So like I said in the MSK post, I thought Rheum was a lot less straightforward than the MSK part. Some pretty minute differences between the diseases and some crazy drugs to try to understand for how to treat them. However, the one thing that they all have in common (and the one thing that makes it slightly easier) is the fact these patients need to have a referral to a rheumatologist
- Charts, charts, charts, charts, charts, everybody! This is going to be your go to for this section. I don’t care what else you do, you need to try to break down the diseases to as basic as possible and compare/contrast them. Knowing the tiny details about what joints the condition affects first, or whether the patient gets fatigued is going to make a whole lot of difference.
- Understand the labs. The great thing about any kind of autoimmune disorder is that often times there are going to markers for it in the labs. While these markers don’t automatically mean that the patient has the illness, they’ve very helpful for ruling out or ruling in conditions. Downside-each condition has its own kind of marker and you’re going to need to remember them. My advice: make a running list of the markers and then which diseases they show up in.
- Ignore the treatment. Sounds counterintuitive I know, especially since you will need to know treatment options for the PANCE. But when you’re just starting to study Rheum, I found it really helpful to ignore the drugs for a while and just focus on the disease. THEN, once I felt like I knew the diseases forwards and backwards, did I start considering treatment options. Even at that point, I tried not to go very in depth into treatments because realistically your patient is going to be getting a referral.
- Draw it out. So you have rheumatoid arthritis versus osteoarthritis (which is technically not a rheumatologic disease). There are going to be some major physical exam findings that should stand out for you to rule in or out one of the conditions. Draw these findings out! The act of seeing it and not just reading it is really going to help you keep them straight in your mind.
- Both Dalmatians and humans lack uricase enzyme, which breaks down uric acid. This is why humans get gout and Dalmatians have a higher chance of getting kidney failure.
- Having a positive RF doesn’t mean that you have rheumatoid arthritis
- Gout is more likely to occur in the extremities, because the crystals form easier where it is cold.
- One treatment for Lupus is to limit sun exposure
Hopefully this was helpful for you guys! Comment below on your thoughts about these Rheumatology study tips, as well as any others you find helpful! I’m always looking for new ways to learn.
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