Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 > Musculoskeletal & Dermatology > Flashcards

Musculoskeletal & Dermatology Flashcards

1
Q

A women who has had a hip replacement due to OA is now feeling pain in the hip radiating down to the knee? What is the most common reason this is happening and so needs a replacement revision?

A

Aseptic loosening of hip replacement

less likely would be prosthetic joint infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When a patient is first diagnosed with RA, a DMARD is recommended to slow disease progression. Alongside this what is co-prescribed?

A

Short course of prednisolone with the Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What scoring system can be used to measure disease activity in RA which considers ‘tender joint count, swollen joint count + ESR, CRP, global patient score’ ?

A

DAS28 (28 for the 28 joints assessed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Methotrexate and pregnancy?

A

Because this DMARD for RA affects DNA synthesis due to its effects on folate it shouldn’t be given. Needs to be stopped 6 months for BOTH the husband or wife who will conceive the baby. Change to sulfasalazine / hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most common agent of osteomyelitis is?

Most common agent of osteomyelitis in sickle cell patients is?

A

Staph aureus

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which nerve is most commonly injured dutring knee arthroplasty and can cause difficulty dorsiflexing the foot?

A

Common peroneal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when should allopurinal be given?

A

it is for recurrent gout prophylaxis

now you give it as soon as someone has one episode of gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

colchicine (option other than NSAID to treat acute gout) side effect?

A

diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When prescribing allopurinol what needs to be given alongside?

A

a ‘cover’ of colchine or nsaid as a co-prescription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

reactive arthritis key quote

A

cant see, pee or climb a tree

  • conjunctivitis
  • Balanitis
  • arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

genetic predisposition SLE

A

HLA DR2 + HLA DR3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

score system to assess risk of pressure sores?

A

Waterlow score , screening test

takes into account
- BMI
- nutritional status
- skin type
- mobility
- continence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rheumatoid factor pathophysio?

A

it itself if an IgM antibody

this antibody targets the bodies IgG antibodies, this caues systemic inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

feltys syndrome?

A

Rhuematoid arthritis
splenomegaly
low white cell count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DIPS vs PIPS

A

Distal = osteoarthritis (distal = older)

proximal = RA, occurs a bit younger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if DMARD (methotrexate, hydroxychloroquine, sulfasalazine) not working for RA?

A

TNF inhibitors = etanerceptm, infliximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

osteoarthritis bony deformities?

A

Heberden nodes (DIPS)
Bouchard nodes (PIPs)
squaring at thumb base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

complication of steroid use for polymyalgia rheumatica?

A

avascular necrosis of femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

corticosteroid induced osteoporosis prophylaxis?

A

e.g. for polymyalgia

alendronate (bisphosphonate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

temporal arteritis summary?

A

headache, jaw claudication, scalp tenderness, visual changes e.g.
tender palpable temporal artery

MX : give prednisolone before biopsy done
- 1st IX = esr, then biopsy
- same day urgent opthalmology review

if no visual loss = high dose oral prednisolone

if vision loss = IV methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

hyperuricaemia causes gout, what causes increased uric acid?

A

Chronic kidney disease
thiazide diuretics
tumor lysis syndrome
idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tophi + podagra?

A

Gout

  • tophi on extensor surface joints
  • podagra is painful MTP of big toe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gout arthrocentesis with synovial fluid analysis?

A

needle shaped crystals, negative birefringence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PsesudoGout arthrocentesis with synovial fluid analysis?

A

rhomboid shaped crystals, positive birefringence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
x-ray gout?
Rat bite erosion
26
why do gram staining and culture for gout?
Exclude septic arthritis
27
septic arthritis synovial fluid analysis?
Yellow/green and turbid 90%+ neutrophils gram stain S aureus = gram + cocci, coagulase positive
28
Abx for staph A septic arthritis
IV abx = flucloxacillin clindamycin if penicillin allergy 4-6 weeks
29
reactive arthritis synovial fluid analysis?
yellow and turbid negative culture normal WBC maybe a bit increased no crystals
30
signs in hx hinting to reactive arthritis?
Hx of UTI/Gastro/STI (chlamdiya) infection patients who have HLA-B27 gene cant see = eye symptoms (conjunctivitis/uveitis) cant pee (uthretitis/balanitis) + enthesitis + keratoderma
31
gene linked with rheumatoid arthritis?
HLA DR4
32
risk factors for pseudogout
risk factors for pseudogout haematochromatosis hyperparathyroidism hypomagnesaemia
33
corticosteroid side effects?
Glaucoma Cataracts weight gain insomnia hypertension hyperglycaemia Cushings
34
SLE - type of hypersensitivity?
Type 3
35
gene linked to SLE?
HLA-DR2 and HLA-DR3
36
SLE is associated with anti-phospholipid syndrome , what are you looking out for 'CLOT"?
Clots Liverdo reticularis Obstetric complications Thrombocytopenia
37
photosensitive rash seen in?
SLE
38
specific vs sensitive SLE ix?
Specific = anti-dsDNA Sensitive = ANA (rule out test)
39
when is CRP high in a SLE px?
When they have infection ESR elevates according to disease activity
40
most common form psoriasis? + summary
Plaque psoriasis silver-white scaly eruptions, worsened by beta blockers, ACE, NSAIDs, lithium better by sun exposure!
41
flexural psoriasis summary
smooth skin in creases e.g. groin / armpit
42
guttate psoriasis summary?
fine erythemarous scaly papules - water drop appearance on trunk arms legs after URTI e.g streptococcal Treat with phototherapy
43
Psoriatic arthritis? Summary
HLA B27 linked asymmetrical polyarthritis (DIPs) , dactylitis, pencil in cup of DIP on Xray Nail signs - oncholysis, nail pitting NSAIDs+ DMARDS AVOID ORAL steroids = worsen skin lesion flare ups
44
Auspitz sign?
pinpoint bleeding when scales from psoriasis scraped off
45
topical hydrocortisone first line for psoriasis, but what to be cautious of?
8 weeks+ = skin atrophy, rebound symptoms, striae
46
Atopic dermatitis and eczema summary?
what - dry, pruritic skin, children, genetic predisposition to increased IgE formation infants = cheeks, forehead scalp, extensors children = flexures, antecubital and popliteal fossa Lichenification and hyperpigmentation (chronic) Mx = emollient, topical hydrocortisone, severe = oral ciclosporin
47
contact dermatitis?
type of eczema occuring following exposure to a causative agent (hx may say patient has new occupation).
48
stage 1 - 4 of pressure ulcers?
1 = nonblanchable erythema skin intact 2 = loss of dermis, a superficial ulcer 3 = loss of all skin types 4 = further damage to structures
49
drugs causing urticaria? 'NOPA'
N = NSAIDs O = opiates P = penicillin A = Aspirin give px antihistamine = loratadine
50
urticaria blanchable?
Yes, blanch on palpation. (Hives)
51
Most common cellulitis organisms?
Catalase + = Staphy A Catalase - = streptococcus pyogenes
52
What is erysipelas?
A limited version type of cellulitis in comparison to cellulitis it causes a well defined lesion that is more superficial caused by strep pyogenes
53
when is cellulitis managed in hospital?
significant systemic upset or have a co-morbidity
54
ERON classification for cellulitis?
Helps guide management Class I - no systemic or co -morbid Class II - either unwell or px has co-morbid Class III = systemic upset, sepsis, nec fasc (class IV) Class I = primary care oral abx Class II = short term hospital Class III = urgent hosp admisison
55
Cellulitis 1st line mx for mild/moderate mx for severe systemic sx?
Flucloxacillin IV-coamoxiclav + cefuroxime + clindamycin/ceftriaxone if penicillin allergy --> clarithryomycin or doxycycline If allergic + pregnant --> erythromycin
56
psoriasis adults
eczema - children
57
patch test vs skin prick test?
For contact dermatitis = skin patch test as its looking for type 4 hypersensitivity (delayed reaction) skin prick = type 1 e.g. IgE allergen mediates
58
SLE renal biopsy?
'Full house' type - deposts that stain for IgA, IgG, IgM, C3, C1q-5 = all positive
59
SLE and resp? SLE and cardio?
Pleurisy, pleural effusion, pneumonitis raynauds phenomenon, myocarditis
60
specific vs sensitive test for RA?
sensitive + 1st line = R factor specific = anti CCP
61
osteomyelitis mx? (after investigating with MRI imaging)
flucloxacillin clindamycin
62
crystals in gout? when do gout attacks happen?
monosodium urate crystals after purine rich food e.g. red meat, seafood
63
when investigating uric levels for gout when shoudl you measure it?
2 weeks after acute attack
64
crystals in pseudogout? x ray findings? management?
calcium pyrophosphate crystals chondrocalcinosis monoarticular disease = intrarticular dexamethasone, NSAIDs, colchine
65
what is allopurinol?
xanthine oxidase inhibitor
66
reactive arthritis vs septic arthritis?
reactive : NO ABX given normal range of motion in the joint, can occur after STI e.g. chlamidya - mx = NSAIDs, steroids, dmard septic: adults + children = staph A sexually active young adult = N gonorrhoea - fever, joint pain, limited range of motion, mx - aspiration + culture, antibiotics
67
osteoarthritis mx?
paracetamol + topical NSAIDs try oral if this doesnt work
68
ankylosing spondylitis 5As?
anteriore uveitis apical lung fibrosis amyloidosis achiles tendos aortic regurg
69
ankylosing spondylitis xray? how to mx?
syndesmophytes - bamboo spine + squaring of L vertebrae NSAIDs+ physio, if severe can give an antiTNF
70
What is the schobers test?
Tests spine flexion, decreased in Ankylosing spondy
71
drug induced lupus causes?
procainamide , hydralazine anti-histone antibodies - seen in SLE also seen in drug indueced
72
SLE mx?
hydroxychloroquine - need to do visual acquity testing

Year 3 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions