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finals > rheum > Flashcards

rheum Flashcards

1
Q

mx of acute flares of RA

A

IM/oral methylprednisolone

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2
Q

mx of antiphospholipid syndrome

A

no VTE - daily low-dose aspirin

after first VTE lifelong warfarin

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3
Q

features of psoriatic arthritis

A

DIP swelling and dactylitis
involves any joint of the body
imaging - pencil in cup and plantar spur

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4
Q

most specific and sensitive antibody tests for SLE

A

specific - anti-dsDNA

sensitive - ANA

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5
Q

what medication used in the mx of RA can lead to reactivation of TB

A

TNF-inhibitor - Etanercept

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6
Q

chondrocalcinosis on x-ray

A

described as ‘linear calcification of articular cartilage’

highly suggestive of pseudogout

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7
Q

extra-articular complications of RA

A

ischaemic heart disease
apical pulmonary fibrosis
pleural effusion

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8
Q

blood test results in osteoporosis

A

all normal

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9
Q

what does malignancy plus raised creatinine kinase indicate

A

polymyositis

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10
Q

mx for ankylosing spondylitis

A

NSAIDs

Etanercept (TNF-alpha inhibitor) if NSAIDs fail

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11
Q

features of polymyalgia rheumatica

A

aching morning stiffness in proximal limb muscles but no weakness
normal CK

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12
Q

antibody test for anti-phospholipid syndrome

A

anti-cardiolipin (aCL) antibodies and lupus anticoagulant (LA)

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13
Q

mx of septic arthritis

A

IV Flucloxacillin (or Clindamycin if penicillin allergic)

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14
Q

risk factors for osteoporosis

A 
history of glucocorticoid use
RA
alcohol excess
low BMI
smoking
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15
Q

antibody associated with drug-induced lupus

A

antihistone antibody

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16
Q

hand joints in OA vs RA

A

OA: CMC and DIP joints
RA: MCP and PIP joints

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17
Q

what rheumatological condition are chemotherapy patients at increased risk of

A

gout due to increased urate production

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18
Q

what baseline investigation must be done before initiating hydroxychloroquine

A

ophthalmological examination

hydrox-E-y-E-chloroquine

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19
Q

causes of drug-induced lupus

SHIPP

A 
Sulfonamide
Hydralizine
Isoniazid
Phenytoin
Procainamid
20
Q

OA mx

A
  1. paracetamol + topical NSAID (if knee/hand)

2. oral NSAIDs/COX-2 inhibitors

21
Q

risk factors for pseudogout

A

hyperparathyroidism
haemochromatosis
acromegaly

22
Q

mx of polymyalgia rheumatica

A

Prednisolone

23
Q

what is measured to monitor SLE flares

A

complement levels

they are usually low during active disease

24
Q

Marfan’s has a deficiency of what

A

fibrillin

25
Q

features of ankylosing spondylitis

A

lower back pain and stiffness
insidious onset
stiffness improves with exercise
pain at night

26
Q

features of OA

A

pain exacerbated by exercise and relieved by rest

unilateral symptoms

27
Q

pseudogout crystals

A

weakly positive birefringent rhomboid-shaped crystals

28
Q

gout crystals

A

negatively birefringent needle-shaped crystals

29
Q

Pre-op imaging for people with RA

A

AP and lateral C-spine radiographs to check for atlantoaxial subluxation

30
Q

oral and genital ulcers not responding to aciclovir

A

think Behcet’s

31
Q

mx of reactive arthritis

A

NSAIDs

if NSAIDs CI - intra-articular steroids

32
Q

features of temporal arteritis

A 
rapid onset
headache
jaw claudication
visual disturbance (anterior ischaemic optic neuropathy)
pyrexia
skip lesions on biopsy
rapid response to prednisolone
33
Q

features of osteogenesis imperfecta

A-F

A 
Autosomal dominant
Blue sclera
Caries
Deafness (otosclerosis)
Every Fracture unexplained
34
Q

adverse effect of hydrocholorquine

A

bull’s eye retinopathy

35
Q

Felty’s syndrome

A

rheumatoid arthritis
splenomegaly
low WCC

36
Q

advice for conception if taking methotrexate

A

must want at least 6 months after stopping methotrexate before conceiving

37
Q

anterior ischaemic optic neuropathy

A

sudden vision loss with disc pallor

seen in temporal arteritis

38
Q

features of antiphospholipid syndrome

A

venous and arterial thromboses
recurrent foetal loss
thrombocytopenia
prolonged APTT

39
Q

where are crystals found in pseudogout

A

synovium first then cartilage

40
Q

mx of acute gout

A

NSAIDs

use Prednisolone if CKD

41
Q

what must be screened for if a person presents with dermatomyositis

A

underlying malignancy

42
Q

adverse effects of methotrexate

A

myelosuppression
pneumonitis
pulmonary fibrosis
mucositis

43
Q

anaemia found in SLE

A

haemolytic anaemia

44
Q

features of osteomalacia (incl. bloods)

A

bone pain and tenderness
proximal myopathy
low calcium, phosphate and vitamin D
raised ALP and PTH

45
Q

joint aspiration findings in reactive arthritis

A

cloudy yellow
negative culture
no crystals
WCC 20,000/mm^3

finals (25 decks)

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