4.09 Rheumatologic Emergencies
Rheumatology review for USMLE Step 1 Exam
Giant Cell Arteritis (GCA)
- A large vessel vasculitis, mainly in older individuals.
- Symptoms: headache, jaw claudication, vision loss.
- Ischemia from granulomas in large vessels causes vision loss.
- Immediate high-dose corticosteroids are crucial.
Scleroderma Renal Crisis
- A complication of scleroderma.
- Symptoms: finger edema, skin tightening, sudden hypertension, rising creatinine.
- Renal artery fibrosis leads to high blood pressure.
- Treat with IV ACE inhibitor, not steroids.
Acute Transverse Myelitis in SLE
- Inflammation of the spinal cord in lupus.
- Symptoms: bilateral numbness, tingling, weakness.
- Treat with corticosteroids.
Catastrophic Antiphospholipid Syndrome (CAPS)
- A rare, life-threatening form of APS.
- Symptoms: unexplained miscarriages, unexplained clots, multiorgan failure.
- Treat with anticoagulation followed by immune suppression
