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MSRA > Rheum > Flashcards

Rheum Flashcards

1
Q

what is HLA 27 associated with

A

ank spond
reactive arthritis
JIA
anterior uveitis
psoriatic arthritis

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2
Q

C-ANCA is associated with

A

Wegners granulomatosis

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3
Q

In a positive C-ANCA test you then need to test

A

PR3 (if negative then all insignificant)

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4
Q

In a positive P-ANCA test you also need to check

A

MPO (if negative then all insignificant)

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5
Q

What category of illness is ANCA associated with

A

vasculitis

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6
Q

What category of illness is ANA associated with

A

connective tissue disease such as SLE or sjogrens

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7
Q

Positive RF or anti CCP in RA suggests what

A

more severe disease/systemic complications more likely

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8
Q

Which arthritis has Hebden’s/Bouchards nodes

A

osteo

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9
Q

T score of -1.5-2.5 suggests

A

osteopenia

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10
Q

T score of -2.5 suggests

A

osteoporosis

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11
Q

Dactylitis is linked to what 3 conditions

A

spondyloarthritises
sarcoid
sickle cell

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12
Q

cardiac complications of ank spond

A

heart block
Aortic regurgitation

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13
Q

resp complication of ank spond

A

pulm fibrosis (apical)

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14
Q

what is the examination test for ank spond

A

schobers

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15
Q

What does MRI spine show in ank spond

A

BM oedema

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16
Q

XR findings of ank spond

A

bamboo spine
squaring of vertebral bodies
subchondral sclerosis and erosions
Syndesmphytes
ossification
joint fusion

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17
Q

what antibiotic must be avoided with MTX

A

trimethoprim (they will become pancytopenic)``

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18
Q

which medication require careful timing with the flu jab

A

rituximab

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19
Q

what other skin manifestation of lupus apart from malar rash

A

discoid rash in sun exposed areas

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20
Q

What are two quite specific lupus antibodies

A

anti smith
anti dsDNA

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21
Q

what other syndrome can SLE deveop

A

APL

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22
Q

diagnostic test for SLE other than bloods

A

skin biopsy

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23
Q

what medication should SLE avoid

A

oestrogen contraceptives

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24
Q

what is a potentially curative option in severe refractory SLE

A

stem cell transplant

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25
Q

Does PMR get true muscular weakness?

A

No it is due to pain

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26
Q

How should PMR respond to steroid

A

dramatically and quickly

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27
Q

first line rx in ank spond

A

NSAIDs

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28
Q

when to use mtx in ank spond

A

peripheral disease

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29
Q

other treatments in ank spond

A

joint steroids
biologics
surgery

30
Q

joints mostly affected in psoriatic arthritis

A

DIPs

31
Q

Sjogren’s antibodies

A

Ro
La

32
Q

Dermatomyositis ab

A

JO1

33
Q

Diffuse sclerosis ab

A

Scl70

34
Q

rash associated with APL syndrome

A

livedo reticularis

35
Q

FBC result in APL

A

low plt

36
Q

Abs in APL synd

A

lupus anticoag

anticardiolipin

anti-B2 glycoprotein

37
Q

Sjogrens has a 5-9x risk of what cancer

A

lymphoma

38
Q

Test for sjogrens with paper

A

Schirmers

39
Q

Antibody in limited systemic sclerosis (CREST)

A

anti-centromere

40
Q

what type of sclerosis has a better prognosis

A

limited

41
Q

Limited sclerosis associated with what heart issue

A

pulm htn

42
Q

Medication options for Reynauds

A

Nifedipine

Iloprost for digital ulcers

Sildenafil

Fluoxetine

43
Q

‘punched out’ erosions, tophi and joint effusions on XR

A

gout

44
Q

Periarticular osteopenia on XR

A

RA

45
Q

Acute gout mx

A

colchicine (continue allopurinol if taking)

46
Q

When to offer allopurinol in gout

A

after first attack as urate lowering therapy

47
Q

How do you decide allopurinol dose

A

Titrate until serum uric acid <300umol/L

48
Q

weakly positive birefringemet rhombiod-shaped crystals on joint aspiration suggests what

A

pseudogout (calcium crystals)

49
Q

Pseudogout rx

A

NSAIDs
steroids

50
Q

When do you start bisphosphonates following fracture

A

> 75 with fragility frature- no need for DEXA first

<75 –> DEXA –> FRAX –> maybe start

51
Q

How can you manage a severe RA flare

A

PO/IM steroids

52
Q

Starting biologics (-mab) can have what adverse affect that requires CXR beforehand

A

reactivation of TB

53
Q

How long should sx be present for chronic fatigue dx

A

3 months

54
Q

Bad GI side effects on aledronate for osteoporosis - alternative?

A

risedronate or etidronate

55
Q

Linear calcification of the articular cartilage on XR

A

Pseudogout- Chondrocalcinosis

56
Q

Pagets rx

A

bisphosphonate

57
Q

hydroxychloroquine side effect

A

retinopathy

58
Q

Rx for OA if paracetamol not working

A

Topical NSAIDs if knee/hand

Oral if other

59
Q

How to manage bone protection if a patient is taking the equivalent of prednisolone 7.5mg a day for 3 or more months

A

> 65 OR previous fragility fracture- aledronate

<65 –> DEXA –> Between 0 and -1.5- Repeat bone density scan in 1-3 years/Less than -1.5- offer bone protection.

Ensure vit D and Ca replete

60
Q

methotrexate SE

A

myelosuppression

61
Q

sulfasalazine SE

A

sperm low

62
Q

Leflunomide SE

A

liver, lung disease

63
Q

What rheum drug causes proteinuria

A

Penicillamine and Gold

64
Q

can you use azathioprine in pregnancy

A

yes

65
Q

Rash on soles of feet is associated with what

(keratoderma blenorrhagica)

A

Reactive arthritis

66
Q

Osteoarthritis XR changes

A

LOSS (lossteoarthritis)

Loss of joint space
Osteophytes forming at joint margins
Subchondral sclerosis
Subchondral cysts

67
Q

which rheum drug can exacerbate myaesthenia gravis

A

penicillamine

68
Q

colchicine side effect

A

diarrhoea

69
Q

Etanercept side effect

A

demyelination (‘intercepts the nerves’)

70
Q

RA XR findings

A

LESS

Loss of joint space
Erosions
Soft tissue swelling
Soft bones (osteoporosis/ osteopenia)

71
Q

oral ulcers, genital ulcers and anterior uveitis

A

behcets

MSRA (21 decks)

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