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Rheumatology > Investigations & Findings > Flashcards

Investigations & Findings Flashcards

1
Q

Ankylosing Spondylitis (8)

A
  1. XRAY of ilio-sacral joint - BEST TEST

showing:

  1. “Bamboo Spine” - (Although a late sign)
  2. Sacroilieitis: Subchondral erosions, sclerosis - MAIN FINDING FOR Dx - EARLY SIGN
  3. Squaring of Lumbar bodies
  4. Syndesmophytes: meaning annulus fibrosus become ossified
  5. Loss of Lumbar Lordosis
  6. Typically raised ESR/CRP although absence doesn’t rule out
  7. THEN get an MRI
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2
Q

APS (Antiphospholipid Syndrome) (5)

A

Antibodies:
1. Anti-cardiolipin

  1. Anti- Beta2GP1
  2. Lupus Anticoagulant

Clotting:
4. Thrombocytopaenia

  1. Prolonged aPTT
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3
Q

Bone disorders Lab results (Ca, P, ALP, PTH): Osteoporosis (4)

A
  1. Ca - NORMAL
  2. P - NORMAL
  3. ALP - NORMAL
  4. PTH - NORMAL
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4
Q

Bone disorders Lab results (Ca, P, ALP, PTH): Osteomalacia (4)

A
  1. Ca -DECREASED
  2. P - DECREASED
  3. ALP - INCREASED
  4. PTH - INCREASED
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5
Q

Bone disorders Lab results (Ca, P, ALP, PTH): Primary Hyperparathyroidism (4)

A
  1. Ca - INCREASED
  2. P - DECREASED
  3. ALP - INCREASED
  4. PTH - INCREASED
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6
Q

Bone disorders Lab results (Ca, P, ALP, PTH): CKD (Secondary Hyperparathyroidism) (4)

A
  1. Ca - DECREASED
  2. P - INCREASED
  3. ALP - INCREASED
  4. PTH - INCREASED
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7
Q

Bone disorders Lab results (Ca, P, ALP, PTH): Paget’s (4)

A
  1. Ca - NORMAL
  2. P - NORMAL
  3. ALP - INCREASED
  4. PTH - NORMAL
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8
Q

Bone disorders Lab results (Ca, P, ALP, PTH): OsteopETrosis (4)

A
  1. Ca - NORMAL
  2. P - NORMAL
  3. ALP - NORMAL
  4. PTH - NORMAL
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9
Q

Reactive Arthritis (4)

A
  1. Arthrocentesis showing: ASEPTIC JOINT (you WONT find the bug in there)

And a:

  1. HIGH WCC in synovial fluid
  2. On a background of either Chlamydia or Dysentry
  3. +/- Cant see, cant wee - active UTI Sxs, or Uveitis
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10
Q

Polymyalgia Rheumatica (4)

A
  1. ESR - RAISED
  2. CRP - RAISED
  3. Anti-CCP - NORMAL
  4. CK - NORMAL

key point is PMR does NOT raise Creatinine Kinase unlike other myosities

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11
Q

Bone pain + an isolated raised ALP suggests: (1)

A
  1. Paget’s Disease of the Bone
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12
Q

Paget’s Disease of the Bone (5)

A
  1. Raised ALP
  2. Normal Ca and P

Xrays:
3. Osteolysis in early disease - mixed lytic and sclerotic lesions later

  1. Skull X-Ray showing Thickened Vault and OP Circumscripta

Antibodies:
Main one - PINP
Tonnes of em - see memorise deck and probably don’t bother

procollagen type I N-terminal propeptide (PINP)
serum C-telopeptide (CTx)
urinary N-telopeptide (NTx)
urinary hydroxyproline

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13
Q

Rheumatoid Arthritis Athrocentesis (5)

A
  1. Yellow / Cloudy Fluid
  2. 2,000 - 50,000 WBC
  3. Mainly PMNs
  4. Gram stain clear
  5. No crystals
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14
Q

Psoriatic Arthritis (4)

A
  1. X-Ray - showing:
  2. Pencil-in-Cup appearance
  3. Erosive and sclerotic mixed pictire
  4. Perisotitis
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Rheumatology (8 decks)

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