Nonarticular Rheumatism Flashcards Preview

Musculoskeletal System II > Nonarticular Rheumatism > Flashcards

Flashcards in Nonarticular Rheumatism Deck (24)
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1
Q

In 65% of dialysis pt’s receiving dialysis > 10 years, what might happen?

A

Destructive arthritis

2
Q

What joints are affected with destructive arthritis?

A

interphalangeal joints, metacarpophalangeal joints, wrists, shoulders, and knees

3
Q

What is deposited in destrcutive arthritis?

A

amyloid deposition (an arthrotropic β2-microglobulin)

4
Q

Fybromyalgia- clinical presentation

A

chronic widespread musculoskeletal pain that is poorly localized. It is accompanied by fatigue, sleep, memory, and mood issues.

5
Q

Fibromyalgia- 3 important labs

A

complete blood count, erythrocyte sedimentation rate, thyroid function studies

6
Q

Fibromyalgia- Tx

A

NSAIDS and sleep meds

7
Q

What 3 things are an indication for more extensive examination in acute low back pain?

A

Objective leg weakness or bladder or bowel dysfunction

8
Q

Which 2 Sx are indicitive of a neoplastic or infectious process?

A

Substantial weight loss or pain that increases with recumbency

9
Q

Which 3 Sx suggests a spinal nerve root irritation?

A

Radiating pain, weakness, or numbness in an extremity

10
Q

What is a pseudoclaudication?

A

narrowing of the lumbar spinal canal. This puts pressure on the spinal roots and affects the control and sensation of the lower limbs. It is named pseudoclaudication because claudication is a vascular problem giving the same symptoms.

11
Q

Which maneuvers improve the Sx of pseudoclaudication?

A

improve with leaning forward on a shopping cart while walking or with sitting

12
Q

What are the 5 most important cases to get radiographs of a pt with acute low back pain?

A

1st episode after 50 y/o, Hx of neoplasm, Fever, weight loss, neurological Sx.

13
Q

What is the initial treatment of acute nonspecific low back pain?

A

reassuring the patient because 90% of all patients with acute low back pain have considerable improvement in 6 weeks

14
Q

What causes bursitis?

A

Irritative stimuli due to trauma or overuse, microcrystalline disease, chronic inflammatory arthritis, and infection

15
Q

What are the two organisms commonly involved with septic bursitis?

A

Staphylococci (80%) and streptococci

16
Q

What causes septic bursitis?

A

puncture wounds, cellulitis, or due to a local injection

17
Q

Septic bursitis- Sx

A

Bursal warmth is the best predictor of infection. Restricted joint range of motion is a red flag for deep infection

18
Q

Septic bursitis- Tx

A

empirically with antistaphylococcal and antistreptococcal oral antibiotics

19
Q

What is polymyalgia rheumatica?

A

an inflammatory disorder that causes muscle pain and stiffness.

20
Q

Polymyalgia rheumatica- populations

A

females > males over 60 years old.

21
Q

Polymyalgia rheumatica- Sx

A

Presents with onset of aching and morning stiffness in the proximal musculature (hips, shoulder girdles).

22
Q

Polymyalgia rheumatica- Labs

A

increase in ESR and CRP

23
Q

Polymyalgia rheumatica- Tx

A

Prednisone

24
Q

In 15% of Polymyalgia rheumatica patients, what other disease do they have?

A

Giant cell arteritis