Meeran Book MSK Flashcards
What is the management of rheumatoid arthritis?
- DMARDs
- Methotrexate
- Sulfasalazine
- Corticosteroid
- Adjunct
- NSAIDs
- Adjunct
Which joints are usually spared at the onset of Rheumatoid arthritis?
DIPs
What are the skin changes in dermatomyositis?
- Heliotrope rash
- Shawl rash
- Macular
- Gottron’s papules
- Mechanics hands
What is the management of osteoarthritis?
- Topical analgesia (+ paracetamol if unsuccessful)
- Capsaicin
- Diclofenac
- Intra-articular methylprednisolone
What are the empirical antibiotics used for septic arthritis?
- Flucloxacillin
- Gentamycin
- Benzylpenicillin
More specific antibiotics are then used once blood cultures have been obtained
Which organisms pre-dispose to Reactive Arthritis?
- Campylobacter
- Yersinia
- Shigella
- Salmonella
- Chlamydia
- Ureaplasma
What is the management of Reactive Arthritis?
- NSAIDs
- Corticosteroids
Which conditions are associated with pseudogout?
- Hypothyroidism
- Hyperparathyroidism
- Wilson’s disease
- Haemochromatosis
- Acromegaly
What is the management of ankylosing spondylitis?
- NSAIDs and back physiotherapy
- Intra-articular steroid injections if needed
How does retinal detachment present?
- Floaters
- Flashing lights
- Rapid loss of vision
What is the pathophysiology of polymyositis?
Inflammation of striated muscle leading to muscle weakness, without pain
Thought to be autoimmune
What is the etiology of SLE?
- 9x more common in women
- More common in Afro-Caribbean patients
- 20-40 years old
What is discoid lupus?
Lupus only characterised by skin changes
What is the most specific antibody for SLE?
Anti-ds DNA
What are anti-centromere antibodies associated with?
Limited cutaneous systemic sclerosis
What is the pulmonary side effect of methotrexate?
Pulmonary fibrosis
What is the triad of anti-phospholipid syndrome?
- Recurrent miscarriages
- Anti-cardiolipin antibodies
- Thrombosis
What are anti-histone antibodies associated with?
Drug induced lupus
What is secondary sjorgen’s syndrome?
Sjorgen’s syndrome on the background of established autoimmune condition
What is the managment of Raynaud’s disease?
- Conservative
- CCBs
- ACEi/ ARBs
What is microstomia?
Beak like nose and small mouth, occasionally seen in limited and diffuse cutaneous systemic sclerosis
Where is skin involvement limited to in limited cutaneous systemic sclerosis?
- Face
- Hands
- Feet
What is Still’s disease?
Juvenile idiopathic arthritis, characterised by swining fevers, a rash and arthritis in those under 16
What is the management of acute gout?
- NSAIDs
- Colchicine (if NSAIDs contraindicated)
What is the managment of chronic gout?
Allopurinol, should not be given in acute episodes as it can exacerbate
What are the clinical features of Behcet’s disease?
- Oral ulcers
- Genital ulcers
- Anterior/ posterior uvetitis
- Erythema nodosum
- Arthritis
- GI features
- Neuro features
What is the first line investigation for Behcet’s?
Pathergy testing within 48 hours
Which sites are typically affected in Padget’s disease?
- Skull
- Can compress nerves leading to sensorineural hearing loss or cranial nerve palsies
- Spine
- Pelvis
- Femur
- Tibia
