Immunology and Inflammatory Post Test. Rosen's Emergency Medicine, 7th Edition. Section Nine: Chapters 114 - 118.
Pseudogout – polyarticular
Gonocoocal arthritis – monoarticular
Gout – polyarticular
Lyme disease – monoarticular
Rheumatoid arthritis – polyarticular
Neisseria gonorrhoeae
Group A streptococcus
Staphylococcus aureus
E. coli
Salmonella species
She may be discharged home on oral antibiotics after a dose of IV antibiotics
It is unnecessary to perform a cervical culture on this patient
This type of arthritis is more commonly oligoarthritis than monoarthritis
The etiology of this arthritis has a high liklihood of creating long-term joint pathology
This type of arthritis is most common in children and adults > 55 years old
Absolute cell count can be used to rule out a septic etiology
Arthrocentesis is contraindicated if infection of any kind covers the joint
If you obtain a very small amount of synovial fluid, the most important test to be run is cell count and differential
The most concerning complication of arthrocentesis is a “dry tap”
Most of the white blood cells in septic arthritis are PMNs, while in inflammatory arthritis, eosinophils predominate.
Platelet count
CPK
Serum protein level
Sedimentation rate
Uric acid level
The most common extra-articular manifestation of ankylosing spondylitis is aortic root disease
There is a genetic component to theses arthropathies related to the HLA-B27 marker
Psoariatic arthropathy occurs in up to 20% of patients with psoriasis
In patients with IBD, the peripheral arthritis tends to correlate with flare-ups of the bowel disease, but the spinal manifestations do not
Reactive arthritis (Reiter’s syndrome) develops 2-6 weeks after an episode of urethritis or dysentery
Colchicine can be safely used in patients with chronic renal insufficiency
Allopurinol increases uric acid elimination and is useful during an acute gouty attack
Intramuscular injections of ACTH are useful if NSAIDs are contraindicated
Treatment with NSAIDs should continue for at least one week after symptoms have abated
There is a high likelihood that a single administration of IM ACTH may lead to suppression of the hypothalamic-pituitary-adrenomedullary axis
The attacks tend to be more severe
The typical patient is younger
The crystals cannot be identified using microscopy
Treatment with colchicines is contraindicated
The knee is the most commonly involved joint
Teres minor
Supraspinatus
Infraspinatus
Deltoid
Subscapularis
De Quervain’s tenosynovitis – Finkelstein test
Rotator cuff tendinopathy – Neer test
Achilles tendon rupture – Thompson test
Bicipital tendinopathy – Empty can test
Lateral epicondylitis – Cozen test
Subacromial and anserine bursitis
Olecrenon and trochanteric bursitis
Iliopsoas and subacromial bursitis
Prepatellar and subacromial bursitis
Prepatellar and olecrenon bursitis
Diabetes mellitus
Trauma
Advanced age
Alcohol abuse
Rheumatoid arthritis
Pericarditis
Oral ulcers
Positive antinuclear antibody
Leukocytosis
Proteinuria >0.5 g/24 hours
70% of patients develop hitchhiker’s thumb
Renal biopsy is not useful in the work-up or management of patients with SLE
Bundle branch block is the most common cardiac manifestation, reported in 30% of patients
Neurologic presentations, such as seizures, stroke, psychosis, migraines, are frequently the first signs of disease
Oral ulcerations commonly accompany disease flares
Procainamide
Acetaminophen
Sulfonamides
Phenytoin
Hydralazine
Absence of temporal artery tenderness would eliminate the possibility of this condition
Polycythemia is a common finding
Elevated ESR level may be a helpful diagnostic clue
Onset of this disease is typically the age 40 years or younger
Steroids must be withheld until arterial biopsy can be done
Goodpasture’s syndrome is characterized by deposition of anti-glomerular basement membrane antibodies and results in alveolar hemorrhage and progressive glomerulonephritis
The hallmark of Behcet’s disease is oral ulceration, which is required to make the diagnosis
Approximately 2/3 of cases of HSP follow an upper respiratory tract infection
Erythema nodosum more commonly affects men than women
The initial complaints of patients presenting with Wegener’s granulomatosis are typically upper respiratory tract symptoms
Cat hair
Crustaceans
Wasp stings
Penicillin
Radiocontrast medium
Methylprednisolone 125 mg IV
Diphenhydramine 50 mg IV
Epinephrine 0.3 mg 1:10,000 solution IM
Nebulized albuterol 2.5 mg diluted to 3 mL of normal saline
Epinephrine 0.1 mg of 1:10,000 solution IV over 5 minutes
Amlodipine
Aspirin
Levothyroxine
Metoprolol
Amiodarone
Atropine 0.3-0.5 mg IV
Glucagon 1 mg IV
Vasopressin 40 units IV
Isoproterenol 0.05-0.2 g/kg/min
Dopamine 5 g/kg/min
Angioedema involves the deeper dermal and subcutaneous tissue and commonly involves the face, mouth, lips, extremities, and genitalia
10% of cases are classified as chronic with recurrent episodes persisting longer than 6 weeks
There is a subset of angioedema which is hereditary due to an autosomal recessive condition caused by C1 esterase inhibitor deficiency or functional deficiency
ACE inhibitor-induced angioedema may occur as many as 10 years after initiation of therapy
All types of angioedema result in elevated bradykinin levels
These lesions are not contagious
Systemic antibiotics have been shown to prevent later occurrence of glomerulonephritis
Group A streptococcus is the most common causative organism
Without treatment, these lesions will heal in 3-6 weeks
Systemic antibiotics have a higher cure rate than topical agents
This illness has been associated with an exotoxin-producing S. aureus and severe group A beta-hemolytic streptococcal infections
The diagnosis of this illness requires fever, hypotension, and rash
You can see pharyngitis, a “strawberry tongue,” conjunctivitis or vaginitis with this illness
The rash associated with this illness is initially a diffuse, blanching erythroderma followed by full-thickness desquamation
Antibiotics are not indicated in the treatment of this illness
Seborrheic dermatitis
Tinea versicolor
Vitiligo
Pityriasis rosea
Erythema multiforme