MSK Flashcards
Features of limited cutaneous systemic sclerosis and the auto-antibody associated with it
Calcinosis
Raynaud’s Phenomenon
Oesophageal dysmotility
Scelrodactyly
Telangiectasia
Anti-centromere antibodies
Describe common features of Marfan’s Syndrome
Autosomal dominant connective tissue disorder affecting fibrillin-1.
Tall stature
High arched palate
Pectus Excavatum
Repeated pneumothoraces
What is antiphospholipid syndrome?
Acquired disorder leading to predisposition developing arterial and venous thromboses, recurrent miscarriages and thrombocytopaenia and livedo reticularis.
Causes paradoxical rise of APTT.
Antibodies- anticardiolipin, anti beta2glycoprotein and lupus anticoagulant
Low dose aspirin for primary prevention, warfarin if suffered with thromboses.
Which DMARD reacts with aspirin?
Sulfasalazine
What is dermatomyositis?
Autoimmune inflammatory disorder causing proximal muscle weakness and skin changes.
Photosensitive, macular rash over back and shoulder.
Heliotrope rash in periorbital region.
Gottron’s papules- roughened red papules over extensor surfaces of fingers.
Proximal and respiratory muscle weakness.
ILD
What enzyme do you check for before initiating azathioprine?
TPMT
What is drug-induced lupus?
Drug induced lupus causes some of the symptoms of SLE. Most common causes are procainamide and hydrazaline, isoniazid, minocycline, phenytoin.
Arthralgia and myalgia, skin and pulmonary involvement are common.
Anti-histone antibodies are found in 80-90%.
What is osteomalacia?
Osteomalacia is defined as reduced bone mineralisation secondary to low vitamin D.
Bone pain, bone/muscle tenderness, waddling gait, proximal myopathy, fractures.
Which investigation needs to be requested before starting biologics in RA?
What is the criteria before starting biologics?
CXR to r/o prev TB.
Unsuccessful treatment with 2 DMARDS before initiating biologics.
What is Sjogren’s syndrome?
Autoimmune disorder affecting exocrine glands and causing dry mucosal membranes.
Features-
Dry mouth
Dry eyes
Vaginal dryness
Arthralgia
Raynaud’s
Associated with RA.
What are the extra-articular manifestations of ank spond?
Apical fibrosis
Anterior uveitis
Aortic regurgitation
AV Node block
Achilles tendonitis
Amyloidosis
Where does osteosarcoma mainly present and what are the characteristic xray findings?
Metaphyseal region of long bones.
Xray findings- codman triangle (triangular area of new subperiosteal bone) and sunburst appearance.
What is Paget’s Disease of the bone?
Increased osteoclast and osteoblast activity leads to bone remodelling- normal biochemistry except for isolated raised ALP.
Features-
Bone pain
Bowing of legs
Frontal bossing
Treated with bisphosphonates
