Communication skills: Rheumatology Flashcards
What questions are relevant in to determine presentation and progression of joint involvement?
- How long have the symptoms been present?
- What joints are involved? (determine pattern)
- Have symptoms progressed? To which joints?
What questions are relevant in to determine the nature of the inflammatory process?
- Is there joint swelling?
- Is there a change of colour round the joints?
- Is there morning stiffness? Are they worse at any other time?
- Better or worse with activity?
What Systemic symptoms should be probed for?
- Fatigue or disturbed sleep?
- Fever?
- Weight loss?
What are the relevant social history questions?
- Difficulties with normal daily activities (Dressing etc)?
- Smoking history?
- Alcohol excess?
- Employed or on disability benefits?
What symptoms would be indicative of bacterial septic arthritis?
- monoarticular arthritis
- red and warm joint
- fevers and chills
- pre-exisiting joint abnormality (prosthetic, RA, OA)
What symptoms are indicative of viral septic arthritis?
-acute polyarticular onset
- <6 weeks duration
-similar sickness at home
+/- rash (Parvovirus)
What features might prompt us towards Rheumatoid arthritis?
- Rheumatoid nodules
- symmetrical involvement of MCP, PIP and MTP joints
- sicca (Sjorgen) features: dry eyes/mouth
- Raynaud’s
- Lung disease
- Occular inflammation
What clues might indicate Gout?
- past/family history
- diuretic use
- alcohol excess
- renal impairment
- hypertension, obesity, insulin resistance, hypercholesteraemia
RA patients have an increased of peptic ulcer disease. What drugs should be avoided?
NSAIDs
What questions should be asked in Rheumatological consultation?
-Joint pain?
-Joint stiffness?
-Difficulty getting dressed?
-Problems w/ stairs?
Symptoms:
-Deformity?
-Pain?
-Stiffness?
-Swelling?
-Redness?
-Hot?
-Locking?
-Giving way?
