The USMLE Step 1 exam will likely need to test your ability to comprehend the basic sciences, but as we move forward the exam is become that a great many clinical in nature, so it is essential that you learn tips to combine the basic sciences because of the clinical side of resolution. When it comes to Rheumatoid Arthritis recorded at a Step 1 exam, there are numerous important things you going to have to understand, namely: Main conditions Symptoms, clinical findings, laboratory findings, and finally when as well as which medications to use to help you patient.
Here are the main topics we're going to cover to ensure your USMLE Action 1 theory for Rheumatoid Arthritis is roofed completely:
1. The main discomfort Symptoms
2. The main extra-articular discomfort Symptoms
3. The expected clinical findings of RA
4. The stairs to proper management which are more RA
5. Important complications you must be aware of relating to RA
The Main Condition Symptoms:
- Morning stiffness that last more than 1hr with a minimum of 6 weeks
- Swelling each wrists, PIP, or MCP joints with a minimum of 6 weeks
- Symmetric joint swelling with a minimum of 6 week
- Swelling of at least 3 joints for at least 6 weeks
Deformities involving the feeling PIP and DIP joints include "Boutonniere deformity" as well as "Swan-Neck deformity". The Boutonniere deformity is flexion each PIP and extension connected with an DIP, while the Swan-Neck disability is PIP extension any thing DIP flexion.
The Main extra-articular conditions Symptoms
- Rheumatoid nodules (subcutaneous nodules)
- Caplan syndrome (Rheumatoid nodules underneath the lungs)
- Tendon and connective tissue damage
The expected lab end results of RA:
- Rheumatoid Point is increased
- Anemia that happens to be found
- ESR is skyrocketed (due to inflammatory process)
- X-ray wouldn't show bony erosions
- Synovial fluid analysis seeing white blood cell rely (should be elevated)
The to be able to proper management of RA:
We used to keep NSAIDs as the drug and select, but now we stay with using Methotrexate as the main line management. Here add the steps to proper chief executive officer:
- Use methotrexate for 7 days, then add prednisone for 7 days (using prednisone subsequently for flare-ups)
- If your clientele cannot use methotrexate, you could give them hydroxychloroquine rather, which is an anti-malarial. This drug is able to cause retinopathies, so let us ensure they get constant eye exams.
Important complications you must be aware of in RA:
- An extension each inflamed synovium into the popliteal space translates into a Baker's cyst, which presents any swollen, tender, and irritated calf
- Prior to any surgical procedure, it is important to eliminate a subluxation of strategies atlantoaxial joint, which can accidentally be a little more hyperextended during intubation and potentially entice post-operative paralysis.
Understanding and following used for the high-yield Rheumatoid Arthritis information above will make sure you cover all the RA what exactly you need for your USMLE Action 1 exam..