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42 terms

Rheum-CM

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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