rheum Flashcards
what arthristis is associated with a rash on palms and soles and whats it called
reactive arthritis
keratoderma blenorrhagica
how is a dexaethasone suppression test done in cushings
dex given at 10pm and measured in morning
treatment of methotrexate toxicity
folinic acid
what things do the spondyloarthropothhies have in common
inflammatory arthritis
dactlyitis
enthesis
sacroiliac/ spinal involvement
is azathioprine safe in pregnancy
yes
how often is methotrexate taken
weekly
what antibiody is assoc with diffuse systemic sclerosis
anti-scl 70
what test should be done before starting biologics in Rheumatoid arthirtis and why
CXR to check. for Tb as may reactivate
methotrexate should not be prescribes alongside what antbiotic and why
trimethoprim - may cause bone marrow suppression and severe pancytopeania
what is side effecct of sulfasalazine
steven johnson syndorme
oligospermia
pneumonitis
myelosuppression
colouring of tears - staining contact lenses
how should bisphosphonates be taken and why
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
whats the most specific test for SLE
ANti dsDNA
whats a good rule out test for lupus
ANA - 99% specific
what baseline test should be doen before staarting hydroxychloroquine
pthalmologist exam as causes bull’s eye retinopathy - may result in severe and permanent visual loss
eye complication of tamporal arteritis
anterior ischaemic optic neuropathy
what is feltys syndrome
RA- spenomegaly and low WCC
most common septic arthirits organism over all? in adults? where does it come from ie how does it spread to joint
staph aureus
gonorrhoea in young adults
haematogenous spread
when should bisphosphonates be strated in osteoporsis
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)
what sntbody seen in limited systemic sclerosis- where on body is sclerosis seen
anti-centromere - distal arms and legs
duration of antibiotic course in septic arthritis
4-6 weeks
first lien investigation in coeliac. what additional things can be tested for
what is gold standard
Anti-TTG antibodies (IgA)
others = endomyseal antibody (IgA)
anti-gliadin antibody (IgA or IgG)
anti-casein antibodies
gold standard = endoscopic intesinal biopsy
- what do carcinoid tumours secrete
- investigation and treatment of carcinoid tumour
serotonin (sometimes ACTH and GnRH)
urinary 5-NIAA
octreotide
what kind of antibody is RF
what kind of antibodies are hep A, B and C
IgM
Hep A -IgM
Hep B- IgM
Hep C - IgG
what test detects RF
rose waater test
what investigaition should be done on all newly diagnoses RA patients
Hand and feet X-RAy
what DMARDS are safe in pregnancy
Sulf and HCQ
in gout when is uric acid retested
2 weeks after flare
what drugs casue gout
thiazides - reduced urate excretion
loop diuretics
what is the rule of 2s in meckels diverticulum
2% of population
2 foot from ileoceacal
2 inch long
what conditions is pseudgout assoc with
haemochromatosis
hyperparathyroid
wilsons
acromegaly
what feature other than crystal type can differentiate gout from pseudogout
chondrocalcinosis
management of lupus
sunscreen NSADIS, HQC
what cancer is sjogren assoc with
LYMPHOID
Sjogrens antibodies
ANA, Anti-RO anti - La
test in sjogrens
schimers test
what are peoplw with systemic sclerosis screened for yearly
pulmonary hypertension
what type of systemic sclerosis is CREST syndrome assoc with
limited
what does CREST syndrome cause
calcinosis
raynauds
oesophageal dysmotility
sclerodactyl
telangectasia
treatment of systemic sclerosis
immunosuppressants
the As of spondyloarthropathies are
Apical fibrosis
Aortic regurg
Ant uveitis
Achilles tendonits
Av node block
Amyloidosis
and cauda equina
what blood investigations would be seen in ank spond
raised CRP and ESR
what is the normal physiological response to an insulin stress test
Gh and Cortisol shoudl rise
antibodies seen in polymyositis
anti-synthetase
anti -jo
treatment of polymyositis
steroids and immunosupp if steroid sparing
what is the relationship beteen different LFTS in alcholic hepatitis and NAFLD
alcoholic hepatitis - AST>ALT>1.5 GGT raised too
NAFLD ALT>AST
most common cause painless massive GI bleeding n in children between the ages of 1 and 2 years
meckels diverticulum
imagine og takayasu arteritis
MRA or CTA
features of takayasu arterits
claudication of exertion
unequal upper limb BP
absent or weak peripheral pulses
management of takayasu
steroids
features of GPA
spistaxis, nasal crusting, sinusitis
haemoptysis , dyspnoea
rapidly progressing glomerulonephritis
treatment of alcoholic heaptitis
Steroids
what tumour is assoc with coeliac
T-cell lymphoma of small intestine
differentiating feature between eGPA and GPA
asthma
features of HSP
abdo pain, vasculitic rash , polyarthritis and features of IgA nephropathy eg haematuria
treatment of HSp
aupportive and analgesia
what tests should be done in HSP
Bp an durinalysis monitoring
