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BPT Exam Prep > BPT Rheumatology > Flashcards

BPT Rheumatology Flashcards

1
Q

Anti-ribosomal P antibody association

A

Present in minority of patients with SLE, but highly specific

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2
Q

Anti-fillagrin antibody associations

A

Another name for anti-CCP - rheumatoid arthritis, 90% specificity, 70% sensitivity

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3
Q

Predictors of erosive disease in rheumatoid arthritis

A
    • Erosions at baseline
  • Sustained raised inflammatory markers
  • High number of swollen, tender joints
  • High titre RF and anti-CCP
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4
Q

Novel therapeutics: abatacept

A

CTLA4 linked to IgG, interrupts CD28 and B7 costimulation, preventing T-cell activation by APCs.

Used in RA in MTX-resistant disease, reducing clinical and radiographic progression.

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5
Q

Novel therapeutics: tocilizumab

A

IL-6 receptor antagonist, reduces acute inflammation and cytokine release, osteoclastic activity.
Used in RA
Side effects: reversible cytopaenias, dyslipidaemia, abnormal LFTs

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6
Q

Novel therapeutics: tofacitinib

A

Oral JAK1/3 inhibitor, blocks DNA signalling via STAT impeding cytokine release.
Novel agent being used in MTX-resistant RA

Side effects: neutropenia, abnormal LFTs

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7
Q

Novel therapeutics: anakinra

A

IL-1 receptor antagonist
Limited use in RA - modest effect only
Cannot be combined with TNF inhibitors due to risk of serious infections.

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8
Q

Rheumatoid factor

A

Positive in 70-90% of RA, also in up to 95% Sjogren’s, 40-100% cryoglobulinaemia, 15-35% SLE, 20-75% HBV/HCV.

Indicates a worse prognosis in RA, more severe joint disease, higher risk of rheumatoid nodules, vasculitis.

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9
Q

Anti-CCP

A

90% specificity for RA, 70% sensitivity.

Predictive of RA in asymptomatic patients or in early, undifferentiated arthritis.
Marker of severe erosive disease, but not useful for monitoring disease activity.

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10
Q

Rheumatoid arthritis in pregnancy

A
  • Disease tends to improve during pregnancy
  • Contraindicated: MTX, leflunomide (requires cholestyramide washout)
  • “Safer”: azathioprine, hydroxychloroquine, sulfasalazine, steroids
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11
Q

anti-U1 RNP (ribonucleoprotein)

A

Mixed connective tissue disease

Typically only other raised marker is RF and C3/C4 are reduced

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12
Q

Anti-Ro, anti-La

A

Associated with Sjogren’s syndrome - longer disease duration, more severe lymphocytic infiltrate, extraglandular manifestations.

Anti-Ro positivity in pregnancy associated with risk of congenital complete heart block.

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13
Q

Anti-Jo

A

Polymyositis (anti-synethetase syndrome)
- Myositis and/or ILD and/or chronic articular involvement

  • Mechanic’s hands, Raynaud’s
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14
Q

Anti-histone antibody

A

Present in >95% drug-induced lupus and 50-70% SLE

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15
Q

Anti-Smith (anti-Sm) antibody

A

Present in 20% of SLE but the most specific autoantibody. Does not correlate with disease activity.

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16
Q

Markers of disease activity in SLE

A

Anti-dsDNA; C3/C4 levels ESR less specific

17
Q

Definition of catastrophic antiphospholipid syndrome

A
  • APLS
  • 3+ organ / tissue thromboses within a week
  • Occurs in
18
Q

Anti-Mi2 antibody

A

Dermatomyositis

19
Q

Anti-SRP antibody

A

Polymyositis, associated with more severe disease

20
Q

Features of psoriatic arthritis on clinical findings and X-ray

A

More destructive if older onset. Not as strongly linked to HLABR27

RF neg
Symmetrical: similar to RA but DIP involved
Osteolitis mutilans: osteolysis, joint disolution, pencil in cup, digit telescoping
Spondylitis
Psoriasis
Achilles tendinitis
Finger dactylis
Nails: beau lines, onychilitis, pitting
21
Q

Systemic sclerosis antibodies

A
  • ANA
  • Scl70/topoisomerase1: risk pul fibrosis, poor prognosis
  • Anti RNA polymerase: Dx activity, increased skin involvement/renal crisis
  • Anti Th/To: poor prognosis

CREST
Anti centromere: specificity 95%

22
Q

Arteries involved in PMR/GCA

A 
Ophthalmic
Post ciliary 
Occipital
Vertebral
Carotid
Temporal artery
23
Q

Treatment of

  • RA
  • SLE
  • ank spondylitis
  • psoriasis
  • reactive arthritis
A
  • RA: DMARDs
  • SLE: hydroxychloroquine
  • AS: sulfasalazine (if IBD) adalimumab PO, etanercept IV
  • Ps: MTX, ustekinumab
  • Reactive: tx chlamydia, NSAIDs, topical steroids
24
Q

Ustekinumab

A

Psoriatic arthritis

Anti IL 12 and 23

25
Q

Scleroderma

A

Anti centromere
(limited)

Anti Scl, Anti topoisomerase
(diffuse)

26
Q

SLE

A

ANA
Smith
dsDNA
Ribosomal p (10%, very specific)

27
Q

What conditions are RF positive

A

RA
Sjogren
Cryoglobulinemia

BPT Exam Prep (15 decks)

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