Dermatology and Rheumatology Flashcards by Miranda King

Biopsy finding in pemphigoid

IgG/C3 deposition at the dermo-epidermal junction

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Management of Still’s Disease

NSAIDs in first instance
Steroids
Anakinra/MTX if not improving with steroids

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Mononeuritis multiplex
ANCA +VE

Microscopic Polyangiitis

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Felty’s syndrome

RA, splenomegaly, neutropaenia = classic triad
May also see recurrent infections, lymphadenopathy, leukopaenia, ulcers and episcleritis

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Factors associated with guttate psoriasis

Beta blocker
Lithium
Streptococcus
Viral infection

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Lichen planus
- precipitant
- feature

Can be precipitated by B blockers
Can exhibit Koeber’s phenomenon

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SCC management
- immunosuppressed

Surgery + retinoid
e.g. acitretin - reduces risk of further SCC

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DIP + morning stiffness

Psoriatic arthritis

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Monitoring of MTX

Every 1-2 weeks until they are stable on dose

Then every 2-3 months

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HCQ in Lupus

Avoid in severe renal impairment
e.g. acute lupus
= use IV cyclophosphamide + steroids

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Treatment of PBC

Ursodeoxycholic acid = reduces progression
Cholestyramine = reduces itch by sequestering bile acids

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Erythematous reaction during vancomycin

Red Man Syndrome
= related to rate of vancomycin: not an allergic reaction

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Erythema associated with sunlight, sparing face

Polymorphic light eruption

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Eruption of seborrheic keratoses
- consideration

= Leser-trelat sign
Need to consider malignancy - associated with GI cancer

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Diagnosis of primary Sjogren’s syndrome

Salivary gland biopsy

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Diagnosis of polyarteritis nodosa

Renal angiogram

Management of GCA where steroids cannot be weaned

Methotrexate

Management of Still’s Disease

NSAIDs
- can use steroids if nil response or evidence of organ dysfunction

Biochemical marker in Paget’s Disease

C-telopeptide

What might you see in supraspinatus tendonitis?

Calcified tendon

Diagnostic test for adhesive capsulitis

Clinical diagnosis - no test required

Side effect of dapsone

Agranulocytosis
- need to monitor with FBC

Pain worse on wrist extension and supination

Lateral epicondylitis

Greater than 75
Fragility fracture
- bone protection plan?

Start bisphosphonate
Don’t wait for DEXA

Causes of osteoporosis (2)

Hyperthyroidism Low testosterone

Causes of pyoderma gangrenosum (7)

Idiopathic IBD SLE Rheumatoid arthritis MGUS GPA PBC

Skin sign in reactive arthritis

Keratoderma blenorrhagica = soles of feet, hyperkeratotic plaque, reddish brown

Osteoporosis - when to consider treatment break?

Consider treatment break if <75 years Femoral BMD >2.5 Nil fractures in that time

Management of PMR

15 mg prednisolone Wean over two years (ish)

What should you do with azathioprine in pregnancy?

Continue nil issues

Test for Bechet's disese

Pathergy test

What should you avoid in scleroderma?

Steroids - can trigger renal crisis

What is psoriasis associated with?

Metabolic syndrome

Management options in vitiligo

Phototherapy Topical steroids Topical tacrolimus

anti-RNP antibody

Mixed connective tissue disease - can be positive in SLE (40% of the time)

Management of GCA - any history of visual loss

IV methylprednisolone

Risk factor for pseudogout

Hypomagnesaemia

What is associated with ILD?

Diffuse systemic sclerosis Anti Scl 70 antibody