Rheum Flashcards
What is methotraxate
A folate antagonist, of dihydrofolate reductase enzyme. Inhbits the synthesis of DNA and RNA
What are bisphophantes associated with
Osteonecrosis of jaw so regular dental checkups are needed
What medication are risk factors for gout
Aspirin and thiazide diuretics because they decrease uric acid excretion and cause build up in the body
What is polyarteritis nodosa
Segmental transmural necrotising vasculitis of medium sized muscular arteries. Associated with hep B
What is polyarteritis nodosa
Segmental transmural necrotising vasculitis of medium sized muscular arteries. Associated with hep B
Gout on microscopy?
Needle shaped negatively birefringment crystals of monosodium urate
Pseudogout on microscopy
Formed by calcium pyrophoshate which are rhomboid shaped and positively birefringement
What is contraindicated in patients with anti-phospholipid syndrome and a history of clots
Combined oral contraceptive pill as it contains oestrogen
CLOT for anti-phospholipid syndrome
Clots - Usually venous thromboembolism (DVT/PE), but arterial embolism (eg. MI or stroke) can also occur.
Livedo reticularis - A mottled, lace-like appearance of the skin on the lower limbs.
Obstetric loss - Recurrent miscarriages, pre-eclampsia and premature births can occur.
Thrombocytopenia.
What is raised in polymalgia rheumatica
ESR
Describe the results of DAS score
<2.6= remission
2.6-3.19= low disease activity
3.2-5.1= moderate disease activity
>5.1= high disease activity
Osteomalacia findings
Low serum Calcium, low serum phosphate, raised ALP and raised PTH
Limited vs diffuse sclerosis
Limited- hardening of skin,
Diffuse- visceral organ involvement eg pulmonary hypertension, ILD
Side effects of methotrexate
Folic acid deficiency and macrocytic anaemia
Which abx should not be taken with methotrexate
Trimepothrin
