Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK+rheumatology > diseases > Flashcards

diseases Flashcards

1
Q

what is rheumatoid arthritis

A

autoimmune condition that causes chronic inflammation of the synovial lining of the joints, tendon sheaths and bursa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

genetic associations of rheumatoid arthritis

A

HLA DR4

HLA DR1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

antibodies associated with rheumatoid arthritis

A

rheumatoid factor present in 70% of RA patients

anti-CCP antibodies are autoantibodies that are more specific to rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

presentation of rheumatoid arthritis

A

pain swelling stiffness
symmetrical distal polyarthropathy
fatigue, weight loss, flu like illness
pain worse after rest but improves with activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

common joints affected by rheumatoid arthritis

A 
PIP joints
MCP joints 
wrist and ankle 
metatarsophalangeal joints
cervical spine 
large joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

atlantoaxial ubluxation

A

occurs in the cervical spine

can cause spinal cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

signs of rheumatoid arthritis in the hands

A

palpation of the synovium feels boggy
z shaped deformity to the thumb
swan neck deformity
boutonnieres deformity- due to a tear in the central slip of the extensor componenets of the fingers
ulnar deviation of the fingers at the knuckle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

extra-articular manifestations of rheumatoid arthritis

A 
pulmonary fibrosis 
bronchiolitis obliterans 
felty's syndrome (RA, neutropenia, splenomegaly) 
secondary sjogrens syndrome 
CV disease
episcleritis and scleritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

investigations of rheumatoid arthritis

A

check RF and anti-CCP
inflammatory markers such as CRP and ESR
X ray of hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Xray changes in RA

A

joint destruction and deformity
soft tissue swelling
periarticular osteopenia
boney erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

management of RA

A

short term- NSAIDS/COX-2 inhibitors
first line: methotrexate, leflunomide or sulfasalazine
second line: two in combination
third line: methotrexate plus biological therapy usually TNF inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is psoriatic arhtritis

A

inflammatory arthritis associated with psoriasis

seronegative spondyloarthropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

presentation of asymmetrical pauciarthritis

A

affects mainly the digits and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

spondylitic pattern presents

A 
more commonly in men
back stiffness 
sacroiliitis 
atlanto-axial joint involvement 
(spine, achilles tendon, plantar fascia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

signs of psoriatic arthritis

A 
plaques of psoriasis 
pitting of nails 
onycholysis 
dactylitis 
enthesitis 
eye disease 
aortitis 
amyloidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

xray changes in psoriatic arthritis

A 
periostitis 
ankylosis 
osteolysis 
dactylitis 
pencil in cup appearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

management of psoaritic arthritis

A

NSAIDS for pain
DMARDs
anti-TNF medications
ustekinumab last line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is reactive arthritis

A

synovitis occurs in the joints as a reaction to a recent infective trigger
typically causes an acute monoarthritis, affecting a single joint in the lower limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

most common infections that trigger reactive arthritis

A

gastroenteritis or chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

associated conditions with reactive arthritis

A

bilateral conjunctivitis
anterior uveitis
circinate balanitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

management of reactive arthritis

A

given antibiotics until septic arthritis is excluded
aspirate the joint and sample for gram staining, culture and sensitivity
NSAIDs
steroid injections
systemic steroids may be required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is ankylosing spondylitis

A

inflammatory condition mainly affecting the spine that causes progressive stiffness and pain
part of seronegative spondyloarthropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

key joints affected in AS

A

sacroiliac joints and joints of the vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

presentation of AS

A

young adult male
symptoms develop gradually over 3 months
lower back pain and stiffness and sacroiliac pain
worst with rest and improves with movement
worse at night
flares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

systemic presentation of AS

A 
weight loss and fatigue 
chest pain 
enthesitis 
dactylitis 
anaemia 
anteror uveitis 
aoritis 
IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

schober’s test

A

used to examine AS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

investigations for AS

A

inflammatory markers
HLA B27 genetic test
Xray of spine and sacrum
MRI of the spine can show bone marrow oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

management of AK

A

NSAIDs
steroids can be used durinng flares
anti-TNF medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

bisphosphonates

A

used to prevent or slow done bone thining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is SLE

A

inflammatory autoimmune connective tissue disease

relapsing-remitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

pathophysiology of SLE

A

characterised by anti-nuclear antibodies (antibodies to proteins within own cell nucleus)
causes immune system to target these proteins
generates inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

presentations of SLE

A 
fatigue and weight loss 
arthralgia and non-erosive arthritis 
myalgia 
fever
photosensitive malar rash (buttergly)
lymphadenopathy and splenomegaly 
SOB 
mouth ulcers 
hair loss 
raynaud's phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

investigations for SLE

A

autoantibodies
FBC
CRP and ESR urinalysis and urine protein:creatinine for proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

autoantibodies associated with SLE

A

associated with anti-nuclear antibodies- 85%

anti-double stranded DNA- specific to SLE 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

complications of SLE

A

CV disease
infection
anaemia
pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

treatment of SLE

A

anti-inflammatory medication and immunosupression

  • NSAIDs
  • steroids (prednisolone)
  • hydroxychloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is systemic sclerosis

A

autoimmune inflammatory and fibrotic connective tissue disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

two main patterns of systemic sclerosis

A

limited cutaneous systemic sclerosis

diffuse cutaneous systemic sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

limited cutaneous systemic sclerosis features

A 
calcinosis 
raynauds
oEsophageal dysmotility 
sclerodactylyl 
telangiectasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

diffuse cutaneous systemic sclerosis features

A

all the same as limited plus

  • CV problems
  • lung problems
  • kidney problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

autoantibodies present in systemic sclerosis

A

antinuclear antibodies
anti-centromere antibodies - limited cutaneous
anti-scl-70 antibodies- diffuse cutaneous

42
Q

management of systemic sclerosis

A

steroids and immunosuppresants
nifedipine for raynauds
anti-acid medications- PPI
analgesia for joint pain

43
Q

what is polymyalgia rheumatica

A

inflammatory condition that causes pain and stiffness in shoulders, pelvic gridle and neck
strong association with GCA

44
Q

common features of polymyalgia rheumatica

A 
bilateral shoulder pain that may radiate to elbow 
bilateral pelvic girdle pain
worse with movement 
interferes with sleep 
stiffness for at leat 45 mins in morning
45
Q

treatment of polymyalgia rheumatica

A

steroids

- prednisolone

46
Q

What is GCA

A

a systemic vasculitis of the medium and large arteries

47
Q

key complication of GCA

A

vision loss- high dose steroids used immediately

48
Q

symptoms of GCA

A 
severe unilateral headahce typically around temple and forehead
scalp tenderness
jaw claudication 
blurred or double vision 
systemic symptoms
49
Q

findings on temporal artery biopsy that show GCA

A

multinucleated giant cells

50
Q

management of GCA

A

steroids
aspirin
PPI

51
Q

what is anti-phospholipid syndrome

A

disorder associated with antiphospholipid antibodies where the blood becomes prone to clotting

52
Q

associations with antiphospholipid syndrome

A

venous thromboembolism
arterial thrombosis
pregnancy complications

53
Q

management of antiphospholipid syndrome

A

long term warfarin with an INR of 2-3 is used to prevent thrombosis

54
Q

what is sjogren’s syndrome

A

autoimmune condition that affects the exocrine glands

55
Q

symptoms of sjogren’s syndrome

A

dry mucous membranes

such as dry mouth, eyes and vagina

56
Q

associated antibodies with sjogren’s syndrome

A

anti-Ro and anto-La

57
Q

test used in sjogren’s syndrome

A

schirmer test

58
Q

management of sjogren’s syndrome

A

artificial tears
artificial saliva
vaginal lubricants
hydroxychloroquine

59
Q

complications of sjorgren’s syndrome

A

eye infections
oral problems
vaginal problems

60
Q

vasculitis

A

inflammation of blood vessels

61
Q

types of small vessel vasculitis

A

henoch schonlein purpura
eosinophilic granulomatosis with polyganiitis
microscopic polyangiits
granulomatosis with polyangiitis

62
Q

types of vasculitis affecting medium vessels

A

polyarteritis nodosa
eosinophilic granulomatosis with polyangiitis
kawasaki disease

63
Q

types of vasculitis affecting the large vessels

A

GCA

takayasu arteritis

64
Q

presentation of vasculitis

A 
purpura 
joint and muscle pain 
peripheral neuropathy 
renal impairment 
gastrointestinal disturbance 
anterior uveitis and scleritis 
hypertension
systemic manifestations
65
Q

tests for vasculitis

A

inflammatory markers
anti neutrophil cytoplasmic antibodies (anca)
- p-ANCA and c-ANCA

66
Q

management of vasculitis

A 
depends on the type 
steroids 
immunosuppressants:
- cyclophosphamide
- methotrexate 
- azathioprine 
- rituximab
67
Q

henoch- schonlein purpura

A

IgA vasculitis that commonly presents with a purpuric rash affecting the lower limbs or buttocks in children

68
Q

gout

A

crystal arthropathy associated with chronically high blood uric acid levels
monosodium urate crystals are deposited in the joint causing it to be hot and swollen

69
Q

gout tophi

A

subcutaneous deposits of uric acid typically affecting the small joints and connective tissue of hand, elbows and ears

70
Q

presentation of gout

A

single acute hot, swollen and painful joint

71
Q

typical joints affected by gout

A

base of big toe
wrists
base of thumb

72
Q

diagnosis of gout

A 
clinical
aspiration of fluid from the joint
- no bacterial growth 
- needle shaped crystals 
- negative birefringement of polarised light 
exclude septic arthritis
73
Q

management of gout

A

during acute flare: NSAIDs, colchicine, steroids

prophylaxis: allopurinol

74
Q

pseudogout

A

crystal arthropahy caused by calcium pyrophosphate crystals

deposited in the joint

75
Q

presentation of pseudogout

A

older adult with hot swollen stiff painful knee

other joints affected: shoulders, wrists and hips

76
Q

diagnosis of pseudogout

A

exclude septic arthritis
aspirate joint: no bacterial growth, calcium pyrophosphate crystals, rhomboid shaped crystals, positive birefringent of polarised light

77
Q

management of pseudogout

A 
NSAIDS
colchicine 
joint aspiration
steroid injections
oral steroids
78
Q

paget’s disease

A

disorder of bone turnover
excessive bone turnover due to excessive activity of both osteoblasts and osteoclasts
leads to areas of high density and low density

79
Q

peripheral rash
raynauds
ulceration

A

cryoglobulinaemia

80
Q

what is cryoglobulinaemia

A

form of vasculitis characterised by a large number of cold sensitive antibodies in blood

81
Q

associations with cryoglobulinaemia

A 
membranoproliferative glomerulonephritis 
- haematuria and proteinuria 
SOB
chest pain 
pleural effusions 
GI bleeding
82
Q

management of cryoglobulinaemia

A

NSAIDs
where ineffective:
- corticosteroids and steroid-sparing agents (cyclophosphamide)

83
Q

what is polymyositis

A

disease that causes muscles to become irritated and inflammaed
muscle eventually starts to break down and become weak

84
Q

clinical presentation of polymyositis

A 
muscle pain and stiffness 
insidious onset 
usually symmetrical. proximal muscle 
muscle weakness: belly, shouldrs, upper arms, hips
joint pain and stiffness
irregular heart rhythms
85
Q

presentation of dermatomyositis

A

same and polymyositis
rash on hands and knuckles- gottrons
rash around eyes- heliotrope
rash on neck and chest- shawl sign

86
Q

heliotrope rash

A

rash around eyes

associated with dermatomyositis

87
Q

gottrons sign

A

rash on hands and knuckles

associated with dermatomyositis

88
Q

investigations for polymyositis/dermatomyositis

A

Bloods- CK, inflammatory markers
elecyromyelogram
MRI
muscle biopsy

89
Q

treatment of polymyositis

A

corticosteroids
immunosuppression:
- azathioprine, methotrexate, ciclosporin

90
Q

osteochondroma

A

commonest benign tumour which produces bony outgrowth on external surface

91
Q

clinical presentation of osteochondroma

A 
hard mass that is painless and doesnt move 
lower than normal age for height 
one leg shorter than the other 
pressure or irritation with exercise 
soreness of near by muscle
92
Q

enchondroma

A

benign bone tumour that originates from cartilage

93
Q

giant cell tumour

A

predilection for the metaphyseal region
tend to involve epiphysis
most commonl appear on lower end of femur or upper tibia

94
Q

presentation of giant cell tumour

A

painful
may cause pathological fracture
can metastasize to the lung
pain with movement

95
Q

soap bubble appearance

A

giant cell tumour

96
Q

treatment of giant cell tumour

A

intralesional excision with use of phenol, bone cement or liquid nitrogen

97
Q

fibrous dysplasia

A

usually occuring during adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone

98
Q

chondrosarcoma

A

cartilage producing primary bone tumour
less common
less aggressive than osteoscarcoma

99
Q

clinical presentation of chrondrosarcoma

A

large mass on affect bone- usually pelvis or proximal femur
feeling of pressure around the mass
pain- worse at night
local swelling

100
Q

osteosarcoma

A

most common type of primary bone tumour

101
Q

ewing’s syndrome

A

malignant tumour of primitive cells in the marrow
rare type of cancer
most often begins in leg bones and pelvis

102
Q

myeloma

A

malignant B cell proliferation

MSK+rheumatology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions