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RHEUMATOLOGY > OA, SepticA and RA > Flashcards

OA, SepticA and RA Flashcards

1
Q
A

LOSS

Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts

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2
Q
A

TOLD

Tissue swelling
Osteopenia (Juxta-articular)
Loss of joint space
Deformed joint

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3
Q
A

NET

Normal joint space
Erosions
Tissue swelling

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4
Q
A

20

55

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5
Q
A

Gelling (stiffness)

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6
Q
A

Herbedens nodes

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7
Q
A

Bouchards nodes

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8
Q
A

LOSS

Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts

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9
Q

[OA}: Core treatments for OA involve 2 main lifestyle changes irrespective of age/co-morbidity. What are they?

A

Weight loss

Exercise

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10
Q

[OA}: 1st line tX

A

Paracetamol (+- topical NSAIDs)

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11
Q

[OA}: If 1st line tx is inneffective you use …. or ….

A

Codeine

short term ORAL nsaid (+PPI)

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12
Q

[OA}: If severe what can you use to non-surgically tx the pt

A

Intra-articular steroid injections

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13
Q

[OA}: If substantially decreased QOL what is indicated

A

Joint replacement

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14
Q

[OA}: What is the pattern of morning stiffness

A

<30 mins

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15
Q
A

It can destroy a joint in <24hrs

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16
Q
A

RA

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17
Q
A

Infection is difficult to treat there.

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18
Q
A

Synovial fluid (via aspiration)

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19
Q
A

Straight after aspiration

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20
Q
A

Staph Aureus
Streptococci
Neisseria Gonnococcus
Gram -ve

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21
Q
A

Flucloxacillin

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22
Q
A

Clindamycin

23
Q
A

Vancomycin

24
Q
A

Cefotaxime

25
Q
A

Pt is immunocomromised

26
Q
A

HLA DR4

HLA DR1

27
Q
A

Recurring rapid attack of mono (poly) arthritis of various joints.

28
Q
A

Dorsal wrist

Atlanto-axial (! - threatens spinal cord)

29
Q
A

extensor tendons

30
Q
A

Ulnar deviation
Z-thumb
Swan-neck
Boutonierre

31
Q
A

RA
splenomegaly
Neutropenia

32
Q
A

elbows

lungs

33
Q
A

Fibrosing alveolitis
obliterative bronchiolitis
pleural effusion
Lung nodules

34
Q
A

RhF

70

35
Q
A

Anti-cyclic citrullinated peptide antibodies are abbreviated to anti-CCP/ACPA. (98%)

36
Q

[RA}: Why would RA cause decreased Hb

A

Anaemia of chronic disease

37
Q

[RA}: how is disease activity measured

A

DAS28

38
Q

[RA}: What DAS28 should you aim for

A

<3

39
Q

[RA}: What are the 4 criteria for diagnosing RA

A

Joint involvement
Serology
Acute Phase reactants
Duration of symptoms

40
Q

[RA}: In the diagnostic criteria what does serology look at

A

RhF
Anti-CCP

(looking at absent, low or high levels)

41
Q

[RA}: In the diagnostic criteria what does APR look into

A

CRP

ESR

42
Q

[RA}: In the diagnostic criteria what are the duration of symptom cut offs

A

6 weeks

43
Q

[RA}: In the diagnostic criteria how do they differentiate between number of joints

A 
1 large joint = 0
2-10 large joints = 1
1-3 small = 2
4-10 small = 3
>10 (one has to be small) = 5
44
Q

[RA}: 1st line tx is … and …. and …

A

Methotrexate
Sulfasalazine
Hydroxychloroquine

45
Q

[RA}: Why do DMARDs require frequent FBCs

A

Immunosuppresive leading to pancytopenia and neutropenic sepsis

46
Q

[RA}: When can you use the TNF-a inhibitor infliximab (+methotrexate)

A

After Tx with 2 DMARDs with a DAS28 of >5.1

47
Q

[RA}: If tx with DMARDs alone, and then with infliximab has failed what can you use

A

Rituximab (B cell depeletion)

+methotrexate

48
Q

[RA}: If tx with DMARDs alone, and then with infliximab and then rituximab has failed what can you use

A

Tocilizumab (IL-6 blocker)

+methotrexate

49
Q

[RA}: The major SE of DMARDs is reactivation of … and ….

A

TB

Hepatitis C

50
Q

[RA}: What is 1st line in treating an acute flare of RA

A

Methylprednisolone IM depot

51
Q
A

Scleritis
Episcleritis
Keratoconjuctivitis Sicca
Scleromalacia

52
Q
A

Pneumonitis
Oral Ulcers
hepatoxicity

53
Q
A

Rash
Sperm count decreased
oral ulcers

54
Q
A

Irreversible retinopathy

RHEUMATOLOGY (5 decks)

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