MSK Flashcards
In reactive arthritis, what would be seen in a joint aspiration of the knee?
Sterile synovial fluid with a high white blood cell count
Reactive arthritis: develops after an infection where the organism cannot be recovered from the joint
What joints are more involved in osteoarthritis?
Carpometacarpal and distal interphalangeal joint
What is the most specific antibody for rheumatoid arthritis?
Anti-cyclic citrullinated peptide (anti-CCP)
What is given for cute flares of rheumatoid arthritis?
Intramuscular steroids such as methylprednisolone
When would a 10-year fracture risk be reassessed?
After 5 years of treatment with alendronate
What condition causes Gottorn’s papules (roughened red papules over extensor surfaces of fingers)
Dermatomyositis
What is a side effect of methotraxate?
Iatrogenic pulmonary fibrosis
What is the BNF advice regarding methotrexate and pregnancy?
She should wait at least 6 months after stopping methotrexate before trying to conceive
What is first line treatment of Knee osteoarthritis?
topical NSAIDs
What would you see in an X-ray of Ankylosing spondylitis?
x-ray findings: subchondral erosions, sclerosis
and squaring of lumbar vertebrae
What is a side effect of Hydroxychloroquine?
severe and permanent retinopathy
What is treatment of mild-moderate symptoms of carpal tunel syndrome?
Wrist splinting
When starting allopurinol, what should be added?
Add colchicine cover for the first 6 months
when starting allopurinol, colchicine or NSAID cover is recommended to reduce the risk of precipitating another acute gout attack. Colchicine interferes with the inflammatory process by inhibiting neutrophil motility and activity, thereby preventing flare-ups during the initiation of urate-lowering therapy.
What is osteogenesis imperfecta?
- brittle bone disease
- group of disorders of collagen metabolism, resulting in bone frailty and fractures
What are the blood results for osteogenesis imperfecta?
Normal adjusted calcium, normal PTH, normal ALP and normal PO4
What is a CT chest/abdomen/pelvis are done after a diagnosis of Dermatomyositis?
paraneoplastic phenomenon
What is Dermatomyositis?
An inflammatory disorder causing symmetrical, proximal muscle weakness and characteristic skin lesions
Usually idiopathic with connective tissue disorders or underlying malignancy
What is Systemic sclerosis and the 3 types?
- unknown aetiology characterised by hardened, sclerotic skin and other connective tissues. More common in females.
Types:
- Limited cutaneous systemic sclerosis
- Diffuse cutaneous systemic sclerosis
- Scleroderma (without internal organ involvement)
What is Limited cutaneous systemic sclerosis?
- Raynaud’s may be the first sign
- scleroderma affects face and distal limbs predominately
- associated with anti-centromere antibodies
- a subtype of limited systemic sclerosis is CREST syndrome: Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia
What is Diffuse cutaneous systemic sclerosis?
- scleroderma affects trunk and proximal limbs predominately
- associated with anti scl-70 antibodies
- Causes interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH)
- other complications include renal disease and hypertension
patients with renal disease should be started on an ACE inhibitor - poor prognosis
What is scleroderma?
- tightening and fibrosis of skin
- may be manifest as plaques (morphoea) or linear
What are signs of Anterior ischemic optic neuropathy?
fundoscopy typically shows a swollen pale disc and blurred margins
What are signs of De Quervain’s tenosynovitis?
Pain on the radial side of the wrist/tenderness over the radial styloid process