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MSK Revision > Autoimmune and Systemic MSK Conditions > Flashcards

Autoimmune and Systemic MSK Conditions Flashcards

1
Q

What is Polymyalgia Rheumatica?

A

This is essentially a systemic vasculitis owing to inflammation of the vessels

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2
Q

What type of arthritis is it?

A

Giant Cell arteritis

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3
Q

What is the prevalence of this disease?

A

This affects mainly the over 50’s with a F:M of 2:1

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4
Q

What is the classical presentation of the disease?

A

Sudden onset of severe pain and stiffness in the morning lasting longer than 45 minutes usually affecting the shoulder, hips and lumbar spine

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5
Q

What HALLMARK symptom do the NOT show?

A

No weakness

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6
Q

What systemic symptoms do people with PR have?

A 
Tiredness
Apetite loss
Weight loss
Depression 
Fever
Malaise
Noctuanl sweats
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7
Q

What are the main investigations of PR?

A

Raised ESR and CRP
FBC shows anaemia
temporal artery biopsy
CK is normal as the differential is myopathy

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8
Q

What is the main management of PR?

A

Corticosteroids = prednisone

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9
Q

What is giant cell arteritis ?

A

This is a granulomatous inflammation of the superficial femoral or occipital arteries

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10
Q

How does a person present with GCA?

A 
Headache over one area
Pain in the same area
Tenderness
Jaw claudication 
Painless temporary loss of vision
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11
Q

What is the diagnostic test for GCA?

A

Temporal artery biopsy

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12
Q

What is the treatment for GCS?

A

Start ASAP on prednisone to prevent blindness

Step dow the steroids within 2 years

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13
Q

What does SLE stand for?

A

Systemic lupus erythematous

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14
Q

What is SLE and what are the 4 key features of the disease?

A

This is a systemic chronic autoimmune condition which shows 4 key factors:

  1. Inflammation
  2. Fibrosis and scarring
  3. Vasospasm
  4. Vascualar thrombosis
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15
Q

Who tends to present with SLE?

A

women of reproductive age

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16
Q

What are the causes of SLE?

A

Genetics
UV light
Premenopausal

17
Q

What are the 11 criteria of SLE?

How many do you need to have to have the condition?

A 
Mary          Macular Rash 
Did            Discoid rash
Pass          Photosensitivity 
Over          Oral ulcers
All              Arthritis 
Somewhat  Serositis
Risky          Renal issues
Now           Neuro - psychiatric/ seizures 
Having       Haematological = low platelets, WCC anaemia
Incredible  Immunology 
Adventures ANA+
18
Q

What are the key investigations in SLE?

A 
ANA testing 
Urine dip
FBC
Immunological testing 
Anti-dsSNA
19
Q

What is the management of SLE?

A 
Flare = IV prednisolone and cyclophosphamide
Skin issues with topic steroids 
Maintenance with NSAID's 
Immunosupressnats 
Biologica 
Check renal function
20
Q

What is systemic sclerosis otherwise known as?

A

Scleroderma

21
Q

What is scleroderma?

A

This is a chronic multi-system disorder that is autoimmune has family links

22
Q

What are the 5 clinical features of Scleroderma?

A 
Calcinosis 
Reynauds
Esophageal dysmotility
SSkin thickening 
Telangiectasia
23
Q

What re some of the associated features of scleroderma?

A 
Mouth ulcers 
Dry eyes
Dry mouth 
Hair loss
Ulcers
24
Q

What are the key investigations in scleroderma?

A

Autoantibodies - ANA
Anti-centromere antibodies
Anti - SCL - antibodies

25
Q

What is the management?

A 
Very much dependant on the type of symptoms
Asprin, CCB
Topicals
Ulcer care
Coticosteroids 
PPI, ACEi
26
Q

What is Sjorgen’s syndrome?

A

This is an autoimmune condition causing fibrosis and infiltration of the exocrine glands causing lack of lacrimal and salivary secretions

27
Q

What are the diagnostic features?

A

In the absence of RA, dry eyes is diagnostic, especially in females

28
Q

What are some of the features of SS?

A 
Dry eyes, mouth and vagina
Parotid gland enlargement
Athralgia
Reynauds
Dysphagia
Pulmaory fibrosis
29
Q

What test are you going to do in SS?

A

Schirmer test = filter paper under eyelid

Sjorgen autoantibody

30
Q

What is the treatment of Sjorgens?

A

Artificial tears

Hydroxychoroquine

31
Q

What is Dermato/polymyositis

A

this is a rare disorder of unknown cause which caused inflammation of the striated muscle causing proximal muscle weakness

32
Q

What are the 4 clinical features?

A

Skin itching
Muscle weakness
Dysphagia
Athralgia

33
Q

What are the diagnostic tests?

A

Serum CK increase
EMG
Muscle biopsy

34
Q

What are you going to do for them?

A

Prednisolone IV

Suncream

MSK Revision (14 decks)

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