AMK rheum Flashcards
rheumatoid arthtrits more specific antibody
CCP
specific mean not seen in many other condtions
sensitive most likely to be positive as most senstive to be detected
more sensitive is rheumatoi facotr
if rf negative then look for anti-ccp
do you take methotraxate and folic acid together
no 24hr apart
MX of rheum
1st present
refer to rhuem and NSAID
dont give steriods as can mask sx
confrimed dx
then give steriods for flares and DMARS
DAS28 score
chlamydia synovial joint fluid sample would show what - leads to reactive arthritis
sterile fluid with high WCC
cnat see cant pee cant climb tree
most common cause of septic arthritis
staph a
symmetrical polyarthriits, asymetricla oligoarthritis, dip joitn disease adn nail changes such as pitting adn onycholysis what is seen on xray fro this conditon and what is tx
dmard
when do oyu measure urate post gout
2w
abx for septic arthritis how long
4-6weeks - local guidlines and theatre for joint washout
kochers criteria in children for septic arthrtisi vs transietn synovitis what is the criteria
non-weight bearing
esr over 40
fever over 38.5
wcc over 12000
what ix supports ank spondy
pelvic x ray sacroiltiis
ank spond
mronig stiff
improve with activity
extraarticular features
muscular abck pain presnet slike
pain worse when moving
localised pain
neurological pain
radiates along dermatome
parasethesia
bony pain
worse with movement
neurolgoical sx
most senstiive sle
ANA
most specific autoanitbodu for sle
anti-dsDNA
anti-smith
tx for SLE
hydroxycholorquine and NSAID
derm features of sle
malar rash
discoid rash
cardiac features of sle
pericarditis
myocarditis
raynauds
polymyalgia rheumatica
pain stiffnes in prox muscles
morning stiffness
no weakness
systemic features - fever, fatigue, weight loss
over 60 females
1st line polymyalgia
steriods such as pred
fibromyalgia
pain and fatigue
widespread tender spots
30-50yr female
cbt lifestyle
poly dermatomysositis sx
bilateral proximal muscle pain
weakness
systemic sx and raynauds
females
BLOOC malig
polymyositis autoanitbody
anti-Jo1
gold standard ix is muscl ebiopsy
tx for myositis
steriods
lambert eaton synrome
autoimune agaisnt ca channels - ascending - improves with use
Antibodies to presynaptic voltage gated calcium channels of the P/Q–type
guillian barre syndrome
ascending paraetheisa
peripherla nerve demyeliantion
most appropraite dose for steriods for giant cell arthritis
40-60mg - pred
bone protection?
ppi?
aspirin
visual sx and refer to opahtlomology
bloods in temproal arthritis show
nromocytic mornochormic anaemai and high esr
USS shows hypoechocic halo sign
need biopsy gold
methotraxate how much do you give dose wise weekly
7.5mg
how much folic acid do you co-prescrib ewith methotrexate
5mg
avoid preg for 6m as well as men too
monitor FBC, UandE and LFT ( risk of liver fibrosis)
hydroxychloroquine what major risk
cause bull eys retinopathy - yearly screening
sulfasalazinen se
reduced sperm count
cautions - aspirin allergy and GPD6 def berfore starting
safe in preg and breastfeeeding - one of the onyl
only DMARD safe in preg and breastfeeding
sulfasalazine
