Rheum

Question 1

Dermatomyositis signs

Answer 1

Gottrons papules - on extensor joints of the hands
Maculopapular linear erythema on neck chest and shoulders

Question 2

what abx drug should NEVERRRR be prescribed with methotrexate and why

Answer 2

trimethoprim (or cotrimoxazole)
can precipitate agranulocytosis

Question 3

presentation of antiphospholipid syndrome

Answer 3

recurrent miscarriage
bloods weird - clots, dvts,
lived reticular

Question 4

what are PTH, calcium an phosphate levels like in osteoporosis

Answer 4

all normal

Question 5

what additional drug should be started alongside allopurinol in gout to prevent flares

Answer 5

colchicine or NSAID if not tolerated

Question 6

imaging of choice for AS and finding

Answer 6

X-ray pelvis for sacroilitis

MRI spine and SI joint
Subschondral sclerosis of SI Joint

Question 7

sarcoidosis presentation

Answer 7

GRANULOMA
General - fever, malaise, lymphadenopathy
Resp - SOB, cough
Arthralgia
Neuro -
Urinary stones
Low
O
M
A

Question 8

rheumatoid arthritis features on hand exam

features on X-ray

extra articular features

Answer 8

swelling of joints, subluxation of wrist, ulnar deviation, swan neck, boutonniere, z shaped thumb

loss of joint space, bony erosions, subluxation, soft tissue swelling, juxtaposition articular osteopenia

scleritis, episcelritis, carpal tunnel, splenomegaly (Feltys), anaemia, pulmonary fibrosis, pulmonary and pericardial effusions