General

Question 1

What is the most common rheumatological cause of dactylitis?

Answer 1

psoriatic arthritis

Question 2

Which specific questions should you ask when taking a PMHx for rheumatology?

Answer 2

• other autoimmune disease
• any rashes
• recent infections (UTIs, STIs- Reactive arthritis), prev painful eyes (arteritis for RA), peptic ulcers/renal disease (SE for treatments), joint replacements

Question 3

Drug history for rheumatology?

Answer 3

anticoagulants, immunosuppressants, steroids, diuretics

Question 4

Systemic enquiry for rheumatology?

Answer 4

dry eyes, dry mouth, headache (GCA), fatigue, abdominal pain

Question 5

What is the S factor?

Answer 5

Tips for RA history
Stiffness in the morning >1hr
Symmetrical joint pain
Swollen joints 
Small joints of hand feet wrist
Sex female: male 3:1
Speed: quick onset over weeks to months
Specific signs of the hand
Supra articular manifestations

Question 6

How does morning stiffness compare in RA and OA?

Answer 6

RA >1hr, OA>30 min

Question 7

Patient has a type of gout. Their urate is normal. Which gout do they have?

Answer 7

pseudogout (normal serum urate)

Question 8

Which crystals are associated with pseudogout?

Answer 8

rhomboid

Question 9

Which conditions are pseudogout/CPPD associated with?

Answer 9

haemochromatosis, hypomagnesia, hyperparathyroidism, hypothyroidisim

Question 10

Is allopurinol used in gout and pseudogout?

Answer 10

only in gout!

Question 11

Which other condition has similar symptoms to polymyalgia rheumatica?

Answer 11

myeloma (bone pain, fatigure, raised ESR/CRP)

Question 12

Where is pain in polymyalgia rheumatica most typically experienced?

Answer 12

shoulders and hips/lower back

Question 13

Three differentials for monoarthritis

Answer 13

Septic arthritis
Crystal arthritis: gout, CPPD
Osteoarthritis
Trauma: haemarthrosis

Question 14

Three differentials for oligoarthritis (<5 joints)

Answer 14

  Crystal arthritis 
  Psoriatic arthritis 
  Reactive arthritis 
  Ankylosing spondylitis 
  Osteoarthritis

Question 15

Three differentials for polyarthritis (>5 joints)

Answer 15

RA
OA
Viruses
Reactove arthritis 
Psoriatic arthritis
Systemic disease

Question 16

Two examples of systemic disease that cause polyarhtritis

Answer 16

SLE
Endocarditis
Sarcoid

Question 17

Example of symmetrical polyarthritis

Answer 17

RA
OA
Viruses

Question 18

Example of asymmetrical polyarthritis

Answer 18

reactive arthritis

psoriatic arthritis

Question 19

Four radiological features you would see in OA

Answer 19

 Loss of joint space
 Osteophytes
 Subchondral cysts
 Subchondral sclerosis

Question 20

Four radiological features you would see in RA

Answer 20

  Loss of joint space 
  Soft tissue swelling 
  Peri-articular osteopenia 
  Deformity 
  Subluxation

Question 21

Two radiological features of gout

Answer 21

 Normal joint space
 Soft tissue swelling
 Periarticular erosions

Question 22

Name two conditions in which RF is positive

Answer 22

Sjorgen’s 100%
Felty’s 100%
RA 70%

Question 23

Name two conditions in which ANA is positive

Answer 23

 SLE >95%
 AIH 75%
 Sjogren’s 70%

Question 24

Name three autoimmune connective tissue disorders

Answer 24

SLE
Sjorgen’s
Myositis
Vasculitis

Question 25

Jaccoud’s arthropathy is seen in which disease?

Answer 25

SLE