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FINALS - RHEUM > Misc (gout, ehler's-danlos, stills, behcets) > Flashcards

Misc (gout, ehler's-danlos, stills, behcets) Flashcards

1
Q

what is Behcet’s syndrome

A

autoimmune –> arteries and veins

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2
Q

who gets Behcet’s

A

eastern med eg turkey // men // 20-40 // FH

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3
Q

gene assoc with Behcets

A

HLA B51

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4
Q

triad of Behcets

A

oral ulcers, genital ulcers, anterior uveitis

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5
Q

other symptoms behcets

A

thrombophlebiti, DVT, arthritis, aseptic meningitis, GI stuff, erythema nodosum

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6
Q

what is chronic fatigue syndrome

A

3 months of fatigue affecting medical and phyiscal function (usually idiopathic)

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7
Q

symptoms chronic fatigue

A

sleep problems // muscle or joint pain // headache // lymph // sore throat // cognitive fig // flu symptoms // dizzy

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8
Q

invx chronic fatigue

A

diagnosis of exclusion

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9
Q

mx chronic fatigue

A

CBT, exercise therapy, low dose amitrip

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10
Q

who gets still’s

A

15-25 or 35-46

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11
Q

symptoms stills

A

arthralgia // pink rash // pyrexia (worse at end of day) // lymph

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12
Q

diagnosis still’s

A

raised ferritin // Yamaguchi criteria

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13
Q

mx stills

A

NSAIDs –> steroids –> methotrexate, anti TNF

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14
Q

inheritance marfans

A

autosomal dominant

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15
Q

genes marfans

A

protein fibrillin 1

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16
Q

aesthetic symptoms marfans

A

tall, long arms // high palate // long fingers // pectus excatavum // flat feet // scoliosis // blue sclera

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17
Q

internal symptoms marfans

A

mitral valve prolapse // dilation of aortic sinus –> AA, aosrtic dissection, regurg // pneumothorax // lens dislocation // dural ectasia

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18
Q

mx marfans

A

regular echo, ACEi, BB

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19
Q

biggest cause of death marfans

A

heart problems

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20
Q

inheritance ehlers danlos

A

autosomall dominant

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21
Q

gene in ehlers danlos

A

type III collagen

22
Q

symptoms ehlers danlos

A

elastic skin, joint hypermobility, easy bruising, aortic regurg, SAH!!

23
Q

what causes gout

A

build up of purines and guanine –> hyperuricaemia

24
Q

symptoms acute gout

A

pain, swelling, redness, painful, one joint affected

25
Q

which joint is usually affected in gout

A

1st metatarsal (MTP)

26
Q

features of chronic gout

A

high serum uric acid, tophi form (hard nodules), 2 or more bouts in a year

27
Q

what medication is chronic gout assoc with

A

diuretics

28
Q

when should serum uric acid be checked in gout

A

2 weeks later as may be high or low in acute attack

29
Q

what is seen on synovial fluid in gout

A

needle shaped negatively bifringing rate crystals

30
Q

xray findings gout

A

jount effusion, punched out erosions, tophi

31
Q

1st line mx gout

A

NSAID or colchine

32
Q

SE colchine

A

diarrhoea

33
Q

2nd +3rd line mx gout

A

2) steroids eg pred 3) steroid injection

34
Q

when is prophylaxis for gout indicated

A

after 1 attack (esp if tophi, renal disease, stones, diuretics, 2+ attacks)

35
Q

1st line prophylaxis gout + mechanism

A

allopurinol (Xanthine oxidase inhibitor)

36
Q

2nd line prophylaxis gout

A

febuxostat

37
Q

when should prophylaxis for gout be started and what cover is needed

A

2-4 weeks after attack // cover with NSAIDs // continue prophylaxis if an attack flares

38
Q

lifestyle mx gout

A

reduce alcohol, lose weight, avoid high purine food eg liver, kidnye, seafood, oily fish

39
Q

what can cause decreased excretion of uric acid –> gout

A

diuretics, CKD, HF, lead, hypothroid

40
Q

what can cause increased production of uric acid –> gout

A

psoriasis, alcohol, meat, myeloproliferative disease eg cancer

41
Q

what inheritance is Lesch Nyhan

A

x-linked (boys only)

42
Q

features Lesch Nyhan

A

gout, renal failure, neuro deficits, learning disability

43
Q

what is deposited in joints in pseudogout

A

calcium pyrophosphate dihydrate crystals

44
Q

RF psuedogout

A

age, haemochromatosis, hyperparathyroid, low mg, low phosphate, acromegaly, wilsons

45
Q

joints affected pseudogout

A

knee, wrist, shoulder affected

46
Q

joint aspiration psudogout

A

positive bifringement rhomboid crystals

47
Q

xray pseudogout

A

chondrocalcinosis -

48
Q

mx pseudogout

A

NSAIDs, steroids, injection steroids

49
Q

what is Hydroxyapatite

A

cystal deposits in soft tissue

50
Q

symptoms Hydroxyapatite

A

v aggressive + sore, shoulder, women

FINALS - RHEUM (8 decks)

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