random ;p Flashcards
1
Q
nail changes, rash and dactilytis
A
psoriatic arthritis
2
Q
prolonged early morning stiffness better with movement
A
ankylosing spondylitis
3
Q
painful red eye, with reduced acuity and a constricted pupil
A
acute anterior uveitis
4
Q
negatively birefrigent needle shaped crystals
A
gout
5
Q
positively birefirgent rhomboid shaped crystals
A
pseudogout
6
Q
neutrophil level in septic arthritis
A
> 90
7
Q
which condition is assoc with syndesmophytes
A
ankylosing spondylitis
8
Q
gold standard for GCA
A
temporal artery bioppsy
9
Q
dermatological sign assoc with antiphospholipid syndrome
A
livedo reticularis
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
11
Q
what is found in 95% patient with RA
A
anti cyclic citrullinated peptide autoantibody
12
Q
linear calcification of the articular cartilage
A
pseudogout
13
Q
which drugs can cause osteomalacia
A
anti epileptic drugs
14
Q
bone pain, myalgia and weakness
A
osteomalacia
15
Q
feltys syndrome
A
splenomegaly neutropenia and RA
16
Q
what condition is associated with polymyalgia rheumatica
A
Giant cell arteritis
17
Q
role of tendons
A
connect muscle to bone
18
Q
role of ligamenta
A
often connect two bones otgetehr
stabilise the joint/ hold the two bones together
19
Q
antibody assoc with chrug strauss
A
p-anca
20
Q
Antibody assoc with granulomatosis with polyangitis
A
c-anca
21
Q
which vasculitis is assoc with hep b
A
polyarteritis nodosa
22
Q
drugs for ankylosing spondylitis with spinal inflammation
A
anti-tnf such as adalimumab
23
Q
drugs for ankylosing spondylitis with peripheral joint disease
A
dmards such as methotrexate and sulfasalazine
24
Q
rash over cheeks in combo with systemic illness and mild arthritis
A
SLE, anti ds-dna
25
diagnosis for takysus
CT aortogram or magentic resonance aortogram
26
tender scalp, headache and vsiual loss diagnosis and treatement
GCA, treat with prednisolone
27
first line investigation for patients with GCA
ESR but if have signs of temporal arteritis then treat without waiting results
28
diagnostic criteria and specific antibody for APLS
Anti beta 2 glycoprotein 1 antibodies
29
what is given as a follow up drug post GCA temporal arteritis
biphosphonate to prevent glucocrticoid associated bone loss
30
what mediciation may be considered in GCA with vascular ischameic complications
aspirin 75mg daily
31
non traumatic cause of avascular necrosis
steroid use
32
which drug can increase risk of tendinopathies
ciprofloxacin
33
best imaging for meniscal tears
MRI as can visualise the soft tissue
34
locking and swelling knee injury
meniscal tear
35
hyperintense line in the medial mensicus
medial meniscus injury
36
test for meniscus injury
mcmurrays
37
positive anterior drawer test
ACL injury
38
only arthritis to be assoc with skin and nail changes
psoriatic arthritis
39
which joints does rheumatoid usually affect
metacarpophalangeal joints
40
which joints does psoritatic arthritis usually affect
distal interphalangeal joints
41
definitive diagnosis for osteomyelitis
bone biopsy
42
gold standard for osteomyeltitis
MRI
43
role of osteoclast
responsible for bone resorption
44
MOA of osteoporosis medication
to inhibit osteoclats as they absorb bone
45
what is lymphopenia often associated with
SLE
46
poor prognosis of rheumatoid arthritis
rhuematoid nodules, positive rheumatoid factor and anti-CCP antibodies, insidious disease onset, smoking history, HLA-DR4 and poor functional status at presentation.
47
extra articular features common with ankylosing spondylitis
anterior uveuits
aortic insufficiencies
apical pulmonary fibrosis
48
meniscal calcification suggestive
pseudogout
49
what can chronic inflammation of MCP joints result in
ulnar deviation of the digits in rheumatoid arhtitis
50
risk factors for gout
diuretics and salicytes - aspiirn
51
help confirm sjrogens
schirmers test
52
antigen that supports ankylosing spondy
human leukocyte antigen b27
53
what is impaired renal function a risk factor for
GOUT due to impaired function of urate excretion
54
first line treatment for polymyalgia rheumatica
oral prednisolone
55
first line treatment for SLE
hydroxychloroquine
56
first line gout treatment
nsaids
57
sign on doppler of temporal arteries in GCA
halo sign showing
58
xray changes seen in rheumatoid
Periarticular osteopenia- this is often an early sign
Joint erosions
Periarticular soft tissue swelling
Joint space narrowing
59
risks specific to pseudogout
hyperparathyroidism and haemochromatosis
60
complication of sjrogens
MALT lymphoma
61
is GORD suggestive of limited or diffuse sclerosis
limited
62
what is it important to screen for in SLE
renal involvement via urinakysis
63
commonest causative organism of septic arthritis in early infections of prosthetic joints
staph aur
64
which antibodies in sjorgens
anti ro and anti la
65
what are syndesmophytes
bony outgrowth originating inside a ligament
66
what disease are syndesmophytes often seen in
ankylosing spondylitis
67
urgen referral to rheumatology criterai
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
68
what should patients get put on to reduce the risk of side effects from steroids
bisphosphonate and PPI
69
what type of drug is allendronic acid
bisphosphonate
70
antibody seen in systemic sclerosis
anti scl 70
71
extra articular manifestations of ankylosing spondylitis
aortitis
anterior uveitis
iga nephrophathy
upper lobe pulmonaryfibroiss
72
is gout positive or negative birefirngence
negative
73
what is commonly requested in RA patient pre operation
c spine x rayw
74
what part of the spine does RA usually spare
lumbar and thoracic spine
75
what is hypromellose
eye drops for sjorgens to soothe them
76
what is intermittent parotid gland swelling assoc with
sjrogens
77
what is necessary for pseudogout confirmation
needle aspiration
78
when does myositis ossificans usually occur
AFTER TRAUMA USUALLY SPORTING INCIDENTS
79
Xray finding in ewings sarcoma
onion skin periosteal reaction
80
what age is ewings more seen in
paediatrics
81
what does amitryptilline help with
nerve pain so is useful in sciatica
82
role of bsiphosphonates
slows bone loss
83
first line treatment for knee osteoarthritis
topical NSAIDS
84
First medication to strat with RA
methotrexate and steroids
85
which arthropathy is hypothyroidism assoc with
pseudogout
86
which nerve root lesion is affected ankle jerk is affected and have weak foot eversion
S1
87
Treatment for psoriatic arthritis
DMARD - methotrexate
88
signs of osteomyelitis on xray
focal cortical loss
periosteal reaction ; formation of new bon ein response to injury
regional osteopenia; decrease in bone mineral density
89
what might septic arthriits lead to
osteomyelitis by spreading to adjacent joints
90
what test needs to be done as part of baseline for hydroxychloroquine
Baseline ophthalmology assessment including visual acuity incase of hydroxy induced retinopathy
91
what might granulomatosis with polyangitis cause
myocarditis
92
classic findings on fundus of Anterior ischemic optic neuropathy
swollen, chalky white, optic disc
93
antibody assoc with limited systemic sclerosis
anti centromere
94
antibody assoc with diffuse scleoris
anti- scl 70
95
what predisposes to tendon ruptures
RA, steroid use and diabetes
96
what is allopurinol used with to reduce risk of recurring gout
NSAIDS for 3 months as allopurinol may worsen flare at start as can acutely raise levels of urate
97
treatment for if arthritis gotten so bad even with conservative management
joint arthroplasty
98
how long are steroids gradually tapered post GCA
daily for 4 weeks then gradually tapered 6 months- year
99
what is a frequent feature of systemic sclerosis
oesophageal dysmotility
100
negative gram stain, dysuria
chlamydia
101
what will nesseria show up as on gram stain
Gram negative intracellular diplococci
102
why are no organisms seen on gram stain for chlamydia
poorly staining cell wall
103
investigation for suspected septic arthritis
joint aspiration in thteatre
104
what might give the clue of septic arrhtir s
previous surgery
105
caplans syndrome overview
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
what should be requeste din all patients presenting with inflammatory back pain
pelvic xray
107
what antibodies are assoc with psoriatic arthirtis
none
108
what are anca assoc with
vasculidities
109
what is warfarin contraindicated in
pregnancy
110
if have visual compromise in GCA what is given
METHYLPREDNISOLONE
111
Scleroderma crisis management
ace inhib
112
most common side effects of colchicine
diarrhoea
113
signs of fracture
crepitus
swelling
deformity
bony tenderness
114
what antibiotics are used in an open fracture
within 1 hour
co amoxiclav
co trimazole and metronidazole if allergic
115
what nerve is the deltoid muscle supplieby
axillary
116
"locking and twisting" meniscal or ACL?
meniscal
117
shouolder pain, at night , pain on active and passive movement
frozen shoulder
118
frozen shoulder treatment
NSAIDS, physio then steroids if not working
119
common risk factor for frozen shoulder
typw 2 diabetes
120
what must radius and ulna fractures be treated with
open reduction and internal fixation
121
stable intertrochanteric fracture treatmetn
dynamic hip screw
122
when does mensical injury present
12-24 hours after
123
whne does ACL injury presetn
often right away
124
classification for ankle fractures
weber
125
fall onto outstreched hand fracture type
colles fracture
126
test for cauda equina syndrome
MRI
127
gold standard for RAA
MRI
128
DAS-28 components
tender joint count
swollen joint count
esr
global health scan
129
motor supply to SCM
accessory nerve
130
MOA of methotrexate
Inhibits dihydrofolate reductase which is crucial for the synthesis of DNA and RNA
131
what must be prescirbed along with methotrexate
folic acid on a different day to be taken
132
flu like symptoms in fibromylagia or chornic fatigue syndrome
chronic fatigue syndrome
133
side effecct of bisphosphonates
oesophagitis, ulcers, erosions and strictures which can present as odynophagia, dysphagia, or new/worsening dyspepsia
134
feature seen on xray in OA
squarin gof the thumbs
135
side effect of hydroxychloroquine
retinal toxicity
136
most sensitive investigation for ankylosng
MRI scan of sacroiliac joints
137
what is required for straight leg raise
quadriceps tendon
138
what is enteropathic arthritis a complication of
IBD
139
common side effect of methotrexate
oral ulcers due to folate disturbance
140
treatment of reactive arthriits
NSAIDS
141
side effects of nsaids
nephrotoxicity so shouldnt be used in. acute kidney injury
142
common presenting pattern of psoriatic arthritis
assymetrical oligoarthritis
143
antibdoy in diffuse sclerosis
anti-scl
144
antibody in limited sclerosis
anti centromere
145
which sclerosis is assoc with scleroderma
diffuse
146
what is crest syndrome also known as
limited cutaneous systemic sclerosis
147
what might OA present with
gait
joint crepitus
limiation of movement
148
is joint swelling seen in oa of the hip
not really as deep as the hip would you see swelling
149
radiological features of OA
cyst formation and osteophytes
loss of joint space
150
what investigation is useful in confirming diagnosis of osteoporosis
dexa scan- measures bone mineral density
151
treatment of osteporosis
bisphosphonates
152
what is key to maintaining bone density in women
oestrogen
153
what is offered to women with osteporosis
HRT
154
what is the menopause a risk factor for
osteoporosis due to less oestrogen
155
is osteoarthirtis a risk factor for osteoporosis
no
156
are vitamin d levels low or high in osteomalacia
low
157
butterfly rash across face
SLE
158
what type of view is a joint effusion seen better on
lateral view
159
antibodies in sle
anti nuclear
dsdna
160
consideration of management in SLE
immunosuppression- azathioprine
steroids
161
are complement levels low in sle
yes
162
which complement levels are low in sle
c3,c4
163
immediate investigations for acute monoarthritis
FBC
Urinalysis
crp
knee radiograph
164
acute monoarthritis
acute arthritis which occurs in a aingle joint for less than 2 - 4 weeks
165
what conditions can cause septic arthritis
osteomyelitis
penetrating trauma
staph aur
166
why is septic arthritis an emergency
the joint can be rapdily destroyed by iinfection
167
acute gout, previous duodenal ulcer, treatment ?
colchicine due to nsaid contraindication
168
what lab test may be abnormal and lead to diagnosis of PMR
ESR >40
169
complications of steroids
cataract
avascular necrosis
osteoporosis
diabetes
170
what is helpful in AS for those who have peripheral joint problems
methotrexate
171
daignosis for AS
HLA-B27 , xray of sacroiliac joints
172
associations with AS
IBD, anterior uveitis, aortic regurg, skin psoriasis, cauda equina syndrome
173
tests to asses AS
schobers, wall to tragus distance , chest expansion
174
triad for reactive arthritis
urethirtis, conjunctivitits, sero negative arthritis
175
is periosteal reaction common in RA
no
176
what is periosteal reaction
new bone formation
177
ciclosporin side effects
hypertension, tremulousness- shaking/quivering , and gingival hypertrophy.
178
is periarticular erosions seen in OA
no its more in RA
179
what might elevated ALP be a sign of in th epresence of previous breast cancer, lytic lesions
metastatic bone disease
180
most commonly damaged nerve in shoulder injuries
axillary
181
what needs to be done to diagnose cauda equina syndrome
whole spine. MRI
182
what can scapular winging be caused yb
damage to seratus anterior/ long thoracic nerve which innervates it
183
what is the supraspinatous innervated by
suprascapular nerve
184
first line for carpal tunnel in pregnancy
wrist splint
185
positive phalen test
numbness and tingling on passive wrist flexion
186
early changes in RA
periarticular osteoporosis; localised bone loss occuring around a joint
loss of joint space
soft tissue swelling
187
later changes in RA
juxta articular erosions , subluxation
188
what is lipohaemarthrosis
fat and fluid in joint capsule
fall onto flexed knee
189
what does dequervains tenosivitirs invlve
extensur pollicis brevis and abductor pollicis longues
190
190
190
190
191
what imaging modality can show undisplaced fractures
MRI
192
are there systemic manifestations in osteoarthritis
no
193
what is the straight let test used for
herniated discs
194
cannot initiate straight leg raise
quadriceps tendon issue
195
which drug will achieve best penetration into bone
flucox
196
is acromegaly assoc with gout or pseudogout
pseudogout
197
what to monitor as disease progression in RA
CRP
198
