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Question 1

PMR and Polymyositis both present with girdle stiffness - what’s the difference clinically?

What investigation can help?

Answer 1

Polymyositis - weakness as well

PMR - no weakness!!

CK raised in polymyositis

Question 2

What is the management of gout?

How long would you expect it to last?

What can the side effects of medication be?

Answer 2

Gout lasts about 7-10 days - an attack will be exceptionally painful and pt will be unable to weight bear

It will compleltly resolve in between time

At the time manage with NSAIDS/cholchine

Cholchine - severe diarrhoea - some pts will really struggle to tolerate it

Prevention (if more than one attack)
- Allopurinol - keep titrating up until get urate <300

Question 3

In an attack of gout is serum urate raised or reduced?

What is the feature you would see from aspirate?

Answer 3

Reduced as gathering in joint

Needle shaped monosodium urate crystals with negative birefringence

Question 4

How long should warfarin be withheld before operation?

Answer 4

5 dayas

Question 5

There is a venous plexus in the epidural space. T/F

Answer 5

T

Question 6

How long does it take for radiotherapy toxicity appear?
(lung scarring)

Answer 6

6-12wks

Question 7

MoA of methotrexate

Answer 7

Dihydrofolate reductase inhibitor

Question 8

How does performance status work

Answer 8

PS0 = fully active
PS1 = restricted in physically strenuous activity
PS2 = capable of selfceare but unable to carry out work activities, up and about >50% of waking hours
PS3 = capable only limited selfceare and confined to bed/chair >50% of waking hours
PS4 - completed disabled - totally bedbound
PS5 = dead