Vignette
55 year old female presents with pain and stiffness of proximal muscles and joints, difficulty combing her hair, 5/5 muscle strength, and normal muscle enzymes.
What is polymyalgia rheumatica?
best initial test for Sjogren syndrome
antiSS-A (Ro) + antiSS-B (la)
first line treatment for polymyalgia rheumatica
What are LOW dose corticosteroids?
Pale fingers that change blue and then red when exposed to the cold
What is Raynaud’s phenomenon ?
most common complication Giant cell arteritis and 1st line treatment for prevention of this compllication
What is blindness? What are high dose PO corticosteroids?
Patient presents with difficulty climbing stairs and rising from the chair. Labs show elevated ESR, CRP, CK and aldolase levels, with erythematous MCP joints and upper eyelids.
What is dermatomyositis?
the most specific blood test(s) used to diagnose a patient with joint pain, fever, and a butterfly rash
What is anti-double-stranded DNA, anti-smith?
first line treatment for a patient whose diagnostic tests show increased levels of CK + aldolase, + ANA, + Anti Jo-1, increased ESR and CRP, and biopsy shows lymphoid inflammatory infiltrates
What are high dose glucocorticoids?
For polymyositis
clinical manifestations of CREST syndrome and the indication
What is "Calcinosis cutis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactly, Telangiectasia"?
limited cutaneous systemic scleroderma. No sign of internal organ involvement initially. Slow progression. Less severe long term damage
2 complications of the dry secretions seen with Sjogren’s and the treatment
What is 1) saliva increases in viscosity, blocks ducts, leads to Salivary gland enlargement and secondary salivary gland infx, treat with oral lubricants + lozenges + PO meds 2) eye become dry subjecting to corneal abrasions, treat with artificial tear drops ?
35 year old female presents with painful finger joints, erythematous rash on cheeks, fever, and low Hgb
What is SLE?
Lab value is the most sensitive and is better at detecting acute inflammation
What is CRP?
First line treatment for a patient with dermatomyositis
What are high dose glucocorticoids?
physical exam findings of a patient with polymyalgia rheumatica
What is "Enlarged silver pink plaques over the knuckles, photosensitive rash over face, diffuse patchy red and pink rash on,anterior neck and bilateral shoulders."
rheumatologic disorder that most commonly can lead to a hypercoagulable state, accelerated atherosclerosis, (d/t chronic inflammation), CAD and myocardial infarctions