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Phase 2 Medicine > more rheum > Flashcards

more rheum Flashcards

1
Q

What are the three ways in which RA causes bone erosions?

A
  1. Focal erosions
  2. Periarticular osteoporosis
  3. Generalised osteoporosis in skeleton
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2
Q

Which joints are most commonly affected in RA?

A
  1. Hands
  2. Feet
  3. Knees
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3
Q

What are the hand deformities associated with RA?

A
  1. Boutonierre - hyperextension of DIPJ
  2. Swan neck - hyperextension of PIPJ
  3. Z thumb
  4. Ulnar deviation
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4
Q

Which joint of the hand is usually spared in RA?

A

DIPJ

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5
Q

What nerve is affected in carpal tunnel?

A

Median nerve

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6
Q

What nerve is affected in tarsal tunnel?

A

Posterior tibial nerve

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7
Q

Which nerve is affected by elbow swelling?

A

Ulnar nerve

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8
Q

Which nerve is affected by soft tissue swelling in the popliteal space and fibular head?

A

Anterior tibial nerve

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9
Q

Name 3 DMARDs

A

Methotrexate
Sulfasalazine
Hydroxychloroquine
Azathioprine

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10
Q

Which type of cartilage does OA affect?

A

articular

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11
Q

Name a MAB that is used as an antiresorptive medication for osteoporosis.

A

Denosumab (mab to RANKL)

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12
Q

Why are bisphosphonates the first line treatment for osteoporosis?

A
  • Cheap
  • Effective
  • Many years of experience
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13
Q

Name two bisphosphonates

A
  • Alendronate

- Ibandronate

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14
Q

What can cause an acute gouty attack?

A
  1. alcohol/red meat/shellfish binges
  2. sepsis/MI/severe illness
  3. trauma, surgery
  4. dehydration and diuretics
  5. cold
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15
Q

How would you treat pseudogout?

A
  1. NSAIDs, analgesics
  2. Aspiration/injection/physiotherapy
  3. DMARDs, synovectomy, surgery
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16
Q

What is fibromyalgia?

A

A chronic condition causing widespread pain through a central processing disturbance - neuropathic

17
Q

What is the difference between the arthritis in RA and the arthritis in SLE?

A

Arthritis in SLE is non-erosive and less proliferative.
It is non-erosive because the tendons are damaged instead of the bone (as in RA)
It is still deforming and symmetrical.

18
Q

What are the three rashes you get in SLE?

A

Photosensitive - UV light
Discoid rash - tends to scar
Subacute lupus rash

19
Q

Which areas are most commonly affected in SLE and how do they present?

A

Skin - rash
Kidneys - nephritis
Joints - arthritis

20
Q

What presentation of lupus affects the hair?

A

Alopecia

21
Q

What is lupus nephritis?

A
  • Nephritis secondary to lupus
  • Used to be a cause of mortality in lupus
  • HTN seen
  • If detected early - urinalysis (shows proteinuria and haematuria), then kidney failure can be prevented
22
Q

What are the haematological signs associated with SLE?

A
  1. Coombs positive haemolytic anaemia
  2. Thrombocytopaenia
  3. Neutropaenia
  4. Lymphopaenia

(Pancytopaenia)

23
Q

What are the differential diagnoses for SLE Pancytopaenia?

A
  1. Leukaemia
  2. Lymphoma
  3. Metastatic cancer
24
Q

What is the pathogenesis for SLE?

A

Inflammation and immune complex mediated tissue damage

25
Q

List the key features of SLE?

A
  1. Symptoms similar to RA
  2. Erythema in a butterfly distribution across the cheeks
  3. Photosensitive rash
  4. Glomerulonephritis with persistent proteinuria
  5. Seizures
  6. Psychosis
  7. Mouth ulcers
26
Q

SLE gives high ESR and low CRP. What would you think of if both ESR and CRP were high?

A
  1. infection
  2. serositis
  3. arthritis
27
Q

What would you give in acute attack of SLE?

A

IV cyclophosphamide and high dose prednisolone

28
Q

What are the other uses of cyclophosphamide?

A

Used for Wegener’s (GPA)

29
Q

What are features of reactive arthritis?

A

(classical triad) +

  • keratoderma blenorrhagia
  • circinate balanitis
  • conjunctivits

Phase 2 Medicine (10 decks)

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