Rheum Flashcards
Earliest radiological finding in ank spon?
Bone marrow oedema
XR findings in ank spon?
Subchondral erosions
Sclerosis
Squaring of vertebrae
Syndesmophytes
Early XR finding in RA?
Juxta-articular osteopaenia
DIP swelling and dactylitis?
Psoriatic arthritis
XR findings in RA
Marginal erosions, soft tissue swelling and periarticular osteoporosis/erosions,
Joint-subluxation is late
Most common secondary cause of Raynaud’s?
Systemic sclerosis (scleroderma)
Obstructive picture PFTs in RA?
Bronchiolitis Obliterans
Pain on the radial side of the wrist/tenderness over the radial styloid process?
De Quervein’s Tensosynovitis
Calcification of the triangular fibrocartilage?
Pseudogout (often flares with infection)
Swelling at the DIP joints (Heberden’s nodes)?
OA
Can anti-TNF alpha drugs slow radiological progression in ank spon?
No (contrary to their effects in RA)
Can’t see/pee/bend the knee?
Reactive arthritis
Waxy yellow rash on the feet in an arthritis?
Keratoderma blenorrhagica - i.e. reactive arthritis
DMARDs safe in pregnancy
Sulfasalazine
Hydrochloroquine
False positive VDRL test?
Antiphospholipid syndrome
Paradoxicallly high APTT and low plateletes? (+/- emobuls) Rheum disease assoc?
Antiphospholipid, SLE
Homogenous ANA staining?
SLE
Speckled ANA staining?
MCTD
Nucleolar ANA staining?
Scleroderma
Centromere ANA staining?
Limited (central) systemic sclerosis, incl. CREST syndrome
RA with +ve ANA?
Felty’s or Sjorgrens
ANA against anti-dsDNA?
SLE
ANA against anti-ssDNA?
Drug-induced lupus
Anti-Ro
Sjogrens/congenital lupus/neonatal lupus syndrome
Anti-La
Primary sjogrens
Anti-Jo1
Polymyositis
Anti-Sm
SLE
Anti-RNP
MCTD
Anti-Scl70
Progressive systemic sclerosis
Treatment in antiphospholipid syndrome?
Primary prevention is low dose aspirin
Secondary prevention is life long warfarin INR 2-3 for first venous or arterial thrombus
Warfarin INR 3-4 for second thrombus/recurrence
Most sensitive vs most specific autoantibodies in SLE
ANA 99% sensitive
Anti-Sm, Anti-dsDNA 90% specific
Which complement levels low in SLE?
C4 (and C3)
3 culprit drugs in drug-induced lupus?
Hydralazine
Isoniazid
Procainamide
SLE - which hypersensitivity reaction?
Type III
HLA assoc in SLE?
HLA B8, DR2, DR3
Mainstay of treatment in SLE?
Hydroxychloroquine
Commonest form of lupus nephritis? Treatment?
Class IV - diffuse proliferative glomerulonephritis
Treat the HTN
Steroids + MMF OR cyclophosphamide
Skin findings in dermatomyositis?
Heliotrope rash around the eyes
Gottron’s papules (scaly papules over MCP/PIP)
Mechanic’s hands
Autoantibodies in dermatomyositis/polymtositis?
Anti-Jo1
ANA
Anti-Mi-2
Classes of systemic sclerosis?
Limited scleroderma with systemic involvement (includes CREST)
Diffuse scleroderma with limited involvement
Scleroderma without internal organ disease
Worst prognosis of the systemic sclerosis patterns?
Diffuse scleroderma with limited involvement
Autoantibody particularly assoc with diffuse scleroderma with limited involvement?
Anti-Scl-70
Autoantibody particularly assoc with limited scleroderma with systemic involvement?
Anti-centromere
Features of CREST syndrome?
Calcinosis
Raynauds
oEsophageal dysmotility
Sclerodactyly
Telangectasia
anti-RNP mnemonic
which condition?
R Raynoud
N swollen hands with No synovitis
P Pain in muscle and joints
Mixed connective tissue
Most likely organism in reactive arthritis aspirate?
None!
TNF primarily secreted by?
Macrophages
Second line for saliva lack in Sjogrens?
pilocarpine
Most likely organism in septic arthritis/discitis?
S aureus
Reactive arthritis HLA association?
HLA-B27