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FINALS (all high yield study decks) > MSK and Rheumatology > Flashcards

MSK and Rheumatology Flashcards

1
Q

Define hemiarthroplasty

A

replacing half of the joint (e.g., the head of the femur in the hip joint)

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2
Q

What is the role of the C5 myotome?

A

Shoulder abduction

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3
Q

What is the role of the C6 myotome?

A

Elbow flexion
Wrist extension

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4
Q

What is the role of the C7 myotome?

A

Elbow extension

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5
Q

What is the role of the C8 myotome?

A

Flexion of fingers

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6
Q

What is the role of the T1 myotome?

A

Finger abduction

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7
Q

What is the role of the L2 myotome?

A

Hip flexion

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8
Q

What is the role of the L3/4 myotomes?

A

Knee extension

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9
Q

What is the role of the L4 myotome?

A

Ankle dorsiflexion

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10
Q

What is the role of the L5 myotome?

A

Big toe extension

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11
Q

What is the role of the S1 myotome?

A

Ankle plantar flexion

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12
Q

Where is the most common site for cervical disc prolapse?

A

C5/6

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13
Q

at which level is the phrenic nerve and what is the consequence of damage to this nerve?

A

C3-5
Damage = loss of respiratory function

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14
Q

What is caudal equina?

A

Compression of sacral nerve roots

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15
Q

What can cause caudal equina?

A

disc prolapse, tumours, trauma, spinal stenosis, infection

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16
Q

How is cauda equina managed?

A

MRI and surgery within 48 hours

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17
Q

How does spinal claudication present?

A

Bilateral sensory dysesthesia +/- weakness

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18
Q

What makes spinal claudication worse?

A

Walking down hills

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19
Q

What causes brown-sequard syndrome?

A

Heme-section of the spinal cord

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20
Q

How does brown-sequard syndrome present?

A

paralysis on the affected side (corticospinal)

loss of proprioception and fine discrimination (dorsal columns) on the affected side

loss of pain and temperature on the opposite side below the lesion (spinothalamic)

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21
Q

How does central cord syndrome present?

A

disproportionate impairment of the upper limb motor function compared to the lower limbs

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22
Q

What causes central cord syndrome?

A

arthritic changes in the neck compressing the cord

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23
Q

What causes anterior cord syndrome?

A

ischaemia to the anterior spinal artery

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24
Q

How does anterior cord syndrome present?

A

like brown squard except Fine touch and proprioception are preserved

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25
Q

What is spinal stenosis?

A

Narrowing of the spinal cord causing compression of spinal cord or nerve roots

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26
Q

How does spinal stenosis present?

A

Claudication-like feeling in buttock and leg

Bending forward improves symptoms

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27
Q

What is the pathophysiology behind dupuytren’s contracture?

A

palmar aponeurosis becomes thickened and contracted, pulling the fingers into a flexed state

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28
Q

What conditions is Dupuytren’s Disease associated with?

A
  • Diabetes
  • Alcohol
  • Tobacco
  • HIV
  • Epilepsy
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29
Q

What factors are associated with worse outcomes in those with Dupuytren’s Disease?

A

Family hx

Early or bilateral disease

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30
Q

How is Dupuytren’s Disease managed?

A

Surgically- cut the aponeurosis

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31
Q

What causes trigger finger?

A

Swelling on tendon catches on pulley

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32
Q

What tendons are involved in De Quervain’s Syndrome?

A
  • Abductor pollicis longus (APL) tendon
  • Extensor pollicis brevis (EPB) tendon
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33
Q

What causes De Quervain’s Syndrome?

A

Overuse causes the extensor reticulatum to swells causing pain in the tendon running up the thumb

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34
Q

What clinical sign is indicative of De Quervain’s Syndrome?

A

Extension of thumb against resistance will cause pain

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35
Q

How is De Quervain’s Syndrome managed?

A

Splints, steroid injections and surgical decompression of reticulatum

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36
Q

Name 3 of the clinical findings you may see when examining the hands of a patient with osteoarthritis

A
  • Heberden’s nodes
  • Bouchard’s nodes
  • Squaring at base of thumb
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37
Q

In osteoarthritis, how is squaring of the base of the thumb managed?

A

Trapeziectomy

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38
Q

What are the x-ray features associated with osteoarthritis?

A

L-loss of joint space

O-osteophytes

S-Subchondral sclerosis (increased density of bone along the joint line)

S- Subchondral cysts (fluid filled cavities in the bone)

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39
Q

When would osteoarthritis be a clinical diagnosis?

A

> 45 years old
typical arthritic pain
and
no morning stiffness lasting >30 minutes

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40
Q

Which nerve roots cause erb’s palsy?

A

C5, 6

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41
Q

What causes erb’s palsy?

A

Downward traction (e.g. forceps)

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42
Q

What is erb’s palsy otherwise known as due to the way it presents?

A

Waiter’s tip

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43
Q

What nerve root is damaged in Klumpke’s palsy?

A

T1

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44
Q

What causes Klumpke’s palsy?

A

Upward traction (e.g. swinging from a tree)

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45
Q

Which nerve is damaged when there is parasthesia of the regimental badge area?

A

Axillary nerve

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46
Q

What is the most common cause of axillary nerve injury?

A

damage to the surgical neck of humerus

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47
Q

Which nerve is damaged in ‘Saturday night palsy’?

A

Radial nerve

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48
Q

How does Saturday night palsy present?

A

Loss of sensation and wrist extension

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49
Q

Which nerve is compressed in carpal tunnel syndrome (give the nerve root for extra points!)

A

Median nerve
C5-T1

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50
Q

What is cubital tunnel?

A

Compression of the ulnar nerve at the cubital tunnel (the space between the medial epicondyle and the olecranon)

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51
Q

What does cubital tunnel syndrome cause?

A

Numbness on the ulnar aspect of hand and arm

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52
Q

Which nerve (+ the roots!) is damaged in patients with pain/burning/tingling on the anteriolateral aspect of thigh

A

Anterior cutaneous nerve of the thigh (L2/3)

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53
Q

What are the nerve roots for the sciatic nerve?

A

L3-4

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54
Q

What is bilateral sciatica a red flag for?

A

Caudal equina

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55
Q

How is sciatica managed

A

Amitriptyline or duloxetine

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56
Q

What nerve (+roots!) causes foot drop

A

Common peroneal nerve L4-S2

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57
Q

What type of injury causes damage to the meniscus of the knee?

A

Twisting

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58
Q

What characteristic ‘symptoms’ indicate a meniscal injury

A

Knee locking or giving way

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59
Q

What is the best imaging modality to visualise the meniscus of the knee?

A

MRI

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60
Q

How is a meniscal injury of the knee managed?

A

RICE, NSAIDs, physio, surgical options if exhausted everything else

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61
Q

What is the function of the anterior cruciate ligament?

A

stops the tibia from sliding forward in relation to the femur.

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62
Q

What is the function of the posterior cruciate ligament?

A

Stops the tibia sliding backwards in relation to the femur.

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63
Q

How can cruciate injuries be differentiated from meniscal injuries on knee examination?

A

Cruciate injury causes knee instability

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64
Q

What is osgood-schlatter disease?

A

Inflammation and avulsion fractures of tibial tuberosity where patellar tendon insert

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65
Q

How is osgood-schlatter disease managed?

A

Supportive management

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66
Q

Prescription of which antibiotic is associates with achilles tendon rupture

A

fluoroquinolone antibiotics (-floxacin)

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67
Q

What is the inheritance pattern os Ehler’s Danlos?

A

Autosomal dominant

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68
Q

What is the most common form of ehler’s danlos syndrome?

A

Hypermobile

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69
Q

Other than hypermobile, what other types of ehler’s danlos are there?

A

vascular (fragile blood vessels prone to rupture)

kyphoscoliotic (poor muscle tone)

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70
Q

Which scoring system is used to assess Ehler’s Danlos?

A

Beighton score

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71
Q

What are gout crystals made from and how do they look under microscopy?

A

Monosodium urate (from purine breakdown)

Needle shaped, negatively bifringent (negative needles)

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72
Q

What are pseudogout crystals made from and how do they look under microscopy?

A

Calcium pyrophosphate dihydrate

Rhomboid shaped, positively bifringent (pseudo positive)

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73
Q

How is gout managed 1st line?

A

NSAIDS

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74
Q

What medication should be used to treat an acute attack of gout if NSAIDs are not tolerated?

A

Colcechine

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75
Q

What medication is given to prevent gout?

A

Allopurinol

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76
Q

When should allopurinol be started for a patient with gout?

A

after 1st attack has settled

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77
Q

What should be prescribed alongside allopurinol when it is given for the first time?

A

colcechine for the first 6 months of allopurinol treatment as ‘cover’

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78
Q

What lifestyle modifications can help prevent gout?

A

Avoid alcohol, dehydration, red meat and being fat

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79
Q

What is the common x-ray finding in patients with pseudo gout?

A

chondrocalcinosis

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80
Q

How is pseudo gout managed?

A

NSAIDs, colcechine and steroids

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81
Q

What is the most common cause of osteomyelitis?

A

Staph aureus

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82
Q

How long should antibiotic therapy be taken for in patients with acute osteomyelitis?

A

4-6 weeks

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83
Q

What is the antibiotic of choice for a patient with an s. aureus osteomyelitis?

A

Flucloxacillin

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84
Q

Which antibiotic is used to treat chronic osteomyelitis?

A

Gent

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85
Q

What is the most common bacterial cause of septic arthritis in a patient with
A) Their own joint
B) An artificial joint

A

A) Own joint = S. Aureus
B) Artificial joint = S. Epidermis

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86
Q

How is septic arthritis managed?

A

Surgical drainage & lavage + 3-4 weeks of antibiotics.

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87
Q

How can osteoarthritis be managed?

A
  • Paracetamol and NSAIDs
  • Intra-articular joint injections
  • Joint replacement
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88
Q

What is osteosarcoma?

A

Bone cancer

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89
Q

What is chondrosarcoma?

A

Cancer of the cartilage

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90
Q

Which demographic is most commonly affected by Ewing’s sarcoma?

A

Children and young adults

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91
Q

How does Ewing’s sarcoma look on x-ray?

A

Onion skin appearance

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92
Q

Name the tool used to assess a patient’s risk of fragility fracture in the next 10 years

A

FRAX tool

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93
Q

What is a ‘complete’ fracture

A

Bone is completely severed

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94
Q

What is a ‘greenstick’ fracture?

A

Snapped but not completely disconnected

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95
Q

What is a ‘buckle’ fracture?

A

Longitudinal compression

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96
Q

What is a ‘plastic’ bone deformity?

A

Bone is bent not broken

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97
Q

What is a physeal fracture?

A

A fracture involving the growth plate

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98
Q

How are physeal fractures graded?

A

Salter-Harris

99
Q

What is the most common part of the clavicle to fracture?

A

Middle 1/3rd

100
Q

What does a Colle’s fracture look like?

A

Dinner fork deformity

101
Q

Which nerve is commonly injured in patients with a colle’s fracture?

A

Median

102
Q

What mechanism of injury most commonly causes a colle’s fracture?

A

FOOSH

103
Q

What is the biggest risk for a patient with a scaphoid fracture

A

Avascular necrosis

104
Q

Discuss the imaging requirements in scaphoid fractures

A

Re-xray 2 weeks after injury if initial x-ray normal

105
Q

What is the common mechanism of action resulting in a scaphoid fracture?

A

FOOSH

106
Q

What is a Bennet’s fracture?

A

Intra-articular fracture at the base of the first metacarpal

107
Q

What is the common mechanism of injury causing a Bennet’s fracture?

A

Boxing or FOOSH

108
Q

How is a Bennet’s fracture managed?

A

Unstable fracture- will require reduction +/- wires / screw fixation and a cast

109
Q

What is Gamekeeper’s thumb?

A

rupture of ulnar collateral ligament of the thumb

110
Q

How does gamekeeper’s thumb present?

A

pain on the radial border of the thumb with a weak pinch grip and a history of injury

111
Q

How is gamekeeper’s thumb managed?

A

cast +/- surgical repair

112
Q

How are intra-capsular hip fractures classified?

A

Garden Criteria

113
Q

How would you fix:

A) Non-displaced intra-capsular hip fracture

B) Displaced intra-capsular hip fracture

A

A) Internal fixation
B) Hemiarthroplasty if previously poor mobility, total hip replacement if mobile

114
Q

How would you fix:

A) intertrochanteric extra-capsular hip fracture

B) sub-trochanteric extra-capsular hip fracture

A

A) Dynamic hip screw

B) Intramedullary nail

115
Q

How are fractures of the lateral malleolus classified?

A

Weber’s classification

Type A- below the ankle joint
Type B- At the level of the ankle joint
Type C- Above the ankle joint

116
Q

What is the most common direction for a shoulder to dislocate?

A

Anterior

117
Q

What is a posterior shoulder dislocation associated with?

A

electric shocks and siezures.

118
Q

Name the two different types of reduction which can be used for an anterior shoulder dislocation

A

Hippocratic and Kocher reduction

119
Q

What is the significant clinical sign associated with subacromial impingement?

A

painful arc when raising arm (joint injection, physio and decompressive surgery)

120
Q

What are the three stages in the disease progression of frozen shoulder?

A

Freezing, frozen and thawing (1 year total time)

121
Q

How is frozen shoulder managed?

A

Self limiting
Physio
Hydrodilation can be tried

122
Q

Is golfers elbow medial or lateral?

A

Medial

123
Q

Is tennis elbow medial or lateral?

A

Lateral

124
Q

What causes tennis/golfers elbow?

A

Inflammation where tendons insert into epicondyles of elbow.

125
Q

What is Paget’s disease?

A

Increased bone reabsorption followed by increased bone formation

126
Q

How does Paget’s disease present?

A

Old man, Hearing loss (unilateral deafness!!), bone pain and bowing of long bones

127
Q

What would you see on blood tests that indicates Paget’s disease?

A

Isolated rise in ALP

128
Q

How is symptomatic Paget’s / Paget’s with skull involvement managed?

A

IV bisphosphonates

129
Q

What is Ricketts?

A

Vitamin D deficiency in a child

130
Q

What is osteomalacia?

A

Vitamin D deficiency in an adult

131
Q

What lab test can be used to identify vitamin D deficiency?

A

serum 25-hydroxyvitamin D (<25 nmol/l = deficiency)

132
Q

How does ricketts present?

A

stunted growth and abnormal bone shape

133
Q

How does osteomalacia present?

A

bone pain, increased fracture risk and muscle weakness

134
Q

What is given to treat rickett’s/osteomalacia?

A

calcium and colecalciferol (vitamin D)

135
Q

What is osteogenesis imperfecta?

A

Genetic disorder of collagen

136
Q

How does osteogenesis imperfecta present?

A

Blue sclera & hearing loss along with fractures

137
Q

What medication is given to prevent fractures in patients with osteogenesis imperfecta?

A

IV Bisphosphonates

138
Q

What is osteopetrosis?

A

Defective osteoclasts- bones grow abnormally and become too dense. They then are brittle and fracture easily

139
Q

What is osteoporosis?

A

Low bone mass and deterioration of structural bone tissues

140
Q

Which patient’s should get a DEXA scan?

A

FRAX score >10%
Low impact mechanism of injury
Young person with unexpected fractures

141
Q

What is a t score in a DEXA?

A

T score = bone mass compared to a healthy young adult (T for Teenager). Measured at femoral neck.

142
Q

What is a Z score in a DEXA?

A

compared to an adult of the patient’s age, sex and ethnicity

143
Q

What DExA score is
A) Normal
B) Osteopenic
C) Osteoporotic

A

A) >1
B) 1 to -2.5
C) <-2.5

144
Q

What is developmental dysplasia of the hip?

A

Ball and socket” joint of the hip does not properly form in babies and young children

145
Q

What are the risk factors for developmental dysplasia of the hip?

A
  • First born
  • Breech
  • Female
  • Oligohydramnios
  • High birth weight
146
Q

How is developmental dysplasia of the hip clinically assessed?

A

Barlow’s and ortalanis

147
Q

What is the gold standard test for diagnosing developmental dysplasia of the hip?

A

Ultrasound

148
Q

How is developmental dysplasia of the hip managed?

A

Pavlik Harness

149
Q

What is Perthe’s disease?

A

Avascular necrosis of femoral head

150
Q

What are the risk factors associated with Perthe’s disease?

A

Male of primary school age
Coagulation issues
repetitive minor trauma
familial history

151
Q

How does Perthe’s disease present?

A

Short stature and a limp

152
Q

How is Perthe’s disease staged?

A

Waldestrom staging

  1. Sclerosis and increased joint space
  2. Fragmentation of the epiphysis
  3. Reossification (new bone begins to appear around the fragments
  4. Reformation of the humeral head
153
Q

How is Perthe’s disease managed?

A

Splints & physio

Osteotomy may be useful in some children >7 years old

154
Q

What is Slipped Upper Femoral Epiphysis?

A

Femoral head slips off the neck of the bone at the epiphysis (growth plate) in a backward direction.

155
Q

What is the classic demographic of a patient with Slipped Upper Femoral Epiphysis?

A

Overweight boy around 13

156
Q

How does Slipped Upper Femoral Epiphysis present?

A

Groin pain persisting for >3 months
Shortened and internally rotated leg

157
Q

How is Slipped Upper Femoral Epiphysis managed?

A

Hips will need to be pinned to prevent slippage after reduction

158
Q

How does transient synovitis present?

A
  • Limping child mainly well
  • Hx of viral infection
  • Apyrexic, low CRP and WCC
159
Q

What is the triad of clinical findings in non-accidental injury?

A

retinal haemorrhage
subdural haemorrhage
encephalopathy

160
Q

What are the requirements for juvenile idiopathic arthritis to be diagnosed?

A

Patient must be <16 and have suffered symptoms for >6 weeks

161
Q

How is idiopathic juvenile arthritis managed?

A

NSAIDs and biologics (methotrexate, anti-TNF)

162
Q

How does juvenile idiopathic arthritis present?

A

Localised growth failures may occur causing things like leg length discrepancies, shortening of the fingers, hands, forearms toes and feet and issues with jaw growth (micrognathia)

Can cause blindness so eye screen is essential

163
Q

What is STILLs disease?

A

Body wide inflammation

164
Q

How does STILLs disease present?

A

salmon-red eruption rash on trunk and thighs

Abdominal pain, splenomegaly, hepatitis, serotitis and pericarditis

165
Q

What is Pauciarticular (oligioarticular) arthritis?

A
  • <4 joints involved
  • Most common
166
Q

What condition is Pauciarticular (oligioarticular) arthritis associated with?

A

Anterior uveitis

167
Q

what is Polyarticular arthritis?

A

Can be Rheumatoid factor negative or positive

Affects >5 joints

Affects large and small joints in a symmetrical fashion

168
Q

What is Polymyalgia Rheumatica?

A

inflammatory condition of the elderly which causes muscle pain and stiffness in the neck, shoulders and pelvic girdle.

169
Q

What condition is Polymyalgia Rheumatica strongly associated with?

A

Temporal arteritis

170
Q

What lab test is helpful when diagnosing polymyaglia rheumatica?

A

ESR (>45)

171
Q

How is polymyalgia rheumatica managed?

A

steroids (pred)- there will be a dramatic response

172
Q

What is the gene associated with rheumatoid arthritis?

A

HLA-DR4

173
Q

What is the pathophysiology behind rheumatoid arthritis?

A

Autoimmune inflammation of the synovial membrane causes thickening and the production of RANKL factor which activates osteoclasts

174
Q

What physical findings might you see in the hands of a patient with rheumatoid arthritis

A

Z-shaped thumb deformity
swan neck deformity
Boutonniere deformity
ulnar deviation of fingers at MCP

175
Q

Which joints are most commonly affected in rheumatoid arthritis?

A

MCP and PIP joints

176
Q

List the x-ray findings you might see in a patient with rheumatoid arthritis

A
  • Peri-articular osteopenia
  • Boney erosions
  • Soft tissue swelling
  • Joint destruction and deformity
177
Q

Which rheumatoid arthritis patients are eligible for biological therapy?

A

Disease activity score (DAS28) > 4.5 = eligible for biologic therapy

178
Q

Which drug is most commonly used in rheumatoid arthritis?

A

Methotrexate

179
Q

What is SLE?

A

Autoimmune attack of cells

180
Q

What is the most common complication of SLE?

A

Cardiovascular disease

181
Q

What are the most common autoantibodies associated with SLE?

A

ANA
Anti-ds DNA

182
Q

What is given to patients with anti-phospholipid syndrome? (not pregnant and pregnant)

A

Not pregnant = Warfarin (INR target 2-3)

Pregnant = LMWH and aspirin

183
Q

What skin rash is antiphospholipid syndrome associated with?

A

Livedo Reticularis (purple lace like rash)

184
Q

What skin rash is SLE associated with?

A

Malar rash

185
Q

how is SLE managed?

A

NSAIDs & hydroxychloroquine first line
DMARDs and biologics for severe disease

186
Q

How does discoid lupus erythematous present?

A

Circular, round, flaky lesions on face, neck and ears

Scarring alopecia and hyper or hypo pigmentation

187
Q

What is localised scleroderma?

A

fibrosis of the skin and subcutaneous fat

188
Q

What autoantibody is associated with localised scleroderma?

A

ANA

189
Q

How does limited cutaneous systemic sclerosis present?

A

CREST
calcinosis, Raynaud’s, oesophageal dysmotility, sclerodactyly, TelangiectasiaH

190
Q

What test can be used to differentiate sclerotic and idiopathic Raynaud’s?

A

Nailfold capilloscopy

191
Q

What is raynauds treated with?

A

Nifedipine

192
Q

Which autoantibodies is CREST syndrome associated with?

A

ANA and Anti-centromere

193
Q

Is CREST syndrome fast or slow progressing?

A

Slow

194
Q

How is CREST syndrome managed?

A

DMARDs and Steroids

195
Q

Which autoantibodies are associated with Diffuse cutaneous systemic sclerosis?

A

ANA
Anti-Scl70

196
Q

How does Diffuse cutaneous systemic sclerosis present?

A

CREST + Internal organ fibrosis

197
Q

How is Diffuse cutaneous systemic sclerosis managed?

A

DMARDs and Steroids

198
Q

What is Sjogrens syndrome and how does it present?

A

Autoimmune destruction of exocrine salivary and tear ducts causing oral, ocular and vaginal dryness.

199
Q

What autoantibodies are associated with Sjogren’s?

A

Anti-Ro or Anti-La

200
Q

How can you test for Sjorgren’s?

A

Schirmer’s test - <10mm of moisture diffusion = significant

201
Q

How is Sjrogren’s managed?

A

artificial lubricants and saliva.
Pilocarpine stimulates tears and saliva.

202
Q

What is the difference between polymyositis and dermatomyositis

A

Both associated with muscle weakness, dermatomyositis also has a skin rash (Gottron’s papule and Heliotrope rash)

203
Q

What antibody is associated with polymyositis?

A

Anti-jo

204
Q

What autoantibody is associated with dermatomyositis?

A

Anti-jo & Anti-Mi-2

205
Q

What blood result will be significantly elevated in autoimmune myositis (polymyositis and dermatomyositis)?

A

CK

206
Q

What is the gold standard for diagnosing Autoimmune myositis?

A

Muscle biopsy

207
Q

How is autoimmune myositis managed?

A

Steroids

208
Q

name the small vessel vasculitisis

A

Henloch-Schönlein Purpura
Microscopic Polyangiitis
Granulomatosis with Polyangiitis (Wegner’s)
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)

209
Q

What are the key features of Henloch-Schönlein Purpura?

A

Affects children
IgA deposits in blood vessels cause rash and nephritis

210
Q

What are the key features of microscopic polyangitis?

A

p-ANCA
Glomerulonephritis causes renal failure
Diffuse alveolar haemorrhage

211
Q

What are the key features of Granulomatosis with Polyangiitis (Wegner’s)

A

c-ANCA
Nasal and respiratory symptoms
Saddle shaped nose due to bridge collapse
Glomerulonephritis

212
Q

What are the key features of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)?

A

p-ANCA
Eosinophils
Affects lungs and skin
Late onset asthma
Sinusitis and rhinitis

213
Q

Name the vasculitis-is affecting medium sized vessels

A

Polyarteritis Nodosum
Kawasaki disease

214
Q

What are the key features of Polyarteritis Nodosum?

A

Often occurs secondary to Hep B
Renal impairment
Hypertension
Cardiovascular events
Tender skin nodules

215
Q

What are the key features of Kawasaki disease?

A

High fever
Widespread rash
Bilateral conjunctivitis
Strawberry tongue
Coronary artery aneurisms

216
Q

What is the most important complication of Kawasaki disease?

A

Coronary artery aneurisms

217
Q

Name the two large vessel vasculitis-is

A

Giant cell arteritis
Takayasu’s arteritis

218
Q

What are the key features of giant cell arteritis?

A

Raised ESR
Unilateral headache
Scalp tenderness
Vision loss

219
Q

What is the gold standard diagnostic modality for giant cell arteritis?

A

Temporal artery biopsy is gold standard – remember lesions can skip so a normal biopsy is not definitive

220
Q

What sign might you see on ultrasound in a patient with giant cell arteritis?

A

Halo sign

221
Q

How is giant cell arteritis managed?

A

Aspirin and IV immunoglobulins

222
Q

What are the key features of Takayasu’s arteritis?

A

Aortic arch affected
Pulseless disease

223
Q

What is Behçet’s Disease?

A

Recurrent oral and genital ulcers caused by inflammation of blood vessels and tissues

224
Q

What gene is associated with Behçet’s Disease?

A

HLA-B51

225
Q

What test is used to diagnose Behçet’s Disease/

A

Pathery test

226
Q

how is Behçet’s Disease managed?

A

Steroids and colchicine

227
Q

Name the 3 seronegative arthropathies and the gene they are all associated with

A

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis

HLA-B27

228
Q

What does “seronegative” mean?

A

negative rheumatoid factor

229
Q

What is ankylosing spondylitis?

A

Inflammation of axial skeleton

230
Q

How does ankylosing spondylitis present?

A

Morning pain & stiffness improving with exercise

231
Q

ankylosing spondylitis can cause fibrosis in other body systems. What are the 5 A’s associated with ankylosing spondylitis?

A
  • A- Anterior uveitis
  • A- Aortic regurgitation
  • A- Atrioventricular block
  • A- Apical lung fibrosis
  • A- Anaemia of chronic disease
232
Q

What might you see on the X-ray of a patient with Ankylosing spondylitis?

A

Syndesmophites, bamboo spine, subchondral erosions and sclerosis

233
Q

How is Ankylosing spondylitis managed?

A

NSAIDs and Anti-TNF

234
Q

What joints are affected in psoriatic arthritis?

A

DIP joints and axial skeleton

235
Q

What other associated symptoms might you see in a patient with psoriatic arthritis?

A

Nail changes
uveitis and IBD

236
Q

What is the classic X-ray finding in psoriatic arthritis?

A

Pencil in cup deformity

237
Q

How is psoriatic arthritis managed?

A

NSAIDs, Steroids & DMARDs

238
Q

Name the causes of reactive arthritis

A

Chlamydia
dysentery caused by salmonella, shigella or campylobacter

239
Q

How does reactive arthritis present?

A

Can’t see, pee or climb a tree (anterior uveitis/conjunctivitis, urethritis and arthritis)

240
Q

What condition must you test for in a patient with reactive arthritis?

A

HIV

241
Q

How is reactive arthritis managed?

A

Joint aspiration, treat underlying cause, steroids

242
Q

How is Kawasaki disease treated?

A

High dose aspirin

243
Q
A

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