Quescardy Bum

Question 1

Dermatomyositis/Polymyositis 3 tests

Answer 1

1. Creatinine kinase
2. Electromyography
3. Muscle biopsy (required for definitive diagnosis)

Question 2

Muscle biopsy in dermatomyositis vs polymyositis ?

Answer 2

Polymyositis = endomysial inflammatory infiltrates
Dermatomyositis = perivascular, perimysial inflammatory infiltrate

Question 3

Dermatomyositis skin changes

Answer 3

Heliotrope rash
Gottron’s papules

Question 4

Cushing’s: how is cortisol excess identified ?

Answer 4

24 hour urinary free cortisol
Overnight Dexamethasone suppression test (administer dexamethasone then measure morning cortisol levels, which should be suppressed to <50 nmol/L. Failure to suppress = Cushing’s syndrome)

Question 5

Electrolyte abnormality in SIADH

Answer 5

Hyponatraemia

Question 6

Serum metabolite of growth hormone that is used to measure it’s activity

Answer 6

IGF-1

(Insulin-like Growth Factor)

Question 7

Chronic hyperprolactinaemia’s effects on the skeleton

Answer 7

Osteoporosis

Question 8

Drugs which increase risk of gout

Answer 8

Thiazide diuretics
ACE inhibitors
Aspirin

Question 9

Which glands are affected by Sjogren’s syndrome ?

Answer 9

Lacrimal and salivary glands
Intermittent swelling of the parotid gland

Question 10

Difference between diffuse systemic sclerosis and limited systemic sclerosis

Answer 10

Diffuse = early internal organ involvement

Diffuse = Scl70
Limited = Anti-centromere

Question 11

Polymyositis/dermatomyositis antibody

Answer 11

Anti-Jo-1

Question 12

Imaging modality for sacroiliitis in ankylosing spondylitis ?

Answer 12

X-ray !

Question 13

Nasal deformity in GPA

Answer 13

Saddle nose

Question 14

Contraindication to COCP

Answer 14

Antiphospholipid syndrome due to clots

Question 15

Side effects of colchicine

Answer 15

Diarrhoea, nausea, vomiting

Question 16

Chest x-ray features in GPA

Answer 16

Bilateral nodular and cavitating infiltrates

Question 17

Anti-smooth muscle antibodies =

Answer 17

Autoimmune hepatitis
or
Primary biliary cirrhosis

Question 18

Septic arthritis treatment

Answer 18

IV Flucloxacillin (within 1 hour)