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#passmed 2023 > MSK n Rheums > Flashcards

MSK n Rheums Flashcards

1
Q

What is the most common causative organism of Discitis?

A

Staph aureus

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2
Q

If Discitis caused by Staph aureus, what investigation tells you the most likely cause?

A

Echo, bc probs caused by Inf endocarditis

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3
Q

What is the Dx when pt has Proximal muscle weakness + raised CK and NO rash?

A

Polymyositis

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4
Q

What are the CF of Polymyositis? (5 things)

A
  1. Proximal muscle weakness
  2. Raised CK
  3. Raynauds
  4. Resp muscle weakness
  5. No rash
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5
Q

What will be raised in Polymyositis? (2 things)

A
  1. CK
  2. Anti-synthetase antibodies
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6
Q

What is the Mx for Polymyositis?

A

High dose corticosteroids

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7
Q

What is the Mx for Polymyositis?

A

High dose corticosteroids

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8
Q

What will you see on joint aspiration of pseudogout?

A

Calcium pyrophosphate dihydrate crystals

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9
Q

What causes Pseudogout?

A

Hyperparathyroidism

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10
Q

What is the Mx for Pseudogout? (2 things)

A
  1. NSAIDs
  2. Steroids
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11
Q

What is a resp side fx of MTX?

A

Pneumonitis (dry cough, SOB, fever)

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12
Q

What drug does Allopurinol have a severe interaction with?

A

Azathioprine –> bone marrow suppression

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13
Q

What is the MAO of Allopurinol?

A

Xanthine oxidase inhibitor

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14
Q

What is a special test you can do when you sus of Ankylosing Spondylitis?

A

Schobers test

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15
Q

What are the CF of Ankylosing Spondylitis in Schobers test? (3 things)

A
  1. Reduced chest expansion
  2. Reduced lateral flexion of spine
  3. Reduced forward flexion
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16
Q

What are some assoc CF of Ankylosing Spondylitis? (4 things)

A

All the A’s:
1. Ant uveitis (painful / blurry vision)
2. Aortic Regurg
3. Apical fibrosis
4. Achilles tendonitis (heel pain)

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17
Q

What is the antibody in Antiphospholipid syndrome?

A

Anti-cardiolipin

18
Q

What is a common cause of BILATERAL carpal tunnel syndrome?

A

RA

19
Q

If pain in a Rib # is not controlled by normal analgesia, what can you consider?

A

Intercostal nerve block

20
Q

What is Psoriatic arthritis assoc with?

A

Psoriasis of skin

21
Q

What antibody is Psoriatic arthritis assoc with?

A

HLA-B27

22
Q

What are the CF of Psoriatic arthritis? (4 things)

A
  1. Symmetrical / asymmetrical arthritis (symmetrical more common tho)
  2. Sausage fingers
  3. Psoriatic skin
  4. Sacroiliitis
23
Q

What are the CF of Dermatomyositis? (3 things)

A
  1. Symmetrical proximal muscle weakness
  2. Macular rash on back + shoulders
  3. Gottrons papules (rough red things on fingers)
24
Q

What do you need to screen for after Dx of Dermatomyositis?

A

Malignancy
(bc assoc w underlying cancer)

25
Q

What are the antibodies in Dermatomyositis? (3 things)

A
  1. ANA
  2. Jo1
  3. anti-Mi-2
    Ana, Jo, wa Me
26
Q

What are the CF of Polymyalgia rheumatica? (5 things)

A
  1. Old pt (60+)
  2. Rapid onset (less than 1 month)
  3. Morning stiffness
  4. NO WEAKNESS (strength no weakness innit)
  5. Mild polyarthralgia
27
Q

What are the investigation results for Polymyalgia rheumatica? (2 things)

A
  1. Raised ESR
  2. NORMAL CK
28
Q

What is the Tx for Polymyalgia rheumatica?

A

Prednisolone

29
Q

What drugs can cause drug induced lupus? (4 things)

A
  1. Procainamide
  2. Hydralazine
  3. Isoniazid
  4. Phenytoin
30
Q

What are the CF of Drug induced lupus? (4 things)

A
  1. Arthralgia
  2. Myalgia
  3. Malar rush
  4. Pleurisy
31
Q

What are the antibodies in Drug induced lupus? (2 things)

A
  1. ANA
  2. Anti-histone
32
Q

What are the CF of Reactive Arthritis? (4 things)

A

Arthritis (asymmetrical) + Can’t see, pee, or climb a tree
1. SEE = Conjunctivitis / Ant Uveitis
2. PEE = Urethritis
3. CLIMB TREE = waxy brown papules on palm + soles

33
Q

Can you recover the causative organism of Reactive arthritis from the joint?

A

No

34
Q

How long after the initial infection do you get Reactive arthritis?

A

4 weeks

35
Q

What movement is impaired in Adhesive capsulitis?

A

External rotation (both active + passive)

36
Q

What are the RF for Adhesive capsulitis? (4 things)

A
  1. Female
  2. 40-70 yrs
  3. DM
  4. Hypothyroidism
37
Q

What should you give in MTX toxicity?

A

Folinic acid

38
Q

What is the best way to Dx Ankylosing Spondylitis?

A

Pelvic XR (will see sacro-ilitis)

39
Q

What abx can you not give with MTX?

A

Trimethoprim
(methoTRexate + TRimethroprim)

40
Q

Why cant you give methoTRexate + TRimethroprim together?

A

Risk of bone marrow suppresion

#passmed 2023 (39 decks)

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