Rheumatology for Internal Medicine

Rheumatology for Internal Medicine Boards
Presentation by:Victoria K. Shanmugam, MD

Assistant Professor of Medicine
Georgetown University Hospital

What is the diagnosis?
Rheumatoid Arthritis

CRITERIA
EPIDEMIOLOGY
RHEUMATOID FACTOR
CCP
Extra-articular manifestations of RA
Cardiac 3x increased risk of atherosclerosis

Pericarditis
NSAID associated
Pulmonary
Interstitial fibrosis
Anemia of chronic disease
Extra-articular manifestations of RA
DMARDS
DRUG MOA ADMINISTRATION SIDE EFFECTS MONITORING
Bone marrow suppression
DRUG MOA ADMINISTRATION SIDE EFFECTS MONITORING

ANA
ANA Patterns
ACR Criteria For Lupus
Discoid rash
Photosensitivity
Mucocutaneous Ulcers
Lupus Arthritis
Pleuritis
Pericarditis
Nephritis
Neurologic manifestations
Cardiac involvement in Lupus
Cardiovascular risk and Lupus
Disease activity parameters
Symptomatic treatment
PRIMARY AND SECONDARY APS
Myositis
Myositis Antibodies
GOUT vs. PSEUDOGOUT
What is the diagnosis
Disseminated Gonococcal Infection
SYNOVIAL FLUID ANALYSIS
The Antibodies
Scleroderma Renal Crisis
Pathology of renal crisis
Steroids and renal crisis
Management of Renal Crisis
BP Elevated
Risk factors for Renal Crisis
Presentation of Renal Crisis
Raynaud’s Syndrome
DDx Raynaud’s
Wegener’s Granulomatosis
Churg Strauss Syndrome
Giant Cell Arteritis
Polymyalgia Rheumatica

and much more are discussed in this presentation

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Rheumatology

Rheumatology What you need to know for your ambulatory medicine experience
Presentation by Kevin Latinis, M.D./Ph.D.
Division of Rheumatology
Dept. of Internal Medicine

This Rheumatology presentation covers the following topics.

* Arthritis
-Inflammatory (RA, spondyloarthropathies)
-Mechanical (OA)
* Lupus
* Fibromyalgia
* Low back pain and other peri-articular complaints
* General musculoskeletal exam

Mechanical vs. Inflammatory Arthritis
Osteoarthritis-Background
Osteoarthritis-Distribution
Osteoarthritis-Diagnosis
* Clinical
* Supported by X-rays
* Non-inflammatory lab data, if any

Osteoarthritis-Treatment
Clinical Pearl:
Arthritis of the DIP joint
OA (non-inflammatory)
Psoriatic Arthritis (inflammatory)
Inflammatory Arthritis
Systemic Lupus Erythematosus-Background
Clinical features, classification criteria
Treatment of SLE
Steroids in Lupus
Fibromyalgia-Background -Diagnosis
Fibromyalgia-Treatment
General Musculoskeletal Exam

* Underutilized by primary care providers
* Should be simple and quick
* Goal is to recognize signs of rheumatological diseases and determine if it is appropriate to refer to a rheumatologist or manage independently

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Drug Induced Liver Injury

Drug Induced Liver Injury
Presentation by:Robert J. Fontana, MD
University of Michigan Medical Center

Drug Induced Liver Injury
Hepatic Adverse Event Nomenclature
Liver Injury Classification
DILI Population based study
DILI Diagnosis
Clinicopathologic forms of DILI
DILI: A Diagnosis of exclusion
Acute Hepatocellular: Differential Dx
Ultrasound/ CT
DILI: Causality Assessment
RUCAM
RUCAM limitations
Prognosis in DILI with jaundice
Spectrum of DILI
ALT monitoring and DILI
DILI pathogenesis
DILIN: Sphere of Influence
Idiosyncratic Liver Injury Associated with Drugs (ILIAD)
New agent signals
Drug
Human genome
DILIN Genotyping Initiative
Acetaminophen: Friend or foe ?
Glucuronyl transferases sulfotransferases
Acetaminophen
ACM-cysteine adducts
Biomarker for ACM hepatotoxicity
Implications of ACM related ALF
Acetaminophen advice
Acetaminophen toxicity in severe acute HAV/ HBV
Prospective Study Design
DILI Causality Instrument
Prognosis in DILI with jaundice

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