TRIPLE HELIX please help, can't rheumatology n - shapiro

[ArchivalUser]

I went to the website that you have given in the link, it has cardio, neuro, and general medicine and I couldn't find rheumatology notes, some one please guide, thanks a ton -for the good notes.

[ArchivalUser]

RHEUMATOLOGY

1066. Manifestations of systemic lupus erythematosus include arthralgias, photosensitive rash, malar rash, oral ulcers, pancytopenia, and serositis.
1067. The most common joints involved in osteoarthritis are the knee, hip, distal and proximal interphalangeal, and first carpometacarpal.
1068. Osteoarthritis is characterized by pain that worsens with activity and morning joint stiffness that lasts less than 30 minutes.
1069. Postmenopausal women who use diuretics have an increased risk for tophaceous gout of the distal interphalangeal joints.
1070. Patients with diffuse cutaneous systemic sclerosis are at increased risk for developing interstitial lung disease.
1071. Anti“Scl-70 antibodies are most frequently associated with diffuse cutaneous systemic sclerosis and an increased risk for interstitial lung disease.
1072. Chest radiography frequently does not detect early interstitial fibrosis.
1073. The chronic inflammatory state of rheumatoid arthritis is associated with an increased risk for death from a coronary event.
1074. The erythrocyte sedimentation rate is useful for monitoring chronic inflammatory changes but may be elevated in the setting of advanced age, anemia, and other disease states.
1075. Takayasu's arteritis is a chronic, idiopathic, granulomatous inflammatory disease primarily of the aorta and its main branches that affects reproductive-age women.
1076. Constitutional symptoms and ischemic signs or symptoms in the territory of one or more large arteries in a woman 18 months of minocycline exposure.
1095. Liver involvement in minocycline-induced lupus often mimics autoimmune hepatitis.
1096. The clinical presentation of adult contacts of children with parvovirus B19 infection may mimic rheumatoid arthritis.
1097. Parvovirus B19“related arthritis is self-limited, may not have an associated rash, resolves within 1 to 2 months, and usually responds to nonsteroidal anti-inflammatory drugs.
1098. Polymyalgia rheumatica is characterized by pain or morning stiffness in the neck or torso, shoulders and upper arms, or hips and thighs in patients >50 years of age with an erythrocyte sedimentation rate >40 mm/h.
1099. Prednisone therapy rapidly alleviates symptoms of polymyalgia rheumatica.
1100. Olecranon bursitis may be infectious, crystalline, or traumatic.
1101. Bursa aspiration is indicated for patients with acute olecranon bursitis to guide therapy.
1102. Patients with fibromyalgia have widespread musculoskeletal pain and stiffness, paresthesias, nonrestorative sleep, fatigue, and multiple symmetrical painful tender points.
1103. Results of laboratory studies in patients with fibromyalgia are normal.
1104. Patients with a long history of Raynaud's phenomenon and diffuse or limited cutaneous scleroderma are at risk for pulmonary vascular disease.
1105. High-dose corticosteroid therapy in the setting of scleroderma may be associated with normotensive renal crisis.
1106. Invasive diagnostic studies or empirical treatment is not indicated in asymptomatic patients with an isolated elevated creatine kinase level.
1107. Anti“cyclic citrullinated peptide antibody positivity is strongly associated with rheumatoid arthritis and may have the best predictive value when combined with rheumatoid factor measurement.
1108. Patients taking prednisone, equal or more than 5 mg/d, for more than 3 months may benefit from calcium and vitamin D supplements and a bisphosphonate.
1109. Allopurinol is equally effective in the setting of inefficient excretion and overproduction of urate.
1110. Allopurinol at a dose of more than 300 mg/d is necessary for approximately 50% of patients with hyperuricemia in order to achieve urate levels less than 6 mg/dL.
1111. Antibiotics, such as ampicillin“sulbactam and others with broad-spectrum coverage, are indicated for animal bites.
1112. There is no treatment for scleroderma that is disease modifying.
1113. Therapy for scleroderma involves systematic management of end-organ involvement.
1114. In patients with scleroderma, high-dose corticosteroid therapy may be associated with normotensive renal crisis.
1115. Estrogen therapy is contraindicated in women with antiphospholipid antibodies.
1116. An unexplained prolonged activated partial thromboplastin time raises suspicion for the antiphospholipid antibody syndrome.
1117. Rheumatoid arthritis predisposes patients to secondary osteoarthritis.
1118. Immediate prednisone therapy is indicated for patients with clinical suspicion for giant cell arteritis before temporal artery biopsy to decrease the risk for visual loss.
1119. Low-dose aspirin may decrease visual loss and cerebrovascular incidents in the setting of giant cell arteritis.
1120. Left shoulder pain may be referred from the neck; chest; or subdiaphragmatic area, including the spleen.
1121. Intra-articular corticosteroid injections effectively relieve symptoms of knee osteoarthritis.
1122. Small-bowel bacterial overgrowth is a common cause of diarrhea in patients with scleroderma and is treated with intermittent broad-spectrum antibiotics.
1123. Opioid antidiarrheal therapy is not indicated for patients with scleroderma because it may worsen intestinal motility disorders.
1124. Psoriatic arthritis is associated with dactylitis and asymmetrical distal interphalangeal joint inflammation.
1125. The risk for malignant disease is increased in dermatomyositis and polymyositis and in inclusion body myositis.
1126. ¢ Evaluation for an underlying malignancy is indicated in patients with refractory myositis
1127. Combination therapy with methotrexate and anti“tumor necrosis factor agents is the most likely regimen to improve function, limit further damage, and control disease in severe rheumatoid arthritis.
1128. Immunosuppressed patients have increased risk for developing primary or reactivation tuberculosis.
1129. Prophylactic isoniazid therapy is beneficial in patients who use prednisone, equal or more than 15 mg/d, or any other immunosuppressive agent and who have equal or more than 5 mm of induration on tuberculin skin testing.
1130. Urate levels in patients with tophaceous gout should be reduced to 6.0 mg/dL (0.36 mmol/L) to dissolve tophi and other urate depositions in the tissue.
1131. Because decreasing the urate level in a patient with tophaceous gout may induce a gouty attack, continuation of prophylactic doses of colchicine is indicated until the tophi resolve and the urate level stabilizes.
1132. Acetaminophen is an effective, safe, and inexpensive treatment for osteoarthritis.
1133. Patients with osteoarthritis who have high risk for nonsteroidal anti-inflammatory drug complications may use alternate therapy with acetaminophen, often without compromising pain control.
1134. Patients with joint abnormalities have an increased risk for joint infection.
1135. Intra-articular corticosteroid therapy is contraindicated until infection is excluded.
1136. Alveolar hemorrhage may develop in systemic lupus erythematosus even without hemoptysis.
1137. Amyloidosis is an uncommon but potentially severe side effect of chronic inflammatory diseases, such as rheumatoid arthritis.
1138. Rheumatoid arthritis“associated amyloidosis primarily involves the kidneys and may lead to the nephrotic syndrome and renal failure.
1139. Patients treated with cyclophosphamide have increased risk for transitional cell carcinoma of the bladder.
1140. Lifelong screening for bladder cancer is indicated for patients treated with cyclophosphamide.
1141. Adequate drainage and intravenous antibiotics are standard treatment for a œclosed-space joint infection.
1142. The malar rash of systemic lupus erythematosus is often photosensitive and spares the nasolabial folds and areas below the nares and lower lip.
1143. Rosacea is an inflammatory dermatitis characterized by erythema, telangiectasias, papules, pustules, and sebaceous hyperplasia that affects the central face, including the nasolabial folds.
1144. Anti“tumor necrosis factor-α therapy is contraindicated in patients with infection.
1145. Corticosteroid-induced myopathy is characterized by continued or worsening proximal muscle weakness, particularly in the lower extremities, after a decrease in or normalization of muscle enzyme levels.
1146. Tramadol is as effective as ibuprofen in alleviating pain in osteoarthritis of the hip and knee in patients in whom nonsteroidal anti-inflammatory drugs are contraindicated or do not provide adequate pain relief.
1147. Upper- and lower-extremity weakness and gait abnormalities associated with rheumatoid arthritis strongly suggest cervical spine impingement.
1148. Immediate MRI scanning is indicated in patients with rheumatoid arthritis with suspected cervical spine impingement.
1149. Postexposure prophylaxis may benefit immunocompromised patients exposed to influenza virus.
1150. Administration of antiviral therapy does not affect the immune response to inactivated influenza vaccine.
1151. Intranasal trivalent live-attenuated influenza vaccination is contraindicated in immunosuppressed patients.
1152. Colchicine toxicity may cause acute vacuolar myopathy and axonal neuropathy.
1153. Use of colchicine with inhibitors of CYP3A4 and P-glycoprotein, which metabolize and transport this agent, respectively, may increase the likelihood of drug toxicity.
1154. Calcification of the cartilage, particularly the fibrocartilage of the knee meniscus, symphysis pubis, and glenoid and acetabular labrum and the triangular cartilage of the wrist, is pathognomic for calcium pyrophosphate deposition disease.
1155. An atypical distribution of osteoarthritis without a history of trauma suggests calcium pyrophosphate deposition disease.
1156. Prednisone and hydroxychloroquine are the preferred anti-inflammatory drugs during pregnancy.
1157. Upward titration of prednisone may be indicated if other immunosuppressant agents are discontinued during pregnancy.
1158. Hemorrhagic cystitis and bladder cancer are uncommon side effects of cyclophosphamide therapy.
1159. Follow-up cystoscopy is indicated for patients with hematuria and a history of treatment with cyclophosphamide.
1160. Methotrexate remains a vital drug in the treatment of rheumatoid arthritis.
1161. Combination therapy with methotrexate and anti“tumor necrosis factor-α agents provides the best suppression of joint damage and leads to maximal clinical improvement in rheumatoid arthritis.
1162. Wegener's granulomatosis is a necrotizing granulomatous inflammation of small- to medium-sized vessels with a predilection for the upper and lower respiratory tracts and kidneys.
1163. Löfgren's syndrome, a variant of sarcoidosis, is characterized by the concomitant presence of acute erythema nodosum, hilar adenopathy, arthritis or periarthritis, and fever.
1164. Compared with physical examination, radiography of the hands is less sensitive and specific for symptomatic hand osteoarthritis.
1165. The most characteristic radiographic finding of osteoarthritis is osteophytes with joint-space narrowing.
1166. The most characteristic radiographic finding of psoriatic arthritis is the coexistence of erosive changes and new bone formation in the distal joints.
1167. Methotrexate is metabolized by the liver and excreted by the kidneys and should be reduced or discontinued in the setting of renal insufficiency.
1168. Inclusion body myositis is characterized by proximal and distal muscle involvement, asymmetrical muscle weakness and atrophy, falls, and mixed neuropathic and myopathic findings on electromyography.
1169. Muscle biopsy is the diagnostic study of choice for myositis.
1170. Characteristic radiographic changes of the hands associated with rheumatoid arthritis include juxta-articular osteoporosis and marginal erosions in the metacarpophalangeal joints.
1171. Propylthiouracil use is strongly associated with the development of antineutrophil cytoplasmic antibodies directed against myeloperoxidase and associated vasculitis.
1172. Antineutrophil cytoplasmic antibody“positive drug-induced vasculitis may continue to progress after discontinuation of the inciting medication.
1173. Whipple's disease is a chronic infection with multiorgan manifestations, including uveitis, diplopia, asymmetrical inflammatory arthritis, and weight loss.
1174. Corticosteroid therapy often resolves polymyalgia rheumatica symptoms within 24 hours.
1175. The mean duration of therapy for polymyalgia rheumatica is 2.4 years at an average prednisone dose of 9.6 mg/d.
1176. Hydroxychloroquine therapy is associated with retinal toxicity.
1177. Antinuclear antibody positivity may occur in 10% to 15% of healthy young women, in pregnancy, and with increasing age.
1178. An antinuclear antibody assay is indicated only if there is a high pretest probability of systemic lupus erythematosus or another connective tissue disease.
1179. Inflammatory changes in ankylosing spondylitis begin in the T12 to L1 region of the spine and eventually lead to ossification of the outer fibers of the annulus fibrosis and the development of syndesmophytes.
1180. Cryoglobulinemic vasculitis is characterized by palpable purpura, arthritis, weakness, neuropathy, and a membranoproliferative glomerulonephritis.
1181. Laboratory findings in cryoglobulinemic vasculitis include circulating cryoglobulins, rheumatoid factor positivity, hypocomplementemia, and an elevated erythrocyte sedimentation rate.
1182. Hepatitis C is a common cause of cryoglobulinemic vasculitis.
1183. Arthritis associated with hepatitis C infection may occur early or late in the disease course of this infection and may mimic rheumatoid arthritis.
1184. Even in the absence of arthritis, patients with hepatitis C infection often are rheumatoid factor positive.
1185. Primary Raynaud's phenomenon is not typically associated with damaging digital ischemia.
1186. The preferred initial treatment for primary Raynaud's phenomenon is nonpharmacologic.
1187. Concomitant use of sulfamethoxazole and methotrexate is contraindicated.
1188. Manifestations of inflammatory myositis may include elevated antinuclear antibody titers and creatine kinase levels, abnormal electromyography findings, proximal muscle weakness, interstitial lung disease, arthritis, and skin rashes.
1189. Reactive arthritis is a systemic inflammatory disorder triggered by a mucosal infection in the urethra or the bowel and is manifested by a nonseptic oligoarticular arthritis; enthesitis; and, occasionally, eye, skin, or mucosal inflammation.
1190. Sjögren's syndrome is characterized by oral and ocular dryness and anti-Ro/SSA and/or anti-La/SSB antibody positivity in women between 40 and 60 years of age.
1191. Sjögren's syndrome is associated with an increased risk for non-Hodgkin's lymphoma and other lymphoproliferative conditions.
1192. A complete response to appropriate antibiotic therapy for disseminated gonorrhea may take up to 72 hours.
1193. Patients with nongonococcal septic arthritis may have positive blood cultures and extra-articular sites of infection.
1194. Hemorrhagic cystitis is a possible complication of cyclophosphamide therapy.
1195. Mononeuritis multiplex is a common presenting feature of polyarteritis nodosa.
1196. Extra-articular manifestations of ankylosing spondylitis include aortitis with aortic insufficiency, upper-lobe pulmonary fibrocystic disease, amyloidosis, cardiac conduction disease, and recurrent uveitis.
1197. Relapsing polychondritis is characterized by inflammation and destruction of cartilaginous structures.
1198. The most common presenting feature associated with relapsing polychondritis is auricular pain and swelling.
1199. Reactive arthritis is characterized by large-joint oligoarthritis; enthesitis involving tendon insertion sites; and extra-articular manifestations, including uveitis.
1200. Reactive arthritis is triggered by infections in the intestines; urogenital tract; and, less commonly, throat or respiratory tract.
1201. Needle aspiration is the least invasive method for draining an easily accessible joint, such as the knee.
1202. In the setting of septic arthritis, a decrease of fluid volume and leukocyte and neutrophil counts in serial samples suggests adequate needle drainage, whereas persistence of inflammatory fluid after 7 days of therapy suggests treatment failure.
1203. Anti“tumor necrosis factor-α therapy increases the risk for reactivation tuberculosis.
1204. Evaluation for possible septic arthritis is indicated for all patients with acute monoarticular arthritis.
1205. Patients with previously damaged joints and immunosuppression are at particularly high risk for septic arthritis.
1206. Peripheral joint disease in psoriatic arthritis responds to methotrexate and sulfasalazine, whereas related spinal inflammation does not.
1207. Psoriatic spinal inflammation responds to anti“tumor necrosis factor therapy.
1208. Behçet's disease is characterized by recurrent aphthous oral ulcers and at least two or more of the following features: recurrent genital ulceration, eye or cutaneous lesions, or positive findings on pathergy testing.
1209. Synovial fluid in osteoarthritis usually is clear, viscous, and noninflammatory with a leukocyte count less than 2000/µL (2 × 109/L).
1210. Gout and pseudogout are associated with inflammatory synovial fluid with a leukocyte count between 2000/µL (2 × 109/L) and 50,000/µL (50 × 109/L) but may be higher.
1211. Synovial fluid in septic arthritis is generally highly inflammatory with a leukocyte count between 10,000/µL (10 × 109/L) and 50,000/µL (50 × 109/L) and is often higher.
1212. Patients with the clinical triad of asthma, nasal polyps, and aspirin allergy also may have cross-reactivity to nonsteroidal anti-inflammatory drugs.
1213. Nonacetylated salicylate agents may be safely used in patients with aspirin sensitivity and asthma.
1214. Anteroposterior plain radiography of the pelvis is the initial imaging test of choice for suspected sacroiliitis.
1215. If findings on plain radiography are unequivocal or normal, MRI may detect subchondral osteitis and bone marrow edema associated with early sacroiliitis and enthesitis.

[ArchivalUser]

gr8 work TH !