Rheum Flashcards
What is seen on joint aspiration with Reactive arthritis ?
organism cannot be recovered from the joint aspiration
Ehler-Danlos syndrome what is defective
AD
affects type III collagen
What causes pain on the radial side of the wrist
tenderness over the radial styloid process
abduction of the thumb against resistance is painful
Finkelstein’s test: +ve
De Quervain’s tenosynovitis
sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed.
How do you distinguish btwn primary (Raynaud’s disease) or secondary (Raynaud’s phenomenon).
What causes 2nadry raynauds
Raynaud’s disease typically presents in young women (e.g. 30 years old) with bilateral symptoms.
2dary causes;
1. connective tissue disorders
- scleroderma (most common)
RA
SLE
erythematosus
leukaemia
type I cryoglobulinaemia, cold agglutinins
use of vibrating tools
- drugs: oral contraceptive pill, ergot
- cervical rib
Rx raynauds
CCB- nifedipine
double-contour sign
Gout
Ankylosing spondylitis features
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
Repeated cramping and myoglobinuria after short bouts of exercise
McArdle’s disease
autosomal recessive type V glycogen storage disease
Dermatomyositis antibodies
ANA most common,
anti-Mi-2 most specific
but seen in 25% of pts
anti-Jo-1 antibodies are not commonly seen in dermatomyositis - they are more common in polymyositis where they are seen in a pattern of disease associated with lung involvement, Raynaud’s and fever
Anti-cardiolipin antibodies and anti-beta2 glycoprotein I
Antiphospholipid syndrome: arterial/venous thrombosis, miscarriage, livedo reticularis, prolonged APTT.
SE Azathioprine
bone marrow depression
nausea/vomiting
pancreatitis
increased risk of non-melanoma skin cancer
significant interaction may occur with allopurinol and hence lower doses of azathioprine should be used.
Sulfasalazine MAO and cautions
- decreasing neutrophil chemotaxis
- suppressing proliferation of lymphocytes and pro-inflammatory cytokines.
Cautions:
- G6PD deficiency
- allergy to aspirin or sulphonamides (cross-sensitivity)
Sjogren’s syndrome has increase risk of what type of cancer
lymphoid malignancies
What is Chondrocalcinosis and what is it ass w/
pseudogout,
Calcification on articular cartilage
T-score of X indicating osteoporosis.
-2.7
mao OF Bisphosphonates
inhibit osteoclasts
abnormality in type 1 collagen
osteogenesis imperfecta
AD
Abnormal Type 4 collagen
Alport’s syndrome - thinning and splitting of the glomerular basement membrane, presenting with isolated haematuria, sensorineural hearing loss, and ocular disturbances.
What caused
1. arthralgia
2. elevated serum ferritin
3. rash: salmon-pink, maculopapular
4. pyrexia- typically rises in the late afternoon/early evening w/ worsening of joint symptoms and rash
WHAT is IX & RX
Still’s disease in adults
Ix :
RF& ANA negative
Yamaguchi criteria
RX: NSAID or steroids
Denosumab SE
Dyspnoea and diarrhoea
‘large, dark shadow’ covering the superior visual field
GCA
anterior ischemic optic neuropathy (AION).
Sulfasalazine SE
oligospermia
Stevens-Johnson syndrome
pneumonitis / lung fibrosis
myelosuppression, Heinz body anaemia, megaloblastic anaemia
may colour tears → stained contact lenses
safe to use in both pregnancy and breastfeeding.