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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
Q

Name two monoarthropathies. Why is RA not a monoarthropathy?

A

Sepsis and Gout.

RA is a polyarthropathy.

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26
Q

What is Sjogren’s syndrome?

A

Exocrine glands involved.
Dry eyes, dry mouth, dry vagina.
Anti-Ro.

27
Q

Which tests do we request in RA?

A

Rheumatoid factor and anti-CCP.

BUT RA has low specificity.

28
Q

What is Gout?

A

A disorder of purine metabolism.

29
Q

Alcoholic, hot joints, 1st MTP affected. Thinking what?

A

Gout.

30
Q

What is the difference between the Boutonniere deformity and Swan-neck deformity?

A 
Boutonniere = Proximal interphalangeal joint (PIP)
Swan-neck = Distal interphalangeal joint (DIP).
31
Q

Name three differentials of arthritis.

A

Osteoarthritis
Rheumatoid arthritis
Crystal arthritis

32
Q

What are the differentials for a hot swollen joint?

A 
Septic arthritis
Crystal arthritis
Reactive arthritis (infection giving a reaction).
Trauma
RA
33
Q

What is pseudogout?

A

The calcium pyrophosphate deposits - often in the knee.

34
Q

What is Felty’s syndrome?

A

A disorder characterised by:
Rheumatoid Arthritis
Splenomegaly
Neutropenia

35
Q

Spondyloarthritis

A

HLA B27+
Sacroiliitis
Arthritis

36
Q

Name the differentials of an acutely inflamed swollen joint

A

Infection
Crystal induced
Reactive arthritis
Trauma

37
Q

Pain/wasting in the base of the thumb is indicative of which condition?

A

Osteoarthritis

38
Q

Name the four radiographic features of osteoarthritis.

A

Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis

39
Q

Which is the inflammatory mediator and which is the protective between Cox-1 and Cox-2?

A 
Cox-1 = cytoprotective
Cox-2 = inflammatory
40
Q

Which medication is used in osteoarthritis?

A

Paracetamol/ NSAIDs.

41
Q

High MCV can indicate what?

A

Folate/B12 deficiency

42
Q

Does a negative test for rheumatoid factor mean an absence of rheumatoid arthritis?

A

No.

43
Q

Inflammatory back pain with HLA-B27 positive. What is the diagnosis?

A

Axial spondyloarthropathy.

44
Q

Which test would we request specifically in suspected malignancy?

A

PTH. Parathyroid hormone to assess hypercalcaemia. Calcium is often raised in malignancy.

45
Q

How do we manage myeloma?

A

Bisphosphanates, analgesia, IV fluid resuscitation.

46
Q

What is the triad of Reiter’s syndrome?

A

Urethritis
Conjunctivitis
Seronegative arthritis

47
Q

Which medication do we often use in rheumatoid arthritis?

A

Ciclosporin. BUT common side effect = hypertension.

48
Q

What is the first line treatment in Osteoporosis?

A

Alendronate, calcium and vitamin D

Alendronate contraindicated in peptic ulcers

49
Q

Q. When do we give alendronate?
Q. When may we want an alternative to alendronate?
Q. What would we use as an alternate?

A

A. Osteoporosis
A. Peptic ulcers
A. Denosumab

50
Q

Give two signs of rheumatoid arthritis

A

Boutonniere deformity (flexion at PIP) and (extension at DIP)

Swan neck deformity

Ulnar deviation at the MCP.

51
Q

What is the triad of reactive arthritis?

A

Arthritis, urethritis, uveitis.

52
Q

Which headache is excruciating?

A

Cluster headache

53
Q

Double vision and neurological disturbances in a history should make you think of what in a neurology history?

A

Multiple Sclerosis.

54
Q

Which cranial nerve exits the brainstem posteriorly?

A

Trochlear nerve

55
Q

What is HRCT?

A

High resolution CT scan.

56
Q

Red, hot tender joints with no crystals is suggestive of which arthritis?

A

Septic arthritis.

57
Q

Name four signs of multiple myeloma

A 
CRAB 
Calcium
renal failure
anaemia
bone pain/fracture
58
Q

Cortisol and which hormone trends go together?

A

Sodium

59
Q

Name one musculoskeletal cause of chest pain.

A

Costochondritis.

60
Q

Which joints are affected in rheumatoid arthritis?

A

Metacarpophalangeal joints, boutonniere deformity, swan-neck deformity, radial deviation of wrist. (PIP) and metacarpophalangeal.

NOT DIP!

61
Q

Which drug do we use to treat opiate overdose?

A

Naloxone.

62
Q

How do we treat polymyalgia rheumatica?

A

Prednisolone.

63
Q

What is the triad for wernicke’s encephalopathy?

A

Confusion
Ataxia
Opthalmoplegia

64
Q

What are the signs of tumour lysis syndrome?

A

Podagra
^K+
Low calcium

Year 3 (13 decks)

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