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Rheumatology (2) > Arthritides (Inflammatory + Non-Inflammatory) > Flashcards

Arthritides (Inflammatory + Non-Inflammatory) Flashcards

1
Q

What is an arthritide?

A

Umbrella term for conditions causing inflammation and degradation of the joint which can include non-inflammatory (OA), inflammatory seropositive (RA) or inflammatory seronegative (psoriatic; crystal arthropathy; reactive; ankylosing spondylitis; enterohepatic arthritis)

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2
Q

How can arthritis be classified?

A
  • Degenerative
  • Inflammatory
  • -> Seropositive

–> Seronegative

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3
Q

Anti-CCP is pathognomonic of?

A

RA

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4
Q

Anti-Centromere is pathognomonic of?

A

Systemic sclerosis (limited)

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5
Q

Anti-Scl70 is pathognomonic of?

A

Systemic sclerosis (diffuse)

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6
Q

RF is pathognomonic of?

A

RA

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7
Q

ANA is pathognomonic of?

A

SLE; Sjogrens; Systemic Sclerosis; MCTD

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8
Q

dsDNA is pathognomonic of?

A

SLE

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9
Q

Anti-SM is pathognomonic of?

A

SLE

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10
Q

Anti-RO is pathognomonic of?

A

Sjogrens

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11
Q

Anti-LA is pathognomonic of?

A

Sjogrens

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12
Q

Anti-RNP is pathognomonic of?

A

Sjogrens

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13
Q

Anti-Jo is pathognomonic of?

A

Myositis

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14
Q

ANCA is pathognomonic of?

A

Small-vessel vasculitis (GPA; EGPA; MPA)

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15
Q

Give 5 risk factors for OA

A
  • Advanced age: > 50 years
  • Female sex
  • Genetic factors
  • Obesity
  • Knee malalignment: Varus thrust
  • Physically demanding sport
  • Occupation
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16
Q

56 year old woman presents with unilateral R sided knee pain. She describes pain beginning insidiously over several years. She has morning stiffness which worsens on exercise.

You note bony deformities on her hands, a reduced range of movement, crepitus and effusion.

She says she used to play a lot of volleyball and has a BMI of 32.

Her XR-Knee shows osteophytes and marked JSN.

Give your ddx.

A

Knee OA

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17
Q

56 year old woman presents with unilateral R sided knee pain. She describes pain beginning insidiously over several years. She has morning stiffness which worsens on exercise.

You note bony deformities on her hands, a reduced range of movement, crepitus and effusion.

She says she used to play a lot of volleyball and has a BMI of 32.

Her XR-Knee shows osteophytes and marked JSN.

What K-L classification is she?

A

KL 3

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18
Q

56 year old woman presents with unilateral R sided knee pain. She describes pain beginning insidiously over several years. She has morning stiffness which worsens on exercise.

You note bony deformities on her hands, a reduced range of movement, crepitus and effusion.

She says she used to play a lot of volleyball and has a BMI of 32.

What is your initial management?

A 
Medical Management
•	Supportive: Education/ Self-management/ Exercise/ Weight-loss
\+
•	Topical Analgesia: Diclofenac 
\+
•	Oral analgesia: Paracetamol

± (Acute exacerbations)
• IA Steroid: Methylprednisolone
-> Every 6 months

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19
Q

56 year old woman presents with unilateral R sided knee pain. She describes pain beginning insidiously over several years. She has morning stiffness which worsens on exercise.

You note bony deformities on her hands, a reduced range of movement, crepitus and effusion.

She says she used to play a lot of volleyball and has a BMI of 32.

She goes away with NSAIDs and an IA injection 6 months later. After 4 years she presents with XR-Knee changes KL-4 and marked pain limiting her ADL.

What is your management?

A

• Surgery: Total Joint Replacement
±
• Analgesia: Paracetamol + Capsaicin topical + Ibuprofen + Tramadol
± (chronic NSAID use)
• Gastroprotection: Omeprazole/Esomeprazole

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20
Q

Give a RF for SLE

A
  • Female sex
  • Young onset: 15-45 years
  • Drugs: Procainamide/Sulfasalazine/Isoniazid/ Phenytoin/ Carbamazepine
  • Infection: EBV
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21
Q

A 23 year old female reports headaches, fatigue and weight loss. She also reports recent joint pain. She has no fever or recent infection.

O/E she has a butterfly rash on her cheeks, is tender on abdominal palpation. Her MSK exam is normal but there is reduced ROM in the MCPs, PIPs and DIPs.

A urinalysis shows no abnormalities. FBC shows anemia (normal MCV), neutropenia and thrombocytopenia. Coombs test is positive. Antibodies show positive ANA, Anti-RNP, Anti-Ro.

Give your DDx.

A

SLE

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22
Q

A 23 year old female reports headaches, fatigue and weight loss. She also reports recent joint pain. She has no fever or recent infection.

O/E she has a butterfly rash on her cheeks, is tender on abdominal palpation. Her MSK exam is normal but there is reduced ROM in the MCPs, PIPs and DIPs.

A urinalysis shows no abnormalities. FBC shows animi (normal MCV), neutropenia and thrombocytopenia. Coombs test is positive. Antibodies show positive ANA, Anti-RNP, Anti-Ro.

Outline your management plan.

A 
•	Anti-malarial: Hydroxychloroquine 
\+
•	NSAIDs: Ibuprofen/Naproxen
\+
•	Corticosteroids: Prednisolone
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23
Q

A 23 year old female reports headaches, fatigue and weight loss. She also reports recent joint pain. She has no fever or recent infection.

O/E she has a butterfly rash on her cheeks, is tender on abdominal palpation. Her MSK exam is normal but there is reduced ROM in the MCPs, PIPs and DIPs.

A urinalysis shows no abnormalities. FBC shows animi (normal MCV), neutropenia and thrombocytopenia. Coombs test is positive. Antibodies show positive ANA, Anti-RNP, Anti-Ro.

Following several months of Hydroxychloroquine, Prednisolone and NSAIDs, she develops systemic disease with D+V, polyneuropathy and pleural effusion.

How would your management differ?

A 
•	Anti-malarial: Hydroxychloroquine 
\+
•	NSAIDs: Ibuprofen/Naproxen
\+
•	Corticosteroids: Prednisolone

± (Systemic disease)
• Immunosuppressants: Azathioprine/ Mycophenolate mofetil

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24
Q

A 23 year old female reports headaches, fatigue and weight loss. She also reports recent joint pain. She has no fever or recent infection.

O/E she has a butterfly rash on her cheeks, is tender on abdominal palpation. Her MSK exam is normal but there is reduced ROM in the MCPs, PIPs and DIPs.

A urinalysis shows no abnormalities. FBC shows animi (normal MCV), neutropenia and thrombocytopenia. Coombs test is positive. Antibodies show positive ANA, Anti-RNP, Anti-Ro.

Following several months of Hydroxychloroquine, Prednisolone and NSAIDs, she develops glomerulonephritis.

What would you do to manage this?

A

Severe Organ Disease
• IV Steroids
+
• Cyclophosphamide

25
Q

Should a patient become unresponsive on a background diagnosis of SLE, how would you manage this?

A

• IVIG
+
• Biologics: Ritixumab
-> TNF-a inhibitor

26
Q

A middle aged woman presents with dry eyes, dry mouth and erythema at the angle of the mouth.

She has no notable PMHx but a FHx of autoimmune conditions.

O/E you note xerostomia, kertaoconjunctiva sicca and angular stomatitis.

A Schirmer’s test is positive and Sialometry shows reduced flow. Additionally, the following antibodies are present Anti-Ro, Anti-La.

Give your DDx.

A

Sjogrens

27
Q

A middle aged woman presents with dry eyes, dry mouth and erythema at the angle of the mouth.

She has no notable PMHx but a FHx of autoimmune conditions.

O/E you note xerostomia, kertaoconjunctiva sicca and angular stomatitis.

A Schirmer’s test is positive and Sialometry shows reduced flow. Additionally, the following antibodies are present Anti-Ro, Anti-La.

Give your management

A
  • Artificial tears/lubricating eye drops

* Pilocarpine- can stimulate salivary gland production (however also produces flushing)

28
Q

A middle aged woman presents with dry eyes, dry mouth and erythema at the angle of the mouth. She reports joint pain and fatigue.

She has no notable PMHx but a FHx of autoimmune conditions.

O/E you note xerostomia, kertaoconjunctiva sicca and angular stomatitis.

A Schirmer’s test is positive and Sialometry shows reduced flow. Additionally, the following antibodies are present Anti-Ro, Anti-La.

Give your management

A
  • Artificial tears/lubricating eye drops
  • Pilocarpine- can stimulate salivary gland production (however also produces flushing)
  • Hydroxychloroquine can help with arthralgia and fatigue
29
Q

A 25 year old female presents with reflux and heartburn. Additionally, she reports extreme cold in the peripheries when it is cold outside. Furthermore, she reports joint pain.

O/E you identify a slow CRT, patient is haemodynamically stable. S1, S2 present and lung fields are clear. No abdominal tenderness and bowel sounds are present.

FBC is normal as is U+Es. Abs show positive Anti-Centromeres and no Anti-Scl70.

Give your Ddx and Tx.

A

Limited Scleroderma

Raynaud’s phenomenon
• Supportive: Exercise/Warmth
+
• CCB: Nifedipine

GI
• PPI: Omeprazole/ Esomeprazole

Myopathy/ Synovitis/ Arthritis
• Oral corticosteroid: Prednisolone

30
Q

A 25 year old female presents with reflux and heartburn. Additionally, she reports extreme cold in the peripheries when it is cold outside. Furthermore, she reports joint pain. Additionally she reports an insidious cough and SOBE.

She has no notable PMHx and is not a smoker.

O/E you identify a slow CRT, patient is haemodynamically stable. S1, S2 present and lung fields bear bibasal rales. No abdominal tenderness and bowel sounds are present.

A urinalysis shows haematuria. FBC is normal as is U+Es show sCr elevated and a depleted eGFR. Abs show positive Anti-Centromeres and Anti-Scl70. AAT1 is negative. A PFT shows a restrictive picture with FEV1/FEVC > 0.7

Give your Ddx and Tx.

A

Diffuse Scleroderma

Raynaud’s phenomenon
• Supportive: Exercise/Warmth
+
• CCB: Nifedipine

GI
• PPI: Omeprazole/ Esomeprazole

Interstitial lung disease
•	Immunomodulator: Cyclophosphamide/Mycophenolate mofetil/Azathioprine
\+ 
•	Oral corticosteroid: Prednisolone 
\+
•	Oxygen

Renal Crisis
• ACEi: Captopril/ Enalapril/ Lisinopril
+
• Antihypertensives: CCBs (Lercanidipine)

31
Q

A 32 year old pregnant woman presents with facial droop with forehead sparing as well as chest pain. She has a PMHx of MI at 28 and recurrent miscarriages. She is G3+P0. The previous causes of miscarriage are unknown.

O/E you identify she has a murmur, she is tachycardic at 100bpm, her BP is 130/90mmHg and she has hepatomegaly as well as hepatic bruits.

Her FBC shows thrombocytopenia, APTT is increased. Antibodies are positive for Lupus Anticoagulant.

What is your DDx?

A

Antiphospholipid syndrome

32
Q

A 32 year old pregnant woman presents with facial droop with forehead sparing as well as chest pain. She has a PMHx of MI at 28 and recurrent miscarriages. She is G3+P0. The previous causes of miscarriage are unknown.

O/E you identify she has a murmur, she is tachycardic at 100bpm, her BP is 130/90mmHg and she has hepatomegaly as well as hepatic bruits.

Her FBC shows thrombocytopenia, APTT is increased. Antibodies are positive for Lupus Anticoagulant.

Give your Tx

A

• COX-1i: Aspirin 75mg

± (Thrombotic event)
• Anticoagulant: Warfarin

33
Q

45 year old female presents with muscle weakness, arthralgia and SOB.

She has no notable PMHx, no FHx and DHx of paracetamol for the joint pain.

O/E she has reduced range of movement in her joints, a rash on her eyelids and a V-shaped rash on her neck.

Her CK and ALT is elevated, ESR is raised and an MRI of her shoulders show muscle inflammation. Autoantibodies are positive for Anti-Jo1.

Give your DDx.

A

Polymyositis and Dermatomyositis

34
Q

45 year old female presents with muscle weakness, arthralgia and SOB.

She has no notable PMHx, no FHx and DHx of paracetamol for the joint pain.

O/E she has reduced range of movement in her joints, a rash on her eyelids and a V-shaped rash on her neck.

Her CK and ALT is elevated, ESR is raised and an MRI of her shoulders show muscle inflammation. Autoantibodies are positive for Anti-Jo1.

Give your Tx.

A

Acute
• Oral corticosteroids: Prednisolone 1/12
–> Taper down

Chronic
• Immunosuppressive therapy: Azathioprine/ Methotrexate/ Ciclosporin

35
Q

A 43 year old female presents with heartburn, dyspnoea and a cough. She reports recent arthralgia which is polyarthrritic and affecting smaller joints. She has no notable PMHx although inflammatory conditions are present in her FHx. She also reports cold peripheries in the Winter when outside. .

She has an unremarkable DHx other than Paracetamol BDS for the pain.

O/E you identify reduced ROM at the MCP, PIP, DIP joints however patient is has normal neurovascular function. Her cough is non-productive and her lung fields are clear. The abdomen is tender, with no palpable masses and bowel sounds are present.

Her FBC shows leukopenia and thrombocytopenia as well as CRP and ESR raised. She has autoantibodies of: Anti-Scl70, Anti-Jo and ANA.

Give your DDx

Outline your Tx.

A

Mixed Connective Tissue Disease (Overlap Syndrome)

  • CCBs: Nifedipine -> Raynaud’s
  • NSAIDs: Ibuprofen/Naproxen -> Arthritis
  • PPI: Omeprazole -> GORD
  • Immunosuppressants: Methotrexate -> Pulmonary disease
36
Q

A 35 year old woman presents with arthralgia in her fingers and toes. The pain is worse in the morning, with stiffness for 2 hours. It gets better with mobility. Additionally, she has a cough and reports having this cough for 9 weeks. She is a non-smoker with no family history of cancer. She reports constitutional symptoms of fatigue and weight loss.

She takes no medication other than paracetamol for the pain.

O/E you identify erythema of the joints which are hot and tender. There is a reduced ROM. You identify a Swan-Neck deformity on the DIP and PIP. Her S1 and S2 are present, no murmur and she is haemodynamically stable. Lung fields are clear.

Antibodies show Anti-CCP and RF positive. XR-Hand shows erosions.

Give your Ddx and Tx.

A

RA

• DMARDs: Methotrexate/ Sulfasalazine/ Leflunomide

±
• Corticosteroid: Prednisolone
+
• NSAID: Ibuprofen/Naproxen/ Diclofenac

37
Q

A 32 year old pregnant woman presents with arthralgia in her fingers and toes. The pain is worse in the morning, with stiffness for 2 hours. It gets better with mobility. Additionally, she has a cough and reports having this cough for 9 weeks. She is a non-smoker with no family history of cancer. She reports constitutional symptoms of fatigue and weight loss.

She takes no medication other than paracetamol for the pain.

O/E you identify erythema of the joints which are hot and tender. There is a reduced ROM. You identify a Boutonniere deformity on the DIP and PIP. Her S1 and S2 are present, no murmur and she is haemodynamically stable. Lung fields have bibasal rales.

Antibodies show Anti-CCP and RF positive. XR-Hand shows erosions.

Give your Ddx and Tx.

A

RA

Pregnancy
• Corticosteroid: Prednisolone

38
Q

What symptomatic triad encompasses Budd-Chiari syndrome?

A

Abdo pain + Ascites + Hepatomegaly

39
Q

What is Felty’s Syndrome?

A

RA + Splenomegaly + Neutropenia

40
Q

List the Calin Criteria.

A
  • Age < 40 years
  • Back pain > 3 months
  • Insidious onset
  • Improves with exercise
  • Early morning exercise
41
Q

A 22 year old male presents with lower back pain. He describes it as a 7/10, localised to his lower back (SI region), bilaterally with a slow onset 4/12. The pain is worst in morning and improves with mobility.

He has no notable PMHx other than asthma which is controlled. He does not take any drugs other than his Salbutamol PRN.

He has a FHx of RA.

O/E you identify the localised pain, a reduced ROM, a kyphosis and SI joint tenderness. There is a positive Schobers test.

His CRP is raised, negative for RF and anti-CCP. His XR shows erosions, sclerosis and sacroiliitis.

Give your Ddx and Tx.

A

Ankylosing Spondylitis

• Supportive: Stretches/ Group sessions/ Assess for CV risk
+
• NSAIDs: Naproxen/ Ibuprofen

± (Local IA inflammation/enthesitis)
• IA Corticosteroid injection: Hydrocortisone

± (Peripheral joint involvement)
• DMARDs: Sulfasalazine

± (Persistent pain refractory to 2 NSAIDs)
• Biologics: Adalimumab/ Infliximab/ Etanercept
-> TNF-a inhibitors

42
Q

What form of arthritis is associated with Psoriasis?

A

Psoriatic Arthritis

43
Q

A 34 year old lady presents with joint pain, a uniform swelling of the entire index finger. The joint pain is described as 7/10, worst in morning, improving with use and worsened with rest.

She has a PMHx of Psoriasis and Asthma which is controlled. She has DHx of Salbutamol PRN and topical steroids. She NKDA.

O/E she has plaques on the extensor surfaces of her shins, knees and elbows. The MCPs, DIPs and PIPs have reduced ROM.

Arthrocentesis is sterile. RF is negative and anti-CCP is negative. XR-Hand shows pencil-in-cup deformity and osteophyte formation.

Give your Ddx and Tx.

A

• Supportive: Physiotherapy
+
• NSAIDs: Naproxen/ Ibuprofen/ Diclofenac

44
Q

A 34 year old lady presents with joint pain, a uniform swelling of the entire index finger. The joint pain is described as 7/10, worst in morning, improving with use and worsened with rest.

She has a PMHx of Psoriasis and Asthma which is controlled. She has DHx of Salbutamol PRN and topical steroids. She NKDA.

O/E she has plaques on the extensor surfaces of her shins, knees and elbows. The MCPs, DIPs and PIPs have reduced ROM. Additionally, the knees are showing reduced extension and flexion ROM as well as synovitis.

Arthrocentesis is sterile. RF is negative and anti-CCP is negative. XR-Hand shows pencil-in-cup deformity and osteophyte formation.

Give your Ddx and Tx.

A

Progressive peripheral joint disease
• Supportive: Physiotherapy
+
• NSAIDs: Naproxen/ Ibuprofen/ Diclofenac
+
• DMARDs: Sulfasalazine/ Methotrexate/ Leflunomide
+
• IA Corticosteroid injection: Methylprednisolone

±
• Biologics: Etanercept/ Infliximab/ Rituximab

45
Q

A 34 year old man presents with arthralgia in his knee. The pain is a 7/10 localised to the knee, worsened on stationary and improved on mobility. He reports a burning sensation in his penis as well as a rash there. Additionally, he has had some red eyes. He has no notable PMHx. He has NKDA. His DHx is unremarkable. He has had no foreign travel recently or risky behaviour other than unprotected sex with 4 partners in the last 2 months.

O/E he is haemodynamically stable, no fever, no tenderness. His knee is painful and has reduced ROM. He has a non-tender, palpable abdomen with normal bowel sounds. His penis has ulcers on the glans. Additionally, there are vesicular lesions on his volar surfaces. His scrotum and PR are normal.

An arthrocentesis is sterile and his FBC is normal with RF being negative.

What is your Ddx?

A

Reactive arthritis

Reiter’s Syndrome

46
Q

A 34 year old man presents with arthralgia in his knee. The pain is a 7/10 localised to the knee, worsened on stationary and improved on mobility. He reports a burning sensation in his penis as well as a rash there. Additionally, he has had some red eyes. He has no notable PMHx. He has NKDA. His DHx is unremarkable. He has had no foreign travel recently or risky behaviour other than unprotected sex with 4 partners in the last 2 months.

O/E he is haemodynamically stable, no fever, no tenderness. His knee is painful and has reduced ROM. He has a non-tender, palpable abdomen with normal bowel sounds. His penis has ulcers on the glans. Additionally, there are vesicular lesions on his volar surfaces. His scrotum and PR are normal.

An arthrocentesis is sterile and his FBC is normal with RF being negative.

What eponymous syndrome is exhibited?

A

Reiters Syndrome

47
Q

A 34 year old man presents with arthralgia in his knee. The pain is a 7/10 localised to the knee, worsened on stationary and improved on mobility. He reports a burning sensation in his penis as well as a rash there. Additionally, he has had some red eyes. He has no notable PMHx. He has NKDA. His DHx is unremarkable. He has had no foreign travel recently or risky behaviour other than unprotected sex with 4 partners in the last 2 months.

O/E he is haemodynamically stable, no fever, no tenderness. His knee is painful and has reduced ROM. He has a non-tender, palpable abdomen with normal bowel sounds. His penis has ulcers on the glans. Additionally, there are vesicular lesions on his volar surfaces. His scrotum and PR are normal.

An arthrocentesis is sterile and his FBC is normal with RF being negative.

Give your likely causative pathogen.

A

C. trachomatis

48
Q

A 34 year old man presents with arthralgia in his knee. The pain is a 7/10 localised to the knee, worsened on stationary and improved on mobility. He reports a burning sensation in his penis as well as a rash there. Additionally, he has had some red eyes. He has no notable PMHx. He has NKDA. His DHx is unremarkable. He has had no foreign travel recently or risky behaviour other than unprotected sex with 4 partners in the last 2 months.

O/E he is haemodynamically stable, no fever, no tenderness. His knee is painful and has reduced ROM. He has a non-tender, palpable abdomen with normal bowel sounds. His penis has ulcers on the glans. Additionally, there are vesicular lesions on his volar surfaces. His scrotum and PR are normal.

An arthrocentesis is sterile and his FBC is normal with RF being negative.

Give the Tx for this.

A

Acute episode
• NSAID: Naproxen/ Ibuprofen/ Diclofenac

Repeated episodes
• DMARD: Sulfasalazine

49
Q

What syndrome is characterised by urethritis, conjunctivitis and arthritis?

A

Reiter’s Syndrome

50
Q

A 35 year old female presents with arthralgia. The pain is in her MCPs and knee (oligoarthritis) and is worse in the morning, and gets better with mobilisation. She has NKDA and takes paracetamol for the pain.

She has a PMHx of Ulcerative Colitis for which she takes Sulfasalazine.

Her arthrocentesis is sterile, RF is negative and XR shows erosions.

Give your DDx and Tx

A

Enterohepatic arthritis

•	DMARD: Methotrexate/ Sulfasalazine/ Leflunomide 
±
•	Corticosteroids: Prednisolone 
±
•	Analgesia: Ibuprofen/ Naproxen
51
Q

Give 3 RFs for Gout

A
  • Older age
  • Male
  • Consumption of meat, seafood and alcohol
  • Use of diuretics
  • Drugs: Cyclosporine (urate reabsorption)/ Pyrazinamide (urate reabsorption)/ NSAIDs (reduce GFR)
52
Q

Name 3 drugs which may cause Gout.

A

Drugs: Cyclosporine (urate reabsorption)/ Pyrazinamide (urate reabsorption)/ NSAIDs (reduce GFR)

53
Q

A 54 year old male presents with severe pain in his 1st MTP joint with a rapid onset. It is relieved by pain relief. There is stiffness in the joint.

He has no notable PMHx. He is a smoker of 16 pack years and drinks 24 units a week - mainly in red wine.

His arthrocentesis shows needle-shaped crystals with no RF or anti-CCP.

Give your DDx and Tx

A

Gout

• NSAIDs: Naproxen/Ibuprofen/Diclofenac/ Celecoxib

54
Q

A 54 year old male presents with severe pain in his 1st MTP joint with a rapid onset. It is relieved by pain relief. There is stiffness in the joint.

He has no notable PMHx. He is a smoker of 16 pack years and drinks 24 units a week - mainly in red wine.

His arthrocentesis shows needle-shaped crystals with no RF or anti-CCP.

He was previously treated once before for a similar flair up but it did not work

Give your DDx and Tx

A

Gout

Colchicine

55
Q

A 54 year old male presents with severe pain in his 1st MTP joint with a rapid onset. It is relieved by pain relief. There is stiffness in the joint.

He has no notable PMHx. He is a smoker of 16 pack years and drinks 24 units a week - mainly in red wine.

His arthrocentesis shows needle-shaped crystals with no RF or anti-CCP. This is now his 3rd episode of this condition and this is 4 weeks following his first presentation.

Give your DDx and Tx

A

Gout

Recurrent gout: 2-3 weeks post acute episode
• Xanthine oxidase inhibitors: Allopurinol
 Inhibit XO enzyme to reduce uric acid production
+
• Uric Acid Transporter Inhibitor: Lesinurad
+
• NSAIDs: Naproxen/Ibuprofen/Diclofenac/ Celecoxib

56
Q

Give 3 RFs of Pseudogout

A
  • Advanced age
  • FHx of CPPD
  • Hypomagnesemia
  • Hypophosphatemia
  • Hyperparathyroidism
  • Wilson’s Disease
57
Q

Give the finding on arthrocentesis of pseudogout

A

• Arthrocentesis: Rhomboid-shaped crystals

58
Q

Give the Tx for Pseudogout

A

Acute
• NSAIDs: Naproxen/ Diclofenac
±
• Analgesia: Paracetamol

± (Monoarticular disease)
• IA Corticosteroids: Dexamethasone

Chronic
•	Surgery: Joint replacement 
±
•	NSAIDs: Naproxen/ Diclofenac
± 
•	Analgesia: Paracetamol

Rheumatology (2) (5 decks)

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