rheum Flashcards
tightening of skin + Raynaud’s + telangiectasia –> ?
(may also have oesophageal dysmotility)
systemic sclerosis
Anti-Ro antibodies are most associated with _______? Typical hx for this pt?
Sjögren’s syndrome
dryness of the eyes and mouth
what are the 3 patterns of systemic sclerosis? What’s the difference between them?
limited Cyteaneous systemic sclerosis = antiCentromere ab
- Raynaud’s
- scleroderma on face and limbs
- subset: CREST syndrome
Diffuse cutaneous Systemic sclerosis = anti-Scl-70 ab
- scleroderma on trunks and proximal limbs
- interstitial lung disease (most common cause of death), pulmonary arterial hypertension
- renal disease, HTN (start ACEI)
just scleroderma
- plaques or linear
which ab may be positive in all types of sclerosis
ANA, RF
polymyalgia rheumatica blood tests:
ESR:
CRP:
anti-ccp:
CK:
ESR: raised
CRP: raised
anti-ccp: -
CK: -
polymyalgia: ____ is common, _____ is uncommon, _____ raised
stiffness
weakness
inflammatory markers
polymyalgia rheumatica tx
prednisolone
Patients that will be taking hydroxychloroquine long-term now require
baseline ophthalmologic examination at the outset of treatment (Bull’s eye retinopathy)
It is important to perform a _______________prior to starting biologics for rheumatoid arthritis as _________________
chest X-ray to look for TB
they can cause reactivation
Dupuytren’s contracture can be a side effect of __________treatment
phenytoin
___________________ should be used when starting allopurinol
NSAID or colchicine ‘cover’
There is no _____________ in polymyalgia rheumatica on examination
true weakness of limb girdles
A key point for the exam is to appreciate that antiphospholipid syndrome causes a paradoxical rise in the _______
APTT
the As of ankylosing spondilitis
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
and cauda equina syndrome
peripheral arthritis (25%, more common if female)
1st line Ix for ankylosing spondylitis and what will it show?
2nd line Ix for ankylosing spondilitis and what will it show?
XRAY of sacroiliac joints: squaring of vertebrae, sacroiiliatis, bamboo spine (late and uncommon), syndesmophytes
MRI: bone marrow oedema
what rheum drug has a significant risk with allopurinol?
azathiopurine
___________________ should be corrected before giving bisphosphonates
Hypocalcemia/vitamin D deficiency
isolated increase in ALP =
Pagets
what is normally given alongside bisphosphonate Tx? What is only given if needed?
Vitamin D normally given
Calcium only given if dietary intake is insufficient
calcium, phosphate, ALP, PTH in:
1. osteoporosis
2. osteomalacia
3. primary hyperparathyroid
4. secondary hyperparathyroid (CKD)
5. CKD
6. Paget’s
ankylosing spondylitis acronym
sausage digit dactylitis
psoriasis
inflammatory back pain
nsaids
enthesitis
arthritic/apical fibrosis/aortic regurg
chrons/uc
hlab27
eye (anterior uveitis)
which antibody marker is negative in drug-induced lupus
anti double-stranded dna
xray feaures of gout
joint effusion, erosion, relative preservation of joint space, NO periarticular osteopenia (as opposed to RA)
later: soft-tissue tophi
