Overview Flashcards
How do you treat temporal arteritis?
High dose prednisolone
Who gets takayasu arteritis?
Asian, female with pulseless arch syndrome
Name the two large vessel vasculitis
Takayasu
Giant cell
Name the three ANCA small vessel vasculitis
Microscopic polyangiitis
GPA
Eosinophilic granulomatosis with polyangiitis
Describe GPA
c-ANCA
anti-PR3
ENT - saddle nose, sinusitis
LRT, uveitis, GN
Describe EGPA
pANCA
anti-MPO
Late onset asthma, eosinophilia, sinusitis, neuropathy
Describe MPA
Commonly causes GN
pANCA
How is small vessel vasculitis treated?
Cyclophosphamide + Steroids
Plasma exchange
How does Kawasaki disease present?
High grade fever in kids, strawberry tongue, red hands/feet, conjunctivitis, lymphadenopathy
What is the treatment for kawasaki?
High dose aspirin
IV immunoglobulins
Echo
What is the RA antibody?
Anti-CCP
What deformities can occur in RA?
Jaccoud’s
Swan neck
Boutonniere
How is RA treated?
DMARD
Prednisolone cover
Biologics
Name two DMARDs used in RA
Methotrexate
Sulfasalazine - red pee
When are biologics used in RA?
No response to 2 DMARDs
What is the buzzword for ank spond xray?
Bamboo spine
How is Ankylosing Spondylitis treated?
NSAIDs
Physio
Name three seronegative arthropathies
Psoriatic - pencil in cup
Enteropathic - IBD
Reactive - GI/GU
How is gout treated?
Acute - NSAID, colchicine
Chronic - allopurinol, febuzostat
What are the side effects of chronic gout treatments?
Bone marrow suppression
What is seen on polarised microscopy in gout?
Needle shaped crystals and negative birefringence
What is seen on polarised microscopy in pseudo gout?
Rhomboid shaped crystals and positive birefringence
Describe the CPPD distinguishing feature
Chondrocalcinosis on x-ray
Summerise polymyalgia rheumatica
>60 year female GCA Morning stiffness, proximal myalgia Raised inflammatory Treat with prednisolone
Summerise dermatomyositis
Inflammatory Symmetrical weakness and tenderness Cutaneous - heliotrope rash, shawl and grotons Lung disease and dysphagia ANA Anti-jo Prednisolone, methotrexate
What is affected in sjogrens?
Exocrine glands
Name the antibodies in sjogrens
Anti-RO
Anti- La
What is the most common antibody in SLE?
Anti-dsDNA
How is SLE treated?
HCQ
Azathioprine
Immunoglobulins/rituximab
Describe limited systemic sclerosis
Calcinosis Raynauds Eosophagus Sclerodactyl Telangiectasia Anti-centromere
Describe diffuse systemic sclerosis
Scleroderma of trunk and proximal limbs
Anti-Scl70
How do you treat systemic sclerosis?
Raynauds - CCB
Renal - ACEi
Lung - cyclophosphamide
GI - PPI
What antibodies are in APLS?
Anti-lupus anticoagulant
Anti-cardiolipin
How is APLS treated?
Warfarin
Aspirin/heparin
What is the most common bone tumour?
Osteochondroma
What is an osteochondroma?
Bony out growth with cartilaginous cap
Describe enchondroma
Intramedullary usually metaphysical cartilage tumour - failure of normal ossification
Patchy sclerosis
What does a osteoid osteoma look like?
Small nidus of immature bone surrounded by intense sclerotic halo
What helps the pain of osteoid osteoma?
NSAIDs
How are bone cysts treated?
Curettage
Bone graft
What are the reg flags for bone tumours?
Skeletal pain
Worse at night
Ill defined bony swelling
Systemic symptoms
Name the most common malignant tumour
Osteosarcoma - usually at knees
How do you treat osteosarcoma?
Adjuvant chemo
What bone tumour has the worst prognosis?
Ewings Sarcoma
How does Ewings sarcoma present?
Fever
Raised inflammatory markers
Summarise paget’s disease
Bone turnover increased
Bone pain + raised ALP
Treat - bisphosphonates
Affects the long bones
What is the most common organism in osteomyelitis?
Staph Aureus
What cell predominates in osteomyelitis in sickle cell patients?
Salmonella