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Rheumatology > 4th Year Additions > Flashcards

4th Year Additions Flashcards

1
Q

management pathway of OA

A 
PO paracetamol and topical NSAIDs
oral NSAIDs (consider PPI)
topical capsaicin (chilli pepper)
intra-articular joint injections
joint replacement
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2
Q

what is the action of drugs that end in -nib?

A

JAK inhibitors

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3
Q

what is mixed connective tissue disease?

A

condition which features symptoms from other CTDs

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4
Q

features of mixed connective tissue disease

A 
Raynaud's
arthralgia/ arthritis
myositis
sclerodactyly
pulmonary hypertension
interstitial lung disease
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5
Q

antibody in mixed connective tissue disease?

A

anti-RNP Ab

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6
Q

what should be done annually in mixed connective tissue disease and systemic sclerosis

A

echo for pulmonary hypertension

PFTs for interstitial lung disease

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7
Q

what is Libman-Sacks endocarditis?

A

growth on valves (commonly mitral) associated with APLS

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8
Q

blood results in APLS

A

thrombocytopenia

prolonged APTT

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9
Q

what is chondrocalcinosis?

A

calcium pyrophosphate deposits occur in cartilage and other soft tissues

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10
Q

what does calcium pyrophosphate deposition disease encompass?

A 
chondrocalcinosis
hyperparathyroidisim
hypothyroidism
renal osteodystrophy
haemochromatosis
Wilson's
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11
Q

side effects of methotrexate

A

teratogenic

pulmonary fibrosis

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12
Q

side effects of leflunomide

A

hypertension

peripheral neuropathy

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13
Q

side effects of sulfasalazine

A

male infertility

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14
Q

side effects of hydroxychloroquine

A

nightmares

reduced visual acuity

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15
Q

side effects of anti-TNF

A

reactivation of TB or hep B

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16
Q

side effects of rituximab

A

night sweats

thrombocytopenia

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17
Q

what is polyarteritis nodosa?

A

medium vessel necrotising vasculitis

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18
Q

what conditions is polyarteritis nodosa associated with?

A

HBV
HCV
CMV
HIV

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19
Q

presentation of polyarteritis nodosa

A 
weight loss
fever
malaise
myalgia
polyarthritis
hip BP
abdo pain
livedo recticularis
renal failure
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20
Q

diagnosis of polyarteritis nodosa

A

arteriography shows multiple small aneurysms
urine
bloods

21
Q

management of polyarteritis nodosa

A

steroids

cytotoxic drugs

22
Q

which vessels does Takayasu affect?

A

aorta and pulmonary arteries

23
Q

what is Takayasu also called?

A

pulseless disease

24
Q

diagnosis fo Takayasu

A

doppler USS
CT
MR angiogrpahy

25
Q

who gets Takayasu?

A

young females 15-35

26
Q

management of Takayasu?

A

steroids +/- immunosuppressants, angioplasty/ surgical repair

27
Q

what is Bechet’s disease?

A

complex inflammatory condition linked to HLA B51

28
Q

where is Bechet’s more common?

A

turkey

iran

29
Q

major criteria for Bechet’s

A

recurrent aphthous stomatitis
sterile pustules at site of skin trauma (pathergy test)
uveitis
genital ulceration

30
Q

minor criteria for Bechet’s

A 
inflammatory large joint arthritis
intestinal ulceration
meningoencephalitis
epididymitis
thrombophlebitis
31
Q

what is the pathergy test?

A

sterile needle creates an abrasion in the forearm > weal progression of >5mm

32
Q

which conditions is pathergy test positive in?

A

bechets
sweet’s syndrome
pyoderma gangrenosum

33
Q

management of bechets

A

steroids
colchicine
topical anaesthetic e.g. lidocaine
immunosuppressants e.g. ciclosporin A and biologics

34
Q

what to do if patients have a raised plasma viscosity?

A

myeloma screen

IgG antibodies screen

35
Q

what is the FRAX tool?

A

assess risk of fragility fractures in OP over the next 10 years

36
Q

who should you perform the FRAX tool on?

A

men >75 and women >65

37
Q

what can be used as secondary prevention for OP in women?

A

raloxifene

HRT

38
Q

action of raloxifene?

A

selective oestrogen receptor modulator that stimulates oestrogen in bone but blocks them in uterus and breast

39
Q

what is the serum blood test for vitamin D?

A

25-hydroxyvitamin D

40
Q

monitoring in Paget’s

A

ALP

41
Q

two complications of paget’s

A

osteogenic sarcoma (osteosarcoma)
spinal stenosis/ compression
hearing loss

42
Q

first line for Paget’s

A

pamidronate (can have flu-like reaction after first dose)

43
Q

L2 nerve root lesion

A

pain across upper thigh

weak flexion and adduction

44
Q

L3 nerve root lesion

A

pain across lower thigh
weak hip adduciton
weak knee extension

45
Q

L4 nerve root lesion

A

pain across knee to medial malleolus
weak knee extension
foot inversion
dorsiflexion

46
Q

L5 nerve root lesion

A

lateral shin to dorsum of foot and great toe

weak hip extension, abduction, knee flexion, foot and great toe dorsiflexion (foot drop)

47
Q

S1 nerve root lesion

A

pain across posterior calf

weak knee flexion, foot plantar flexion and eversion

48
Q

minor SLE symptom management

A

NSAIDs
hydroxychloroquine
low dose steroids

49
Q

major SLE symptoms

A

steroids

immunosuppressants

Rheumatology (8 decks)

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