Meeran Book MSK

Question 1

What is the management of rheumatoid arthritis?

Answer 1

• DMARDs
  
  • Methotrexate
  • Sulfasalazine
• Corticosteroid
  
  • Adjunct
• NSAIDs
  
  • Adjunct

Question 2

Which joints are usually spared at the onset of Rheumatoid arthritis?

Answer 2

DIPs

Question 3

What are the skin changes in dermatomyositis?

Answer 3

• Heliotrope rash
• Shawl rash
  
  • Macular
• Gottron’s papules
• Mechanics hands

Question 4

What is the management of osteoarthritis?

Answer 4

• Topical analgesia (+ paracetamol if unsuccessful)
  
  • Capsaicin
  • Diclofenac
• Intra-articular methylprednisolone

Question 5

What are the empirical antibiotics used for septic arthritis?

Answer 5

• Flucloxacillin
• Gentamycin
• Benzylpenicillin

More specific antibiotics are then used once blood cultures have been obtained

Question 6

Which organisms pre-dispose to Reactive Arthritis?

Answer 6

• Campylobacter
• Yersinia
• Shigella
• Salmonella
• Chlamydia
• Ureaplasma

Question 7

What is the management of Reactive Arthritis?

Answer 7

• NSAIDs
• Corticosteroids

Question 8

Which conditions are associated with pseudogout?

Answer 8

• Hypothyroidism
• Hyperparathyroidism
• Wilson’s disease
• Haemochromatosis
• Acromegaly

Question 9

What is the management of ankylosing spondylitis?

Answer 9

• NSAIDs and back physiotherapy
• Intra-articular steroid injections if needed

Question 10

How does retinal detachment present?

Answer 10

• Floaters
• Flashing lights
• Rapid loss of vision

Question 11

What is the pathophysiology of polymyositis?

Answer 11

Inflammation of striated muscle leading to muscle weakness, without pain

Thought to be autoimmune

Question 12

What is the etiology of SLE?

Answer 12

• 9x more common in women
• More common in Afro-Caribbean patients
• 20-40 years old

Question 13

What is discoid lupus?

Answer 13

Lupus only characterised by skin changes

Question 14

What is the most specific antibody for SLE?

Answer 14

Anti-ds DNA

Question 15

What are anti-centromere antibodies associated with?

Answer 15

Limited cutaneous systemic sclerosis

Question 16

What is the pulmonary side effect of methotrexate?

Answer 16

Pulmonary fibrosis

Question 17

What is the triad of anti-phospholipid syndrome?

Answer 17

• Recurrent miscarriages
• Anti-cardiolipin antibodies
• Thrombosis

Question 18

What are anti-histone antibodies associated with?

Answer 18

Drug induced lupus

Question 19

What is secondary sjorgen’s syndrome?

Answer 19

Sjorgen’s syndrome on the background of established autoimmune condition

Question 20

What is the managment of Raynaud’s disease?

Answer 20

1. Conservative
2. CCBs
3. ACEi/ ARBs

Question 21

What is microstomia?

Answer 21

Beak like nose and small mouth, occasionally seen in limited and diffuse cutaneous systemic sclerosis

Question 22

Where is skin involvement limited to in limited cutaneous systemic sclerosis?

Answer 22

• Face
• Hands
• Feet

Question 23

What is Still’s disease?

Answer 23

Juvenile idiopathic arthritis, characterised by swining fevers, a rash and arthritis in those under 16

Question 24

What is the management of acute gout?

Answer 24

• NSAIDs
• Colchicine (if NSAIDs contraindicated)

Question 25

What is the managment of chronic gout?

Answer 25

Allopurinol, should not be given in acute episodes as it can exacerbate

Question 26

What are the clinical features of Behcet’s disease?

Answer 26

• Oral ulcers
• Genital ulcers
• Anterior/ posterior uvetitis
• Erythema nodosum
• Arthritis
• GI features
• Neuro features

Question 27

What is the first line investigation for Behcet’s?

Answer 27

Pathergy testing within 48 hours

Question 28

Which sites are typically affected in Padget’s disease?

Answer 28

• Skull
  
  • Can compress nerves leading to sensorineural hearing loss or cranial nerve palsies
• Spine
• Pelvis
• Femur
• Tibia