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Lancaster FINALS _slide > Medicine (9) > Flashcards

Medicine (9) Flashcards

1
Q

Methotrexate

  • SEs
  • Monitoring
A
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2
Q

Sulfasalazine

  • SEs
  • monitoring
A
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3
Q

Hydroxychloroquine

  • SEs
  • monitoring
A
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4
Q

Leflunomide

  • SEs
  • monitoring
A
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5
Q

Causes of primary and secondary osteoarthritis

A

Primary

age, obesity, occupation

Secondary:

  • Paget’s disease
  • Acromegaly
  • haemochromatosis
  • Wilson’s disease
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6
Q

What’s that?

A

Osteoarthritis:

  • Heberden’s nodes: DIP
  • Bouchard’s nodes: PIP (“B before H”)
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7
Q

Characteristic changes on X-ray of osteoarthritis

A
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8
Q

Management of OA

A

Conservative

  • Education
  • Exercise (strengthening and aerobic)
  • Weight loss if overweight

Non-pharmacological: Heat/Ice packs, Physiotherapy, Joint support

Medical

Analgesia treatment ladder

Surgical

Joint replacement

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9
Q

OA vs RA

A
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10
Q

What ar seronegative spondylopthies? (mnemonic)

A

(PEAR)

Psoriatic Arthritis

Enteropathic Arthritis

Anklyosing Spondylitis

Reactive Arthritis

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11
Q

Red flags for back pain

A
  • Hx of malignancy
  • Neurological disturbance
  • Sphincter disturbance
  • Morning stiffness
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12
Q

Psoriatic arthritis

  • background
  • clinical features
  • investigations
  • management
A
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13
Q

Ankylosing spondylitis

  • background
  • clinical features
  • investigations
  • management
A
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14
Q

Reactive arthritis

  • background
  • clinical features
  • investigations
  • management
A
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15
Q

Gaut vs Pseudogout

A
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16
Q

Management of Gout

  • conservative
  • flare-ups
  • prophylaxis (2 drug choices)
A

Conservative:

  • Diuretics, alcohol → reduce, eliminate
  • weight loss
  • avoid dehydration
  • Treat associated factors→ hyperlipidaemia, hypertension, hyperglycaemia

Management of flare: (any of) SEs: diarrhoea

  • High-dose NSAIDs
  • Colchicine
  • Oral Steroid
  • Canakinumab (IL-1B)

Prophylaxis:

Urate lowering therapy →xanthine oxidase inhibitors

  • Allopurinol
  • Febuxostat
17
Q

When shall we start prophylactic treatment for gout?

A

Prophylactic treatment with Allopurinol or Febuxostat (xanthine inhibitors - urate-lowering therapies)

  • therapy should be started if a second attack, or further attacks occur within 1 year
  • allopurinol should not be started until 2 weeks after an acute attack has settled as it may precipitate a further attack if started too early
18
Q
A
19
Q

History, aetiology, ethnicity typical for SLE

A
20
Q

SLE

  • what can be seen on examination
  • investigations
  • management
A
21
Q

Drugs that cause drug-induced lupus

A

Drug-Induced SLE:

  • Procainamide
  • Hydralazine
  • Isoniazid
  • Minocycline
  • Phenytoin

ANTI-HISTONE ANTIBODY (95%)

22
Q

What’s polymyositis and dermatomyositis?

A
23
Q

History in Polymyositis/Dermatomyositis

A
  • Proximal muscle weakness
  • swelling/tender muscles
  • Fever, weight loss
  • interstitial lung disease
  • Skin: Heliotrope rash of the eyelids, Gottron’s papules
24
Q

Ix in Polymyositis/Dermatomyositis

A
  • Blood tests: CK ↑, Autoantibodies (ANA, Anti-Jo1 with specific myositis)
  • Special tests: EMG, biopsy
  • Investigate for malignancy → Poly/Dermatomyositis have ↑ prevalence of cancer
25
Q

Management of Polymyositis/Dermatomyositis

A
  • Corticosteroids (CK rapidly falls but muscle power takes weeks to improve)
  • Immunosuppressives for resistant cases
26
Q

History/presentation in systemic sclerosis

A
  • Raynaud’s phenomenon (initial presentation in 70%), arthralgia, oesophageal symptoms (dysphagia, reflux), rapid renal impairment, dysponoea
27
Q

Investigations in suspected systemic sclerosis

A
  • Bedside: urinalysis (proteinuria/haematuria)
  • Bloods: ESR/CRP
  • Autoantibodies:anti-centromere, anti-Scl70, ANA
28
Q

Management of systemic sclerosis

A
  • Monitor renal involvement
  • Corticosteroids
  • Supportive – PPI for reflux, vasodilators for raynaud’s
  • Specific – immunosuppressants
29
Q

Limited systemic sclerosis vs diffuse systemic sclerosis

A

Lancaster FINALS _slide (31 decks)

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