Misc Flashcards
what is Charcot’s arthropathy
progressive condition characterised by joint dislocations, pathologic fractures, and debilitating deformities
usually in diabetes (used to be syphilis)
can occur in any joint but mostly foot/ankle
what is included in inflammatory arthritis
seropositive
RA
seronegative psoriatic ank spond reactive enteropathic
what gene are the seronegative inflammatory arthritises associated with
HLA-B27
what does antiphospholipid syndrome include
thrombosis and/or recurrent miscarriage
what antibodies antiphospholipid syndrome
antiphospholipid
rx antiphospholipid syndrome
if had a thrombosis -> warfarin
aspirin, subcut heparin to reduce chance of miscarriage
what does the onset tell you about the cause of a hot swollen joint
explosive = gout (hours)
a little bit slower = septic arhtritis
slower again = RA
risk factors for gout
CKD
tumour lysis syndrome (occurs when having chemo - pts prophylactically given allopurinol)
triggers of gout
dehydration
alcohol binge
surgery
injury
what is included in purine rich diet
beer fizzy drinks fish pulses/nuts meat
erosions on xray of gout vs RA
gout = rat bite erosions (erosion away from joint) RA = periarticular erosions
short term drugs for gout
colchicine (kowl-chuch-cine) (SE diarrhoea “run before they can walk” run to toilet for diarrhoea before can walk bc of gout pain
NSAID cannot often give bc CKD
steroid injection
class of drug of allopurinol (exam q!)
inhibitor of the enzyme xanthine oxidase
crystals in gout vs pseudogout
gout = needle, negatively birefringent pseudogout = rhomboidal, positively birefringent
finding on examination in gout
tophi
methotrexate SEs
bad N+V tired on the day it is taken macrocytosis mouth ulcers rash hair loss
onion skin lesion seen in
intrarenal vessles in patient with scleroderma who has had a renal crisis
methotrexate monitoring
FBC (for low WBC/neutrophil/platelets or high MCV)
creatinine/eGFR (can cause renal impairment)
LFTs (can raise liver enzymes)
what is coprescribed with methotrexate
folate (to counteract the anti-folate SEs)
common complication of scaphoid fracture
avascular necrosis (death of bone tissue due to lack of blood) => gradual joint pain with limited ROM
interesting fact about raynaud’s to do with thumb
if it includes the thumb it is more likely secondary to another disease
what movement is difficult in OA hip
internal rotation
what two drugs to give with steroids
PPI and bone protection e.g. bisphosphonates and calcium?
is there uricacidaemia in acute flare of gout
sometimes but it is not usually helpful as all the uric acid is in the joint, not in the blood. more useful to measure in a chronic situation
give 6 causes of a positive ANA
SLE sjogren's SSc polymyositis and dermatomyositis RA vasculitis
in what disease are osteophytes seen
OA! NOT RA!!
what is the sail sign at elbow
elevation of the anterior fat pad to create a silhouette similar to a billowing spinnaker sail from a boat =
elbow effusion = likely fracture
what medication can cause avascualr necrosis of femoral/humeral head
chemo
new back pain in pt with ank spond
FRACTURE UNTIL PROVEN OTHERWISE!!!! don’t just rely on xray -> need CT to prove or disprove
