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random ;p Flashcards

1
Q

nail changes, rash and dactilytis

A

psoriatic arthritis

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2
Q

prolonged early morning stiffness better with movement

A

ankylosing spondylitis

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3
Q

painful red eye, with reduced acuity and a constricted pupil

A

acute anterior uveitis

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4
Q

negatively birefrigent needle shaped crystals

A

gout

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5
Q

positively birefirgent rhomboid shaped crystals

A

pseudogout

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6
Q

neutrophil level in septic arthritis

A

> 90

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7
Q

which condition is assoc with syndesmophytes

A

ankylosing spondylitis

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8
Q

gold standard for GCA

A

temporal artery bioppsy

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9
Q

dermatological sign assoc with antiphospholipid syndrome

A

livedo reticularis

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10
Q

young female with new-onset headaches, visual changes, arm claudication, and weak or absent pulses in the upper extremities with a blood pressure difference between arms

A

takaysus arteritis

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11
Q

what is found in 95% patient with RA

A

anti cyclic citrullinated peptide autoantibody

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12
Q

linear calcification of the articular cartilage

A

pseudogout

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13
Q

which drugs can cause osteomalacia

A

anti epileptic drugs

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14
Q

bone pain, myalgia and weakness

A

osteomalacia

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15
Q

feltys syndrome

A

splenomegaly neutropenia and RA

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16
Q

what condition is associated with polymyalgia rheumatica

A

Giant cell arteritis

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17
Q

role of tendons

A

connect muscle to bone

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18
Q

role of ligamenta

A

often connect two bones otgetehr
stabilise the joint/ hold the two bones together

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19
Q

antibody assoc with chrug strauss

A

p-anca

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20
Q

Antibody assoc with granulomatosis with polyangitis

A

c-anca

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21
Q

which vasculitis is assoc with hep b

A

polyarteritis nodosa

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22
Q

drugs for ankylosing spondylitis with spinal inflammation

A

anti-tnf such as adalimumab

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23
Q

drugs for ankylosing spondylitis with peripheral joint disease

A

dmards such as methotrexate and sulfasalazine

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24
Q

rash over cheeks in combo with systemic illness and mild arthritis

A

SLE, anti ds-dna

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25
Q

diagnosis for takysus

A

CT aortogram or magentic resonance aortogram

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26
Q

tender scalp, headache and vsiual loss diagnosis and treatement

A

GCA, treat with prednisolone

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27
Q

first line investigation for patients with GCA

A

ESR but if have signs of temporal arteritis then treat without waiting results

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28
Q

diagnostic criteria and specific antibody for APLS

A

Anti beta 2 glycoprotein 1 antibodies

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29
Q

what is given as a follow up drug post GCA temporal arteritis

A

biphosphonate to prevent glucocrticoid associated bone loss

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30
Q

what mediciation may be considered in GCA with vascular ischameic complications

A

aspirin 75mg daily

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31
Q

non traumatic cause of avascular necrosis

A

steroid use

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32
Q

which drug can increase risk of tendinopathies

A

ciprofloxacin

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33
Q

best imaging for meniscal tears

A

MRI as can visualise the soft tissue

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34
Q

locking and swelling knee injury

A

meniscal tear

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35
Q

hyperintense line in the medial mensicus

A

medial meniscus injury

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36
Q

test for meniscus injury

A

mcmurrays

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37
Q

positive anterior drawer test

A

ACL injury

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38
Q

only arthritis to be assoc with skin and nail changes

A

psoriatic arthritis

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39
Q

which joints does rheumatoid usually affect

A

metacarpophalangeal joints

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40
Q

which joints does psoritatic arthritis usually affect

A

distal interphalangeal joints

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41
Q

definitive diagnosis for osteomyelitis

A

bone biopsy

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42
Q

gold standard for osteomyeltitis

A

MRI

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43
Q

role of osteoclast

A

responsible for bone resorption

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44
Q

MOA of osteoporosis medication

A

to inhibit osteoclats as they absorb bone

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45
Q

what is lymphopenia often associated with

A

SLE

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46
Q

poor prognosis of rheumatoid arthritis

A

rhuematoid nodules, positive rheumatoid factor and anti-CCP antibodies, insidious disease onset, smoking history, HLA-DR4 and poor functional status at presentation.

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47
Q

extra articular features common with ankylosing spondylitis

A

anterior uveuits
aortic insufficiencies
apical pulmonary fibrosis

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48
Q

meniscal calcification suggestive

A

pseudogout

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49
Q

what can chronic inflammation of MCP joints result in

A

ulnar deviation of the digits in rheumatoid arhtitis

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50
Q

risk factors for gout

A

diuretics and salicytes - aspiirn

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51
Q

help confirm sjrogens

A

schirmers test

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52
Q

antigen that supports ankylosing spondy

A

human leukocyte antigen b27

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53
Q

what is impaired renal function a risk factor for

A

GOUT due to impaired function of urate excretion

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54
Q

first line treatment for polymyalgia rheumatica

A

oral prednisolone

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55
Q

first line treatment for SLE

A

hydroxychloroquine

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56
Q

first line gout treatment

A

nsaids

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57
Q

sign on doppler of temporal arteries in GCA

A

halo sign showing

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58
Q

xray changes seen in rheumatoid

A

Periarticular osteopenia- this is often an early sign
Joint erosions
Periarticular soft tissue swelling
Joint space narrowing

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59
Q

risks specific to pseudogout

A

hyperparathyroidism and haemochromatosis

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60
Q

complication of sjrogens

A

MALT lymphoma

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61
Q

is GORD suggestive of limited or diffuse sclerosis

A

limited

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62
Q

what is it important to screen for in SLE

A

renal involvement via urinakysis

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63
Q

commonest causative organism of septic arthritis in early infections of prosthetic joints

A

staph aur

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64
Q

which antibodies in sjorgens

A

anti ro and anti la

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65
Q

what are syndesmophytes

A

bony outgrowth originating inside a ligament

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66
Q

what disease are syndesmophytes often seen in

A

ankylosing spondylitis

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67
Q

urgen referral to rheumatology criterai

A

Small joints of the hands or feet are affected.
More than one joint is affected.
There has been a delay of 3 months or longer between the onset of symptoms and the person seeking medical advice

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68
Q

what should patients get put on to reduce the risk of side effects from steroids

A

bisphosphonate and PPI

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69
Q

what type of drug is allendronic acid

A

bisphosphonate

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70
Q

antibody seen in systemic sclerosis

A

anti scl 70

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71
Q

extra articular manifestations of ankylosing spondylitis

A

aortitis
anterior uveitis
iga nephrophathy
upper lobe pulmonaryfibroiss

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72
Q

is gout positive or negative birefirngence

A

negative

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73
Q

what is commonly requested in RA patient pre operation

A

c spine x rayw

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74
Q

what part of the spine does RA usually spare

A

lumbar and thoracic spine

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75
Q

what is hypromellose

A

eye drops for sjorgens to soothe them

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76
Q

what is intermittent parotid gland swelling assoc with

A

sjrogens

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77
Q

what is necessary for pseudogout confirmation

A

needle aspiration

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78
Q

when does myositis ossificans usually occur

A

AFTER TRAUMA USUALLY SPORTING INCIDENTS

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79
Q

Xray finding in ewings sarcoma

A

onion skin periosteal reaction

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80
Q

what age is ewings more seen in

A

paediatrics

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81
Q

what does amitryptilline help with

A

nerve pain so is useful in sciatica

82
Q

role of bsiphosphonates

A

slows bone loss

83
Q

first line treatment for knee osteoarthritis

A

topical NSAIDS

84
Q

First medication to strat with RA

A

methotrexate and steroids

85
Q

which arthropathy is hypothyroidism assoc with

A

pseudogout

86
Q

which nerve root lesion is affected ankle jerk is affected and have weak foot eversion

A

S1

87
Q

Treatment for psoriatic arthritis

A

DMARD - methotrexate

88
Q

signs of osteomyelitis on xray

A

focal cortical loss
periosteal reaction ; formation of new bon ein response to injury
regional osteopenia; decrease in bone mineral density

89
Q

what might septic arthriits lead to

A

osteomyelitis by spreading to adjacent joints

90
Q

what test needs to be done as part of baseline for hydroxychloroquine

A

Baseline ophthalmology assessment including visual acuity incase of hydroxy induced retinopathy

91
Q

what might granulomatosis with polyangitis cause

A

myocarditis

92
Q

classic findings on fundus of Anterior ischemic optic neuropathy

A

swollen, chalky white, optic disc

93
Q

antibody assoc with limited systemic sclerosis

A

anti centromere

94
Q

antibody assoc with diffuse scleoris

A

anti- scl 70

95
Q

what predisposes to tendon ruptures

A

RA, steroid use and diabetes

96
Q

what is allopurinol used with to reduce risk of recurring gout

A

NSAIDS for 3 months as allopurinol may worsen flare at start as can acutely raise levels of urate

97
Q

treatment for if arthritis gotten so bad even with conservative management

A

joint arthroplasty

98
Q

how long are steroids gradually tapered post GCA

A

daily for 4 weeks then gradually tapered 6 months- year

99
Q

what is a frequent feature of systemic sclerosis

A

oesophageal dysmotility

100
Q

negative gram stain, dysuria

A

chlamydia

101
Q

what will nesseria show up as on gram stain

A

Gram negative intracellular diplococci

102
Q

why are no organisms seen on gram stain for chlamydia

A

poorly staining cell wall

103
Q

investigation for suspected septic arthritis

A

joint aspiration in thteatre

104
Q

what might give the clue of septic arrhtir s

A

previous surgery

105
Q

caplans syndrome overview

A

In individuals with rheumatoid arthritis, exposure to dust particles such as coal, asbestos, or silica can result in Caplan’s syndrome, characterized by intrapulmonary nodules leading to shortness of breath.

106
Q

what should be requeste din all patients presenting with inflammatory back pain

A

pelvic xray

107
Q

what antibodies are assoc with psoriatic arthirtis

A

none

108
Q

what are anca assoc with

A

vasculidities

109
Q

what is warfarin contraindicated in

A

pregnancy

110
Q

if have visual compromise in GCA what is given

A

METHYLPREDNISOLONE

111
Q

Scleroderma crisis management

A

ace inhib

112
Q

most common side effects of colchicine

A

diarrhoea

113
Q

signs of fracture

A

crepitus
swelling
deformity
bony tenderness

114
Q

what antibiotics are used in an open fracture

A

within 1 hour
co amoxiclav
co trimazole and metronidazole if allergic

115
Q

what nerve is the deltoid muscle supplieby

A

axillary

116
Q

“locking and twisting” meniscal or ACL?

A

meniscal

117
Q

shouolder pain, at night , pain on active and passive movement

A

frozen shoulder

118
Q

frozen shoulder treatment

A

NSAIDS, physio then steroids if not working

119
Q

common risk factor for frozen shoulder

A

typw 2 diabetes

120
Q

what must radius and ulna fractures be treated with

A

open reduction and internal fixation

121
Q

stable intertrochanteric fracture treatmetn

A

dynamic hip screw

122
Q

when does mensical injury present

A

12-24 hours after

123
Q

whne does ACL injury presetn

A

often right away

124
Q

classification for ankle fractures

A

weber

125
Q

fall onto outstreched hand fracture type

A

colles fracture

126
Q

test for cauda equina syndrome

A

MRI

127
Q

gold standard for RAA

A

MRI

128
Q

DAS-28 components

A

tender joint count
swollen joint count
esr
global health scan

129
Q

motor supply to SCM

A

accessory nerve

130
Q

MOA of methotrexate

A

Inhibits dihydrofolate reductase which is crucial for the synthesis of DNA and RNA

131
Q

what must be prescirbed along with methotrexate

A

folic acid on a different day to be taken

132
Q

flu like symptoms in fibromylagia or chornic fatigue syndrome

A

chronic fatigue syndrome

133
Q

side effecct of bisphosphonates

A

oesophagitis, ulcers, erosions and strictures which can present as odynophagia, dysphagia, or new/worsening dyspepsia

134
Q

feature seen on xray in OA

A

squarin gof the thumbs

135
Q

side effect of hydroxychloroquine

A

retinal toxicity

136
Q

most sensitive investigation for ankylosng

A

MRI scan of sacroiliac joints

137
Q

what is required for straight leg raise

A

quadriceps tendon

138
Q

what is enteropathic arthritis a complication of

A

IBD

139
Q

common side effect of methotrexate

A

oral ulcers due to folate disturbance

140
Q

treatment of reactive arthriits

A

NSAIDS

141
Q

side effects of nsaids

A

nephrotoxicity so shouldnt be used in. acute kidney injury

142
Q

common presenting pattern of psoriatic arthritis

A

assymetrical oligoarthritis

143
Q

antibdoy in diffuse sclerosis

A

anti-scl

144
Q

antibody in limited sclerosis

A

anti centromere

145
Q

which sclerosis is assoc with scleroderma

A

diffuse

146
Q

what is crest syndrome also known as

A

limited cutaneous systemic sclerosis

147
Q

what might OA present with

A

gait
joint crepitus
limiation of movement

148
Q

is joint swelling seen in oa of the hip

A

not really as deep as the hip would you see swelling

149
Q

radiological features of OA

A

cyst formation and osteophytes
loss of joint space

150
Q

what investigation is useful in confirming diagnosis of osteoporosis

A

dexa scan- measures bone mineral density

151
Q

treatment of osteporosis

A

bisphosphonates

152
Q

what is key to maintaining bone density in women

A

oestrogen

153
Q

what is offered to women with osteporosis

A

HRT

154
Q

what is the menopause a risk factor for

A

osteoporosis due to less oestrogen

155
Q

is osteoarthirtis a risk factor for osteoporosis

A

no

156
Q

are vitamin d levels low or high in osteomalacia

A

low

157
Q

butterfly rash across face

A

SLE

158
Q

what type of view is a joint effusion seen better on

A

lateral view

159
Q

antibodies in sle

A

anti nuclear
dsdna

160
Q

consideration of management in SLE

A

immunosuppression- azathioprine
steroids

161
Q

are complement levels low in sle

A

yes

162
Q

which complement levels are low in sle

A

c3,c4

163
Q

immediate investigations for acute monoarthritis

A

FBC
Urinalysis
crp
knee radiograph

164
Q

acute monoarthritis

A

acute arthritis which occurs in a aingle joint for less than 2 - 4 weeks

165
Q

what conditions can cause septic arthritis

A

osteomyelitis
penetrating trauma
staph aur

166
Q

why is septic arthritis an emergency

A

the joint can be rapdily destroyed by iinfection

167
Q

acute gout, previous duodenal ulcer, treatment ?

A

colchicine due to nsaid contraindication

168
Q

what lab test may be abnormal and lead to diagnosis of PMR

A

ESR >40

169
Q

complications of steroids

A

cataract
avascular necrosis
osteoporosis
diabetes

170
Q

what is helpful in AS for those who have peripheral joint problems

A

methotrexate

171
Q

daignosis for AS

A

HLA-B27 , xray of sacroiliac joints

172
Q

associations with AS

A

IBD, anterior uveitis, aortic regurg, skin psoriasis, cauda equina syndrome

173
Q

tests to asses AS

A

schobers, wall to tragus distance , chest expansion

174
Q

triad for reactive arthritis

A

urethirtis, conjunctivitits, sero negative arthritis

175
Q

is periosteal reaction common in RA

A

no

176
Q

what is periosteal reaction

A

new bone formation

177
Q

ciclosporin side effects

A

hypertension, tremulousness- shaking/quivering , and gingival hypertrophy.

178
Q

is periarticular erosions seen in OA

A

no its more in RA

179
Q

what might elevated ALP be a sign of in th epresence of previous breast cancer, lytic lesions

A

metastatic bone disease

180
Q

most commonly damaged nerve in shoulder injuries

A

axillary

181
Q

what needs to be done to diagnose cauda equina syndrome

A

whole spine. MRI

182
Q

what can scapular winging be caused yb

A

damage to seratus anterior/ long thoracic nerve which innervates it

183
Q

what is the supraspinatous innervated by

A

suprascapular nerve

184
Q

first line for carpal tunnel in pregnancy

A

wrist splint

185
Q

positive phalen test

A

numbness and tingling on passive wrist flexion

186
Q

early changes in RA

A

periarticular osteoporosis; localised bone loss occuring around a joint
loss of joint space
soft tissue swelling

187
Q

later changes in RA

A

juxta articular erosions , subluxation

188
Q

what is lipohaemarthrosis

A

fat and fluid in joint capsule
fall onto flexed knee

189
Q

what does dequervains tenosivitirs invlve

A

extensur pollicis brevis and abductor pollicis longues

190
Q
A
190
Q
A
190
Q
A
190
Q
A
191
Q

what imaging modality can show undisplaced fractures

A

MRI

192
Q

are there systemic manifestations in osteoarthritis

A

no

193
Q

what is the straight let test used for

A

herniated discs

194
Q

cannot initiate straight leg raise

A

quadriceps tendon issue

195
Q

which drug will achieve best penetration into bone

A

flucox

196
Q

is acromegaly assoc with gout or pseudogout

A

pseudogout

197
Q

what to monitor as disease progression in RA

A

CRP

198
Q
A

MSK (51 decks)

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