Deja Vu
these 3 bacteria most commonly cause septic arthritis in adults
N. gonorrhoeae, staph aureus, strep PNA
GCA is commonly associated with what other rheumatic disease?
Polymyalgia Rheumatica
Two muscles that are external rotators of the shoulder
infraspinatus and teres minor muscles
this enzyme is responsible for the synthesis of uric acid
Xanthine oxidase
Which Cytokine family is strongy implicated in the pathogenesis of PsA
IL-17
The autoantibody associated with scleroderma interstitial lung disease and poor prognosis
anti-centromere antibody
this form of endocarditis can be seen in SLE
Libman -Sacks
This somatic mutation is associated with VEXAS syndrome
ubiquitin activating enzyme (UBA1) gene
In addition to ACPA antibodies, this test is commonly abnormal in young patients with JIA
ferritin
this ocular test is abnormal in Sjogren syndrome
Schirmer's test
Treatment for Jumper's Knee
AKA: Patellar Tendinitis
NSAIDS, rest, ice, knee bracing and stretching, strengthening of the quadriceps & hamstring muscles.
CS injections are usually contraindicated due to risk of tendon rupture.
What almost universal feature of scleroderma is usually absent in scleroderma mimics
Raynaud’s phenomenon
this form of arthritis is the severe form of PsA
arthritis mutilans
this disease should be considered in young adults who present with PAN-Like disease
Adenosine deaminase 2 mutation
(DADA2 disease)
This test helps to differentiate episcleritis from scleritis and how does it do so
Phenylepherine test
The phenylephrine blanches the conjunctival and episcleral vessels but leaves the scleral vessels undisturbed.
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Episcerlitis: blanching of erythema
Scleritis : non-blanching of erythema
these tests for STDs can be positive in SLE
VDRL, RPR
What is the MOA of Bimekizumab
Bimekizumab is a humanised monoclonal IgG1 antibody that selectively inhibits IL-17A and IL-17F via a unique mode of action, binding to a similar site on both IL-17A and IL-17F.
this enzyme is helpful in identifying bone marrow toxicity secondary to azathioprine
thiopurine S-methyltransferase (TPMT)
MOA of pegloticase
converts (oxidizes) excess uric acid into allantoin which is water soluble allowing for excretion via the kidneys.
What is the allele that has been implicated in those with GCA?
HLA-DRB1*04:04
The 2 best chemistry tests to measure disease activity in Paget’s Disease
serum alkaline phosphatase and urinary hydroxyproline oxidase
clinical findings AOSD
quotidian fever, salmon-colored rash, joint pain, lymphadenopathy, hepatosplenomegaly, pericarditis, pleural effusion, pulmonary infiltrates, meningioencephilitis
What effect do glucocorticoids have on osteoprotegerin that contributes to osteoporosis as discussed in Medical GR this week?
Inhibit osteoprotegerin (OPG) synthesis thus allowing for more formation of osteoclasts (increased bone resorption)
An autosomal recessive disorder causing dysfunctional leucocytes and resulting in recurrent pyogenic infections.
Chediak-Higashi syndrome
This disorder arises from a mutation of lysosomal surface receptor trafficking regulator protein which leads to an inability of leucocytes to bind correctly to blood vessels and a decrease in phagocytosis. Individuals with this syndrome have partial albinism
Describe this syndrome: Mouth and genital ulcers-inflamed cartilage syndrome (MAGIC)
This is a rare autoinflammatory syndrome characterized by the presence of features of relapsing polychondritis and Behçet's disease in the same individual.
This sign indicates weakness in the hip abductor muscles: gluteus medius and gluteus minimus
Discussed during greater trochanteric pain syndrome: Trendelenburg sign
This DMARD may cause proximal muscle weakness with a normal CPK
HCQ
this upper airway condition seen in RA can be mistaken for asthma
Cricoarytenoid Arthritis
Thompson Heel vs Thompson Test
thompson heel: Pes Planus (Flat feet) A Thomas heel (shoe has a heel one half inch longer and 1/8-1/6th of an inch higher on the inside. Brings heel into varus)
Achilles tendon Rupture: Thompson test (patient kneels on a chair with the feet extending over the edge, and the examiner squeezes the calf and pushes toward the knee), normally this produces plantar flexion, but in a ruptured tendon no plantar flexion occurs
What is the MOA of Leflunomide
Works by inhibiting the mitochondrial enzyme dihydroorotate dehydrogenase (DHODH), which plays a key role in the de novo synthesis of the pyrimidine ribonucleotide uridine monophosphate (rUMP ) thereby inhibiting T cell proliferation and production of antibodies by B cells