CPR #17 Rheum

Question 1

anky spon and IBD usually affect what size joints?

Answer 1

larger joints

Question 2

what are some seronegative polyarthropathies

Answer 2

ankylosing spondylitis, IBD, REactive arthritis

Question 3

White cell count in Rheumatoid? in blood?

Answer 3

leukopaenia

Question 4

how to check for kidney damage in RA without biopsy?

Answer 4

MSU for haematuria

look for casts

Question 5

why do LFTs in RA?

Answer 5

check if their liver is ok to handle RA treatment

Question 6

what can you see on RA x-ray?

Answer 6

periarticular erosions
osteopaenia
subluxations
fluffy erosion(RA)
DIP sparing
soft tissue swelling

Question 7

What disease has arthralgia but no swelling?

Answer 7

lupus

Question 8

Lupus monitoring investigations?

Answer 8

FBE: Hb, lymphopaenia, ESR, CSR
ANA (not usually vary), Anti-ds-DNA (correlated, down with good Rx)
Kidney Function: MSU
bone density: d/t steroids, might need Vit. D
cholesterol: atherosclerosis
immuno-suppression/infection

Question 9

principles of management for lupus

Answer 9

sunscreen
immunosuppression: steroids/biologics
lupus nephritis

Question 10

what happens when you stop steroids too fast?

Answer 10

electrolyte abnormalities
become Addisonian (fatigue etc.)
any stress, won’t have extra cortisol surge: infection

Question 11

what happens if you’re on steroids long term and you get sick?

Answer 11

steroid action plan: if you become sick, then give extra steroids to mimic physiological response