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Ra diagnosis criteria
- 4
- Multiple small joint synovitis
- >6 weeks
- ESR and CRP
- anti-CCP, and RF
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Characteristic finding of RA on pleural effusion tap
low glucose
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rx for RA
DMARD and Nsaids
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MTX failing for RA, next step?
add anti-tnf
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which DMARD requires yearly optho exam
hydroxychlroroqine
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moa of abatacept
t cell activation inhibition
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moa of anakinra
IL-1 inhibitor
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Leflunomaide moa
pyrimidine antagonist
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side effects of gold salts
nephrotic syndrome
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HLA-b37 diseases
- psoriasis
- ankylosing spondylitis
- IBD
- Reactive arthiritis
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characteristic of seronegative spondyloarthropathies
- hla b27
- spine predilection
- SI involvement
- negative for RF
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best initial test for as?
most accurate
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rx for AS
nsaids, anti-tnf, sulfasalazine
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Joint involvement of RA vs OA
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best initial rx for psoriatic arthriis
if not effective
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feltys syndrome
- RA
- Neutropenia and splenomegaly
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junvenile ra
- salmon colored rash
- polyarthritis
- lad
- mylagia
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Dx of juvenile rA
rx
- negative Ana and rf
- high ferritin level, wbc
- nsaids, steroids, mtx, anti-tnf
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most specific test for whipple disease
biopsy of colon showing pas positive organism
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bouteniere, heberson nodes are found where?
bouchards
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wbc count in OA, RA,and infected joint
- OA<2k
- RA 5-50k
- Infected >50K
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best initial test for OA?
what should be ordered
xray
ANA, RF,anti-ccp, ESR
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best 2 tests for disease flare up in sle
complement and anti-ds dna
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rash in sle rx
severe disease relapse when steroids stop
nephritis
- hydroxychloroquine
- belimumab, aza, cylophosphamide
- mycophenolate and steoids
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drugs causing lupus
drug induced lupus vs regular sle
hydralazine, inh, procainamide
complement, anti-ds dna is normal and no renal or cns involvement
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rx for sjogrens?
- pilocarpine systemic
- cevimeline
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scleroderma associated lung fibrosis treated with
cyclophosphamide
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dx of scleroderma diffuse?
crest
- scl-70
- anti-centromere antibodies
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crest involves wht
- calcinosis of fingers
- rayunaudas phenomenon
- esphageal
- sclerodactyly
- Telagienctasia
- pulmonary HTN
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Eosinophilic fascitis dx
rx
- thickened orange pau skin worse with exercise- but no other involvement , DX with high eosinophills
- steroids
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polymyositis and dermatomyositis findings
order what else
- high ck, aldolase, abnormal EMG
- ana and LFT
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anti-joe antibodies confer what increased risk
most serious complication of DM
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RX for polymyosists and dermatomysosis
steroids
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rx for fibromyalgia
duloxetine, amitryptilline, milnacipran, pregabalin, exercise
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side effects of mtx
liver and lung fibrosis
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best initial test for pan
most accurate
- angiography of abdominal bv
- biopsy of skin, muscle or sural nerve
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hep b causes what vasculitis
hep b
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rx for pan
prednisone and cyclophosphamide
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upper and lower resp involvement and renal
wegeners c-anca
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pathergy
sterile skin abscess
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behcet disease
- oral, genital ulcers
- ocular involvement
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when is rasburicase use?
when allopurinol is not enough
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gout vs pseudogout and crystals
- gout-negative
- pseduogount-positive birefringent
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joint fluid test
- cell count
- culture
- crystal
- protein
- uric acid level
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febuxostat is used when
when allopurinol is not tolerated
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when is colchicine used
when nsaids and steroids cannot be used
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when are probenecid and sulfinpyrazone used in gout?
never
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pseudogout is seen with what diseases
- hemochromatosis
- hyperparathyroidism
- hypothyroidism
- acromegalyy
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rx for septic joint
ceftriaxone and vanco
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what bugs are covered in septic arthritis
strepto and staphylococci and GNR
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pagets gives what type of bone lesions
osteolytic and osteoblastic
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best initial test for pagets
alp
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what is ordered for pagets disease
- urinary hydroxyproline
- serum calcium and phosphate and bone scan
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rx for pagests
bisphosphonates and calcitonin
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dx of bakers cyst?
rx
- r/o dvt with ultrasound
- nsaids or steroids
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difference between tarsal tunnel syndrome and plantar fascitis
plantar fascitis is better with use, stretching and
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motor neuroma
ternderness between 3rd and 4th metatarsal heads
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