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Year 3 > Neurology/ Musculoskeletal > Flashcards

Neurology/ Musculoskeletal Flashcards

1
Q

What is Gout?

A

A type of arthritis caused be hyperuricaemia

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2
Q

Which joints are typically affected in Gout?

A 
1st MTPJ (Toe)
Usually monoarticular (1 joint)
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3
Q

Which foods are high in purines?

A

Sardines and bacon

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4
Q

What does RICE stand for?

A

Rest, ice, compression elevation

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5
Q

What is Naproxen?

A

NSAID

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6
Q

What is the go to medication for Gout?

A

Allopurinol

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7
Q

What is the target for Gout medication?

A

Urate lowering therapy

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8
Q

How is pseudogout different to gout?

A

Pseudogout = Calcium pyrophosphate crystal deposition

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9
Q

What is the difference in crystals in Gout Vs. Pseudogout?

A

Negative birefringent crystals Vs positive in pseudogout.

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10
Q

When is pain worse in OA Vs RA?

A 
RA = morning stiffness
OA = evening stiffness
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11
Q

Which joints are typically affected in Osteoarthritis?

A

1st CMCJ (Base of thumb)

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12
Q

Why would you use steroids in osteoarthritis despite condition not being inflammatory?

A

Local inflammation in joint within OA.

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13
Q

What is Felty’s syndrome?

A

RA + Splenomegaly + low WBC

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14
Q

Which are the two tests to consider in diagnosing RA?

A

Rheumatoid factor

Anti-CCP

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15
Q

Which is the most common DMARD?

A

Methotrexate

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16
Q

Which is the condition which overlaps with Polymyalgia Rheumatica?

A

Temporal arteritis (GCA)

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17
Q

What are signs specific to GCA? Is the headache bilateral or unilateral?

A

Unilateral
Scalp tenderness
Jaw claudication (sore, painful)
Visual disturbances

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18
Q

Give three red flags of a headache

A
  1. Sudden onset, ‘thunderclap’
  2. New onset >50 years
  3. Significant change in characteristics (sudden change from their usual headaches)
  4. Fever, photophobia, neck stiffness
  5. Visual disturbances
  6. Vomiting
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19
Q

Heberden’s and bouchard’s nodes are found in which condition?

A

Osteoarthritis.

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20
Q

Give x3 features of osteoarthritis.

A

Asymmetrical

Distal joints

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21
Q

How does osteoarthritis differ from rheumatoid arthritis?

A

Osteoarthritis = distal joints, asymmetrical

Rheumatoid arthritis = symmetrical, proximal joints. MCP, PIPs, worse in the morning.

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22
Q

What is Gout?

A

Disorder of purine metabolism.
Uric crystals.
Treat with Allopurinol.

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23
Q

What is Pseudogout?

A

Calcium pyrophosphate crystals, not uric crystals.

Haemochromatosis = see calcium pyrophosphate.

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24
Q

Name 3 main rheumatological signs

A

Stiffness, pain, swelling.

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25
Name two monoarthropathies. Why is RA not a monoarthropathy?
Sepsis and Gout. | RA is a polyarthropathy.
26
What is Sjogren's syndrome?
Exocrine glands involved. Dry eyes, dry mouth, dry vagina. Anti-Ro.
27
Which tests do we request in RA?
Rheumatoid factor and anti-CCP. | BUT RA has low specificity.
28
What is Gout?
A disorder of purine metabolism.
29
Alcoholic, hot joints, 1st MTP affected. Thinking what?
Gout.
30
What is the difference between the Boutonniere deformity and Swan-neck deformity?
``` Boutonniere = Proximal interphalangeal joint (PIP) Swan-neck = Distal interphalangeal joint (DIP). ```
31
Name three differentials of arthritis.
Osteoarthritis Rheumatoid arthritis Crystal arthritis
32
What are the differentials for a hot swollen joint?
``` Septic arthritis Crystal arthritis Reactive arthritis (infection giving a reaction). Trauma RA ```
33
What is pseudogout?
The calcium pyrophosphate deposits - often in the knee.
34
What is Felty's syndrome?
A disorder characterised by: Rheumatoid Arthritis Splenomegaly Neutropenia
35
Spondyloarthritis
HLA B27+ Sacroiliitis Arthritis
36
Name the differentials of an acutely inflamed swollen joint
Infection Crystal induced Reactive arthritis Trauma
37
Pain/wasting in the base of the thumb is indicative of which condition?
Osteoarthritis
38
Name the four radiographic features of osteoarthritis.
Loss of joint space Osteophytes Subchondral cysts Subchondral sclerosis
39
Which is the inflammatory mediator and which is the protective between Cox-1 and Cox-2?
``` Cox-1 = cytoprotective Cox-2 = inflammatory ```
40
Which medication is used in osteoarthritis?
Paracetamol/ NSAIDs.
41
High MCV can indicate what?
Folate/B12 deficiency
42
Does a negative test for rheumatoid factor mean an absence of rheumatoid arthritis?
No.
43
Inflammatory back pain with HLA-B27 positive. What is the diagnosis?
Axial spondyloarthropathy.
44
Which test would we request specifically in suspected malignancy?
PTH. Parathyroid hormone to assess hypercalcaemia. Calcium is often raised in malignancy.
45
How do we manage myeloma?
Bisphosphanates, analgesia, IV fluid resuscitation.
46
What is the triad of Reiter's syndrome?
Urethritis Conjunctivitis Seronegative arthritis
47
Which medication do we often use in rheumatoid arthritis?
Ciclosporin. BUT common side effect = hypertension.
48
What is the first line treatment in Osteoporosis?
Alendronate, calcium and vitamin D | Alendronate contraindicated in peptic ulcers
49
Q. When do we give alendronate? Q. When may we want an alternative to alendronate? Q. What would we use as an alternate?
A. Osteoporosis A. Peptic ulcers A. Denosumab
50
Give two signs of rheumatoid arthritis
Boutonniere deformity (flexion at PIP) and (extension at DIP) Swan neck deformity Ulnar deviation at the MCP.
51
What is the triad of reactive arthritis?
Arthritis, urethritis, uveitis.
52
Which headache is excruciating?
Cluster headache
53
Double vision and neurological disturbances in a history should make you think of what in a neurology history?
Multiple Sclerosis.
54
Which cranial nerve exits the brainstem posteriorly?
Trochlear nerve
55
What is HRCT?
High resolution CT scan.
56
Red, hot tender joints with no crystals is suggestive of which arthritis?
Septic arthritis.
57
Name four signs of multiple myeloma
``` CRAB Calcium renal failure anaemia bone pain/fracture ```
58
Cortisol and which hormone trends go together?
Sodium
59
Name one musculoskeletal cause of chest pain.
Costochondritis.
60
Which joints are affected in rheumatoid arthritis?
Metacarpophalangeal joints, boutonniere deformity, swan-neck deformity, radial deviation of wrist. (PIP) and metacarpophalangeal. NOT DIP!
61
Which drug do we use to treat opiate overdose?
Naloxone.
62
How do we treat polymyalgia rheumatica?
Prednisolone.
63
What is the triad for wernicke's encephalopathy?
Confusion Ataxia Opthalmoplegia
64
What are the signs of tumour lysis syndrome?
Podagra ^K+ Low calcium

Year 3 (13 decks)

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