MSK

Question 1

Management for osteoporosis?

Answer 1

Alendronic acid
Calcium
Vitamin D

HRT considered if hypogonadism is the aetiology

Question 2

Management for gout

Answer 2

NSAIDs/colchicine

Prophylaxis:
- Allopurinol
- Febuxistat (2nd line)

Question 3

Management for ankylosing spondylitis

Answer 3

NSAIDs (naproxen,diclofenac) + active physiotherapy and analgesia

Infra-articular inflammation/enthesitis: intra-articulate hydrocortisone injection

Peripheral joints: DMARDs
Refractory to 2 NSAIDs: TNF alpha inhibitor

Question 4

Management for SLE

Answer 4

Prevent flares:
- limit sunlight
- Hydroxychloroquine
- NSAIDs

Limit severity of flare:
Mild: low dose steroids
Moderate: DMARDs
Severe: high dose steroids + immunosuppressants

Question 5

Management for poly myalgia rheumatica

Answer 5

Prednisolone
Methotrexate if refractory

Omeprazole, vit D and calcium for protection

Question 6

How does the pain of inflammatory arthritis present?

Answer 6

Worse in the morning and better with activity.

Compared to OA which is worse with use and at the end of the day

Question 7

When is oral bisphosphonate treatment started

Answer 7

Any of the following:
< -2.5 DEXA
> 75 and fragility fracture
High dose corticosteroids for prolonged time