MSK n Rheums Flashcards
What is the most common causative organism of Discitis?
Staph aureus
If Discitis caused by Staph aureus, what investigation tells you the most likely cause?
Echo, bc probs caused by Inf endocarditis
What is the Dx when pt has Proximal muscle weakness + raised CK and NO rash?
Polymyositis
What are the CF of Polymyositis? (5 things)
- Proximal muscle weakness
- Raised CK
- Raynauds
- Resp muscle weakness
- No rash
What will be raised in Polymyositis? (2 things)
- CK
- Anti-synthetase antibodies
What is the Mx for Polymyositis?
High dose corticosteroids
What is the Mx for Polymyositis?
High dose corticosteroids
What will you see on joint aspiration of pseudogout?
Calcium pyrophosphate dihydrate crystals
What causes Pseudogout?
Hyperparathyroidism
What is the Mx for Pseudogout? (2 things)
- NSAIDs
- Steroids
What is a resp side fx of MTX?
Pneumonitis (dry cough, SOB, fever)
What drug does Allopurinol have a severe interaction with?
Azathioprine –> bone marrow suppression
What is the MAO of Allopurinol?
Xanthine oxidase inhibitor
What is a special test you can do when you sus of Ankylosing Spondylitis?
Schobers test
What are the CF of Ankylosing Spondylitis in Schobers test? (3 things)
- Reduced chest expansion
- Reduced lateral flexion of spine
- Reduced forward flexion
What are some assoc CF of Ankylosing Spondylitis? (4 things)
All the A’s:
1. Ant uveitis (painful / blurry vision)
2. Aortic Regurg
3. Apical fibrosis
4. Achilles tendonitis (heel pain)
What is the antibody in Antiphospholipid syndrome?
Anti-cardiolipin
What is a common cause of BILATERAL carpal tunnel syndrome?
RA
If pain in a Rib # is not controlled by normal analgesia, what can you consider?
Intercostal nerve block
What is Psoriatic arthritis assoc with?
Psoriasis of skin
What antibody is Psoriatic arthritis assoc with?
HLA-B27
What are the CF of Psoriatic arthritis? (4 things)
- Symmetrical / asymmetrical arthritis (symmetrical more common tho)
- Sausage fingers
- Psoriatic skin
- Sacroiliitis
What are the CF of Dermatomyositis? (3 things)
- Symmetrical proximal muscle weakness
- Macular rash on back + shoulders
- Gottrons papules (rough red things on fingers)
What do you need to screen for after Dx of Dermatomyositis?
Malignancy
(bc assoc w underlying cancer)
What are the antibodies in Dermatomyositis? (3 things)
- ANA
- Jo1
- anti-Mi-2
Ana, Jo, wa Me
What are the CF of Polymyalgia rheumatica? (5 things)
- Old pt (60+)
- Rapid onset (less than 1 month)
- Morning stiffness
- NO WEAKNESS (strength no weakness innit)
- Mild polyarthralgia
What are the investigation results for Polymyalgia rheumatica? (2 things)
- Raised ESR
- NORMAL CK
What is the Tx for Polymyalgia rheumatica?
Prednisolone
What drugs can cause drug induced lupus? (4 things)
- Procainamide
- Hydralazine
- Isoniazid
- Phenytoin
What are the CF of Drug induced lupus? (4 things)
- Arthralgia
- Myalgia
- Malar rush
- Pleurisy
What are the antibodies in Drug induced lupus? (2 things)
- ANA
- Anti-histone
What are the CF of Reactive Arthritis? (4 things)
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
Can you recover the causative organism of Reactive arthritis from the joint?
No
How long after the initial infection do you get Reactive arthritis?
4 weeks
What movement is impaired in Adhesive capsulitis?
External rotation (both active + passive)
What are the RF for Adhesive capsulitis? (4 things)
- Female
- 40-70 yrs
- DM
- Hypothyroidism
What should you give in MTX toxicity?
Folinic acid
What is the best way to Dx Ankylosing Spondylitis?
Pelvic XR (will see sacro-ilitis)
What abx can you not give with MTX?
Trimethoprim
(methoTRexate + TRimethroprim)
Why cant you give methoTRexate + TRimethroprim together?
Risk of bone marrow suppresion
