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Exam Revision > MSK > Flashcards

MSK Flashcards

1
Q

features of inflammatory arthritis (RA)

A

Joint pain + swelling
pain worse in the morning/ morning stiffness
pain improved with use
raised inflammatory markers- raised CRP + Plasma volume

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2
Q

what joints in the hands does RA affect

A

MCP + PIP

- Spares DIP joints

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3
Q

extra-articular features of RA

A

rheumatoid nodules
pulmonary fibrosis
uveitis/ episcleritis

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4
Q

antibody raised in RA

A

Anti-CCP

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5
Q

Xray features OA

A

LOSS

Loss of joint space
Osteophyte formation
Subcondral cysts
Sclerosis

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6
Q

Xray features RA

A

Swelling
Osteopenia
Bone displacement
Peri-articular erosions in late disease

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7
Q

1st line DMARD in RA

A

methotrexate

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8
Q

other DMARDS

A

sulfsalazine

hydroxychloroquine

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9
Q

main side effects of methotrexate

A

Pulmonary fibrosis
Hepatotoxic
Bone marrow suppression
Teratogenic

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10
Q

main side effects of sulfasalazine

A

Depression
Rash
Oligospermia
Hepatitis

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11
Q

main side effects of hydroxychloroquine

A

irreversible retinopathy

corneal deposits

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12
Q

main side effects IM Gold

A

proteinuria

peripheral neuropathy

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13
Q

main side effects of penicillamine

A

rash
proteinuria
glomerulonephritis

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14
Q

what anti TNF drug causes demyelination

A

etanercept

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15
Q

main side effects of prednisolone

A

osteoporosis
hypertension
cataracts
cushing features

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16
Q

management of OA

A 
physiotherapy + strength exercises 
paracetamol first line pain relief 
2nd line - weak opioid (e.g. codeine) 
short course NSAIDs/topical NSAIDS
intra-articular steroid injections - short term improvement of painful joint effusion 
Joint replacement
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17
Q

what DMARD is safe in pregnancy

A

sulfasalazine

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18
Q

bamboo spine + sacroiliac joint fusion

A

ankylosing spondylitis

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19
Q

presentation of anklosing spondylitis

A

young male, pain + morning stiffness in the back improved with exercise

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20
Q

tx of psoriatic arthritis

A

analgesia + NSAIDS
intra-articular corticosteroid injections for local synovitis
methotrexate for severe disease

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21
Q

what is reactive arthritis

A

acute asymmetrical arthritis following GI/GU infection

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22
Q

Reiters syndrome

A

urethritis, uveitis, reactive arthritis

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23
Q

IBD + arthritis

A

enteropathic arthritis

- large joint mono arthritis occurring in patients with UC/Crohn’s

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24
Q

gout

A

deposition of urate crystals in joints

- swelling, pain, redness of affected joint

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25
Q

needle shaped negative birefringent crystals

A

gout

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26
Q

tx acute gout

A

diclofenac (NSAID)

- colchicine given if NSAIDS not tolerated/ineffective

27
Q

what drug can precipitate gout

A

thiazide diuretics

28
Q

gout prophylaxis

A

allopurinol

- xanthine oxidase inhibitor

29
Q

pseudo gout

A

deposition of calcium pyrophosphate crystals in joint

30
Q

positive birefringent crystals

A

pseudogout

31
Q

most common cause of septic arthritis

A

staph aureus

32
Q

presentation of septic arthritis

A

hot,painful, swollen, red joint

33
Q

anti-CCP

A

RA

34
Q

anti- DsDNA

A

SLE

35
Q

anti-cardiolipin + lupus anticoagulant

A

anti-phospholipid

36
Q

anti Ro + anti La

A

Sjogrens

37
Q

pANCA

A

EGPA

38
Q

cANCA

A

GPA

39
Q

anti-centromere

A

systemic sclerosis

40
Q

anti-Jo

A

polymyositis/dermatomyositis

41
Q

what is released if calcium in the blood is low

A

PTH from parathyroid gland

42
Q

effects of PTH

A

increased calcium release from bone

increased calcium uptake in intestines + reabsorption form urine

43
Q

what facilitates calcium + phosphate absorption

A

Vitamin D

44
Q

what is released if calcium in the blood is too high

A

Calcitonin from thyroid gland

45
Q

effects of calcitonin

A

increased deposition of calcium in the bones

decreased uptake in intestines + decreased reabsorption

46
Q

blood results primary hyperparathyroidism

A

Increased PTH
Increased Calcium
Increased alkaline phosphatase
Low phosphate

47
Q

blood results secondary hyperparathyroidism

A

Increased PTH
Increased alkaline phosphatase
Low calcium
Low phosphate

due to vitamin D deficiency

48
Q

what might an isolated rise in alkaline phosphatase indicate

A

pagets disease

49
Q

what is positive in 90% of people with ankylosing spondylitis

A

HLA-B27

50
Q

Presentation SLE

A 
butterfly rash 
arthritis 
fever
fatigue 
weight loss
reynauds
alopecia
pulmonary fibrosis
51
Q

S1 root compression syndrome

A

Pain from buttock down back of thigh + leg
sensory loss of posterior calf + sole of foot
loss of plantar flexion
loss of ankle jerk

52
Q

loss of knee jerk + dorsiflexion of foot + inversion of ankle + knee extension
what nerve root is compressed ?

A

L4

53
Q

what makes spinal stenosis worse

A

walking downhill/going downstairs

54
Q

what improves spinal stenosis

A

FLEXION of spine

55
Q

presentation of systemic sclerosis

A 
reynauds 
sclerodactyly
telangectasia 
oesophageal involvement 
calcinosis
56
Q

polymyositis symptoms

A

progressive muscle weakness of shoulder + pelvic girdle

57
Q

dermatomyositis symptoms

A

progressive muscle weakness of shoulder + pelvic girdle

+ heliotrope rash + grottons papules + shawl sign

58
Q

definitive test for polymyositis

A

muscle biopsy

59
Q

tx polymyositis

A

prednisolone

60
Q

sjogrens

A

autoimmune destruction of salivary glands

- dry mouth / dry eyes

61
Q

symptoms of polymyalgia rheumatica

A

pain + stiffness in shoulder + hip girdle

62
Q

tx polymyalgia rheumatica

A

low dose prednisolone

63
Q

tx PMR with giant cell arteritis symptoms

A

40mg prednisolone if no visual impairment

64
Q

tx giant cell arteritis with visual symptoms

A

HIGH DOSE PREDNISOLONE - 60mg

Exam Revision (32 decks)

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