rheum Flashcards
mx of acute flares of RA
IM/oral methylprednisolone
mx of antiphospholipid syndrome
no VTE - daily low-dose aspirin
after first VTE lifelong warfarin
features of psoriatic arthritis
DIP swelling and dactylitis
involves any joint of the body
imaging - pencil in cup and plantar spur
most specific and sensitive antibody tests for SLE
specific - anti-dsDNA
sensitive - ANA
what medication used in the mx of RA can lead to reactivation of TB
TNF-inhibitor - Etanercept
chondrocalcinosis on x-ray
described as ‘linear calcification of articular cartilage’
highly suggestive of pseudogout
extra-articular complications of RA
ischaemic heart disease
apical pulmonary fibrosis
pleural effusion
blood test results in osteoporosis
all normal
what does malignancy plus raised creatinine kinase indicate
polymyositis
mx for ankylosing spondylitis
NSAIDs
Etanercept (TNF-alpha inhibitor) if NSAIDs fail
features of polymyalgia rheumatica
aching morning stiffness in proximal limb muscles but no weakness
normal CK
antibody test for anti-phospholipid syndrome
anti-cardiolipin (aCL) antibodies and lupus anticoagulant (LA)
mx of septic arthritis
IV Flucloxacillin (or Clindamycin if penicillin allergic)
risk factors for osteoporosis
history of glucocorticoid use RA alcohol excess low BMI smoking
antibody associated with drug-induced lupus
antihistone antibody
hand joints in OA vs RA
OA: CMC and DIP joints
RA: MCP and PIP joints
what rheumatological condition are chemotherapy patients at increased risk of
gout due to increased urate production
what baseline investigation must be done before initiating hydroxychloroquine
ophthalmological examination
hydrox-E-y-E-chloroquine
causes of drug-induced lupus
SHIPP
Sulfonamide Hydralizine Isoniazid Phenytoin Procainamid
OA mx
- paracetamol + topical NSAID (if knee/hand)
2. oral NSAIDs/COX-2 inhibitors
risk factors for pseudogout
hyperparathyroidism
haemochromatosis
acromegaly
mx of polymyalgia rheumatica
Prednisolone
what is measured to monitor SLE flares
complement levels
they are usually low during active disease
Marfan’s has a deficiency of what
fibrillin
features of ankylosing spondylitis
lower back pain and stiffness
insidious onset
stiffness improves with exercise
pain at night
features of OA
pain exacerbated by exercise and relieved by rest
unilateral symptoms
pseudogout crystals
weakly positive birefringent rhomboid-shaped crystals
gout crystals
negatively birefringent needle-shaped crystals
Pre-op imaging for people with RA
AP and lateral C-spine radiographs to check for atlantoaxial subluxation
oral and genital ulcers not responding to aciclovir
think Behcet’s
mx of reactive arthritis
NSAIDs
if NSAIDs CI - intra-articular steroids
features of temporal arteritis
rapid onset headache jaw claudication visual disturbance (anterior ischaemic optic neuropathy) pyrexia skip lesions on biopsy rapid response to prednisolone
features of osteogenesis imperfecta
A-F
Autosomal dominant Blue sclera Caries Deafness (otosclerosis) Every Fracture unexplained
adverse effect of hydrocholorquine
bull’s eye retinopathy
Felty’s syndrome
rheumatoid arthritis
splenomegaly
low WCC
advice for conception if taking methotrexate
must want at least 6 months after stopping methotrexate before conceiving
anterior ischaemic optic neuropathy
sudden vision loss with disc pallor
seen in temporal arteritis
features of antiphospholipid syndrome
venous and arterial thromboses
recurrent foetal loss
thrombocytopenia
prolonged APTT
where are crystals found in pseudogout
synovium first then cartilage
mx of acute gout
NSAIDs
use Prednisolone if CKD
what must be screened for if a person presents with dermatomyositis
underlying malignancy
adverse effects of methotrexate
myelosuppression
pneumonitis
pulmonary fibrosis
mucositis
anaemia found in SLE
haemolytic anaemia
features of osteomalacia (incl. bloods)
bone pain and tenderness
proximal myopathy
low calcium, phosphate and vitamin D
raised ALP and PTH
joint aspiration findings in reactive arthritis
cloudy yellow
negative culture
no crystals
WCC 20,000/mm^3
