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rheum Flashcards

1
Q

what arthristis is associated with a rash on palms and soles and whats it called

A

reactive arthritis
keratoderma blenorrhagica

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2
Q

how is a dexaethasone suppression test done in cushings

A

dex given at 10pm and measured in morning

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3
Q

treatment of methotrexate toxicity

A

folinic acid

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4
Q

what things do the spondyloarthropothhies have in common

A

inflammatory arthritis
dactlyitis
enthesis
sacroiliac/ spinal involvement

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5
Q

is azathioprine safe in pregnancy

A

yes

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6
Q

how often is methotrexate taken

A

weekly

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7
Q

what antibiody is assoc with diffuse systemic sclerosis

A

anti-scl 70

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8
Q

what test should be done before starting biologics in Rheumatoid arthirtis and why

A

CXR to check. for Tb as may reactivate

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9
Q

methotrexate should not be prescribes alongside what antbiotic and why

A

trimethoprim - may cause bone marrow suppression and severe pancytopeania

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10
Q

what is side effecct of sulfasalazine

A

steven johnson syndorme
oligospermia
pneumonitis
myelosuppression
colouring of tears - staining contact lenses

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11
Q

how should bisphosphonates be taken and why

A

Oral bisphosphonates should be swallowed with plenty of water while sitting or standing on an empty stomach at least 30 minutes before breakfast (or another oral medication); the patient should stand or sit upright for at least 30 minutes after taking

if they sit in oesophagus they cause oesophagitis

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12
Q

whats the most specific test for SLE

A

ANti dsDNA

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13
Q

whats a good rule out test for lupus

A

ANA - 99% specific

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14
Q

what baseline test should be doen before staarting hydroxychloroquine

A

pthalmologist exam as causes bull’s eye retinopathy - may result in severe and permanent visual loss

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15
Q

eye complication of tamporal arteritis

A

anterior ischaemic optic neuropathy

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16
Q

what is feltys syndrome

A

RA- spenomegaly and low WCC

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17
Q

most common septic arthirits organism over all? in adults? where does it come from ie how does it spread to joint

A

staph aureus
gonorrhoea in young adults
haematogenous spread

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18
Q

when should bisphosphonates be strated in osteoporsis

A

Offer prophylactic bisphosphonates to those with a T-score < -1.5 if they are on steroids / going to be on steroids for 3 or more months (even if <65 years-old)

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19
Q

what sntbody seen in limited systemic sclerosis- where on body is sclerosis seen

A

anti-centromere - distal arms and legs

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20
Q

duration of antibiotic course in septic arthritis

A

4-6 weeks

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21
Q

first lien investigation in coeliac. what additional things can be tested for

what is gold standard

A

Anti-TTG antibodies (IgA)
others = endomyseal antibody (IgA)

anti-gliadin antibody (IgA or IgG)
anti-casein antibodies

gold standard = endoscopic intesinal biopsy

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22
Q
  • what do carcinoid tumours secrete
  • investigation and treatment of carcinoid tumour
A

serotonin (sometimes ACTH and GnRH)
urinary 5-NIAA
octreotide

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23
Q

what kind of antibody is RF

what kind of antibodies are hep A, B and C

A

IgM

Hep A -IgM
Hep B- IgM
Hep C - IgG

24
Q

what test detects RF

A

rose waater test

25
Q

what investigaition should be done on all newly diagnoses RA patients

A

Hand and feet X-RAy

26
Q

what DMARDS are safe in pregnancy

A

Sulf and HCQ

27
Q

in gout when is uric acid retested

A

2 weeks after flare

28
Q

what drugs casue gout

A

thiazides - reduced urate excretion
loop diuretics

29
Q

what is the rule of 2s in meckels diverticulum

A

2% of population
2 foot from ileoceacal
2 inch long

30
Q

what conditions is pseudgout assoc with

A

haemochromatosis
hyperparathyroid
wilsons
acromegaly

31
Q

what feature other than crystal type can differentiate gout from pseudogout

A

chondrocalcinosis

32
Q

management of lupus

A

sunscreen NSADIS, HQC

33
Q

what cancer is sjogren assoc with

A

LYMPHOID

34
Q

Sjogrens antibodies

A

ANA, Anti-RO anti - La

35
Q

test in sjogrens

A

schimers test

36
Q

what are peoplw with systemic sclerosis screened for yearly

A

pulmonary hypertension

37
Q

what type of systemic sclerosis is CREST syndrome assoc with

A

limited

38
Q

what does CREST syndrome cause

A

calcinosis
raynauds
oesophageal dysmotility
sclerodactyl
telangectasia

39
Q

treatment of systemic sclerosis

A

immunosuppressants

40
Q

the As of spondyloarthropathies are

A

Apical fibrosis
Aortic regurg
Ant uveitis
Achilles tendonits
Av node block
Amyloidosis

and cauda equina

41
Q

what blood investigations would be seen in ank spond

A

raised CRP and ESR

42
Q

what is the normal physiological response to an insulin stress test

A

Gh and Cortisol shoudl rise

43
Q

antibodies seen in polymyositis

A

anti-synthetase
anti -jo

44
Q

treatment of polymyositis

A

steroids and immunosupp if steroid sparing

45
Q

what is the relationship beteen different LFTS in alcholic hepatitis and NAFLD

A

alcoholic hepatitis - AST>ALT>1.5 GGT raised too
NAFLD ALT>AST

46
Q

most common cause painless massive GI bleeding n in children between the ages of 1 and 2 years

A

meckels diverticulum

47
Q

imagine og takayasu arteritis

A

MRA or CTA

48
Q

features of takayasu arterits

A

claudication of exertion
unequal upper limb BP
absent or weak peripheral pulses

49
Q

management of takayasu

A

steroids

50
Q

features of GPA

A

spistaxis, nasal crusting, sinusitis
haemoptysis , dyspnoea
rapidly progressing glomerulonephritis

51
Q

treatment of alcoholic heaptitis

A

Steroids

52
Q

what tumour is assoc with coeliac

A

T-cell lymphoma of small intestine

53
Q

differentiating feature between eGPA and GPA

A

asthma

54
Q

features of HSP

A

abdo pain, vasculitic rash , polyarthritis and features of IgA nephropathy eg haematuria

55
Q

treatment of HSp

A

aupportive and analgesia

56
Q

what tests should be done in HSP

A

Bp an durinalysis monitoring

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