FRACP questions Flashcards
Leflunomide
Raynauds primary vs secondary
What has the highest negatiev predictive value for primary Raynauds?
Nailfold capilloroscopy!
Serum markers with strong association with disease activity in both GCA and PMR?
BAFF and IL-6
Secukinamab (novel anti IL-17A mab) is useful in which condition?
Febuxostat in comparison to allopurinol
More potent!
What is involved in the breakdown of cartilage in OA?
Aggrecanase
Giant cell arteritis - posisble role of which immunotherapy?
Tocilizumab ( IL-6 receptor inhibition)
IBM
Difference between IBM and polymyositis
Gout management in patient with acute flare 5 days ago
What risk factor causes gout by enhancing crystal formation?
Osteoarthritis!
Drug induced lupus serology - most specific Ab?
Antihistone Ab!
Anti-synthetase syndrome
Mandatory features for diagnosis of PMR
- Age >50
- Bilateral shoulder ache
- abnormal CRP +/- ESR
Timeline of malignancy risk in dermatomyositis. within what time frame?
What is the highest risk factor for developing scleroderma?
Positive family history
What organ involvement is RARE in limited scleroderma?
Renal and cardiac - RARE in scleroderma
Lung dz 30%
Pulmonary HTN 10%
What is the hallmark feature of diffuse scleroderma?
Tendon friction rubs!
Present in 62% of patients with diffuse and only 9% in limited
What is the most common feature of limited scleroderma?
Telangiectasia!
Occurs in 91% of cases
What is the most common immunological marker for renal crisis in diffuse scleroderma?
Anti-RNA polymerase III
Anti-RNA polymerase III isassociated with diffuse cutaenous disease and is the most common immunological marker for renal crisis.
What is the most common histology of interstitial lung disease in systemic sclerosis?
Non-specific interstitial pneumonia
NSIP is the MOST COMMON pattern in systemic sclerosis and responds to treatment with cyclophosphamide
What is the most common gastrointestinal effect in scleroderna?
Oesophageal reflux! Present in 90%
Treatment options for ILD in scleroderma
- First line: mycophenolate 3 g/day1or if intolerant, mycophenolic acid (720mg three times daily).
- Oral or IV cyclophosphamide 500-750 mg/m2for 6-12 months followed by MMF or azathioprine for severe or progressive disease unresponsive to MMF2
