Firms

Question 1

MoA of hydroxychloroquine

Answer 1

TLR9 blocker/antagonist

Question 2

MoA of tocilizumab

Answer 2

Anti-IL6 antibody

Question 3

Disease activity markers for SLE

Answer 3

Complement
ESR
Anti-dsDNA
Cytopaenias (e.g. neutropaenia, leucopaenia)

Question 4

What is an atypical femoral fracture?

Answer 4

One that occurs below the acetabulum

Question 5

What are the causes of secondary osteoporosis?

Answer 5

"SHATTERED"
Steroid use(?)
Hyperthyroidism, Hyperparathyroidism
Alcohol and smoking
Thin(?)
Testosterone low(?)
Erosive/inflammatory bone disease (e.g. RhA/multiple myeloma) (?)
Renal or liver failure
Early menopause
Dietary low Ca2+

Question 6

What is periorbital oedema a sign of?

Answer 6

Nephrotic syndrome

Question 7

Why is BNP useless in CKD?

Answer 7

Because it is renally excreted and so will be high all the time

Question 8

By how much does Sjögren’s syndrome increase risk of lymphoma?

Answer 8

40%

Question 9

What does a RNP antibody positive result point to?

Answer 9

Mixed connective tissue disease

Question 10

[physio] What type of problem is more likely if active movement is restricted but passive movement is normal?

Answer 10

Weakness e.g. rotator cuff tear

Question 11

[phsyio] What problem is more likely if both active and passive movement is restricted?

Answer 11

Mechanical/stiffness e.g. adhesive capsulitis

Question 12

What is the purpose of performing an echocardiogram on a patient positive for RNP?

Answer 12

To look for evidence of pulmonary hypertension

Question 13

MoA of methotrexate

Answer 13

Dihydrofolate reductase inhibitor

Question 14

How long does methotrexate take to have an affect?

Answer 14

About 6 weeks

Question 15

What drug MUST be avoided in a patient taking methotrexate and why?

Answer 15

Trimethoprim

Because it is also an antifolate –> can cause severe bone marrow suppression

Question 16

Side effects of methotrexate

Answer 16

Hepatitis
Interstitial lung disease
Bone marrow suppression
Nausea, diarrhoea, vomiting

Question 17

What must be screened for before starting anti-TNF medication and why?

Answer 17

TB

Because they are immunosuppressive

Question 18

What should be considered when prescribing and monitoring allopurinol?

Answer 18

Kidney function and GFR

Question 19

What are the risk factors for metabolic bone disease?

Answer 19

Early menopause/late menarche
Alcohol/smoking
Steroids
(Lack of) exercise
Calcium intake
Thyroid problems
Weight/height loss
Kidney function
FHx of metabolic bone disease/thyroid problems