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What are some symptoms of inflammatory arthridities vs OA?
Morining stiffness is the key, many patients with inflammatory arthritis will be stiff for an hour in the morning unless treated.
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you tap an arthritic knee and get a WBC count of 75,000, what is the most likely diagnosis.
- This was impa\ortant on my rheum rotation.
- <200 is normal
- 200- 2000 is noninflammatory arthritis
- 2000-75,000 inflammatory arthritis
- >100,000 septic
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A 30 year old woman presents with pain in the wrists and mpj's and increase in joint spaces on radiograph, what is the most likely disease
- Rhematiod
- THey get joint space enlargement early on from pannus formation
- More common in F
- bilateral wrists
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These patients have a posative Shoebers Test/ cant flex their vertebral column well.
That would be ankylosing spondylitis, their vertebral column fuses so the have a + schoeber's test. (that is tested by making 2 marks on a patients back, having them bend forward and then remeasureng, normal peoples skin will stretch and they have a significantly larger number when this is measured again.
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More common in males
asymmetric joint narrowing
effects large WB joints
Keratoderma blennorrhagica
this is Reactive arthritis
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THis bug accounts for 1/2 all septic arthridities in sexually active individuals
Gonnococcal
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Who is at high risk for septic arthritis
Those with joint damage, immunocompromized
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What is the gold standard to Dx gout
tap the joint and see neg birefringent chrystals, yellow when the light is parallel and bluue when perpendicular
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treatment for a Uric acid overproducerTreatment for a unxerexcretor
- treatment for a Uric acid overproducer: Allopurinal
- Treatment for a unxerexcretor Probebecid
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Most common joints in:
Gout:
RA
JRA
AS
Reactive
Psoriatic
Pseudogout
SLe
Chrohn's and UC
- Gout 1st MTPJ
- RA hands and wrists
- JRA: Knees elbows ankle or neck
- AS: Spine
- Reactive: large WB joints
- Psoriatic: large and small including DIPJ's
- Pseudogout: knee
- SLE: pain in the small joints of the hands and feet
- Chrohn's and UC: Knees, ankles, elbows, and Wrists
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AA woman, butterfly rash, renal cardiac, pulmonary, and cardiac problems
SLE
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Who gets CREST
- That would be Scleroderma patients of coarse
- Calcinosis
- Raynauds
- Esophageal dysmotility
- Sclerodactyly
- telangiecasia
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you see a patients x rays there is history of joint pain in the cc joint, there are:
rat bites,
punched out lesions
martel's sign overhanging margins
WHat is this
Gout
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