Inflammatory rheumatic diseases

Question 1

3 kinds of musculoskeletal pain

Answer 1

Back pain
Arthralgia
Myalgia

Question 2

Name 3 autoimmune rheumatic diseases

Answer 2

Rheumatoid arthritis
Connective tissue disorder
Spondarthritis

Question 3

Define monoarthralgia and polyarthralgia

Answer 3

Mono- affects one joint

Poly- many joints

Question 4

Name 3 conditions that affect one joint

Answer 4

Degenerative disorder
Infection
Crystal arthropathy

Question 5

What indicates that fibromyalgia is responsible for polyarthralgia

Answer 5

Presence of tender points

Question 6

What indicates systemic rheumatic disease is the cause of polyarticular pain

Answer 6

Synovitis lasting more than 6 weeks

Question 7

If there is synovitis lasting <6 weeks what is the diagnosis

Answer 7

Viral arthritis

Question 8

What is the female: male ratio of RA

Answer 8

3:1

Question 9

In what % of RA cases are hands and feet affected

Answer 9

> 80% of cases

Question 10

Name 2 knee problems related to RA

Answer 10

Valgus deformity

Bakers cyst

Question 11

Name 3 occular complications of RA

Answer 11

Keratoconjuctivitis sicca
Scleritis and episcleritis
Scleromalacia

Question 12

Name 3 neuromuscular complications of RA

Answer 12

Muscle wastage
Carpal tunnel syndrome
Atlanto-axial subluxation

Question 13

What cardiac complications may follow RA

Answer 13

Ischaemic heart diseasse (pericarditis, nodule, endocarditis)

Question 14

What bone complications may follow RA

Answer 14

Accelerated osteoporosis

Question 15

What is the main auto-antibody seen in RA

Answer 15

Autoantibody against Fc fragment of IgG

Question 16

What can be detected early in RA via an ultrasound

Answer 16

Synovial thickening
Effusion
Poer doppler signal (red)

Question 17

Name 6 elements of the classification criteria for RA

Answer 17

Morning stiffness
Arthritis of 3 or more joint areas
Symmetric arthritis
Rheumatoid factor
Rheumatoid nodules
Characteristic radiological changes

Question 18

What is a more realistic/ pragmatic diagnosis of RA

Answer 18

Inflammation of 3 or more joints
Rheumatoid factor/ anti CPP
Raised ESR

Question 19

Name 2 adjunctive therapies used to treat RA

Answer 19

Bisphosphonates

Statins

Question 20

Name some symptoms of systemic lupus arythematosus

Answer 20

Systemic- low grade fever+ photosensitivity
Face- butterfly rash
Psychological- fatigue/ loss of appetite
Pleura- inflammation
Joints- arthritis

Question 21

What is scleroderma

Answer 21

Immune mediated disease causing hard, thickened skin

Question 22

What is dermatomyositis

Answer 22

Skin rash and muscle weakness

Question 23

What does anklylosing spondylitis have a strong association with

Answer 23

HLA B27

Question 24

Describe onset and duration of ankylosing spondylitis

Answer 24

Onset of back discomfort before age 40
Insidious onset
Duration > 3 months

Question 25

What improves anklylosing spondylitis

Answer 25

Exercise

Question 26

What is reactive arthritis

Answer 26

arthritis occuring in response to infection (urethritis/ cervicitis/ infectious diarrhea)

Question 27

What are the clinical features of reactive arthritis

Answer 27

Urethritis balanitis
Knee effusion
Heel pain
Sausage toe
Synovitis of metatarsophalangeal joint