's cysts
CVD
malignancy
atlantoaxial subluxation

Felty's syndrome

RA +
splenomegaly +
leukopenia +
recurrent pulmonary infections

definition spondyloarthropathy

characterized by enthesopathy & SI joint involvement

common sites of enthesis

pubic symphysis
Achilles tendon
plantar fascia
ischium
iliac crest
greater trochanter
anterolateral ribs

dx criteria for spondyloarthropy

inflammatory spinal pain or synovitis +:
1. FHx
2. psoriasis
3. IBD
4. recent infection (urethra, cervix, diarrhea)
5. alternating buttocks pain
6. enthesiopathy
7. sacroilitis

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