Rheum Flashcards
What drug does co-trimoxazole interact with in RA pt?
Sulfasalazine
What is feltys syndrome?
-Active RA
-Neutropenia
-Splenomegaly(causing infections)
What is first line Ix for giant cell arteritis?
ESR/CRP: Elevated
What RA drug can cause diarrhea as a side effect?
Ciclosporine
Scoring system used in pts with RA
DAS-28
What does a positive anti-histone antibody suggst?
Drug induced SLE
-Like isoniazid
What Ix confirms diagnosis of giant cell arteritis?
Temporal artery biopsy
Mx for giant cell arteritis?
-High dose prednisolone(60mg) if in primary care
-If vision loss, IV methyl pred
What differentiates polymyalgia rheumatica and polymyositis?
Polymyositis has weakness whereas PMR has stiffness and pain
What is commonly associated with polymyalgia rheumatica?
Giant cell arteritis
What to give to pregnant female with RA worried about flare up?
Based on expert consensus (EULAR 2016), Hydroxychloroquine and Sulfasalazine with concomitant folate supplementation can be continued throughout pregnancy
What is the Ix for SLE and what would be more specific and more sensitive?
-ANA is more sensitive and postive in 95% of pts
-A dsDNA more specific to SLE
What is Jaccoud’s arthopathy?
Jaccoud’s arthropathy in SLE presents with rheumatoid-like hands that are reducible in extension
What are Ix findings of giant cell arteritis on ultrasound?
Halo sign
What are Ix findings of giant cell arteritis on biopsy?
granulomatous inflammation in tunica media
CK levels in polymyalgia rheumatica vs myopathy’s
PMR only one where CK levels are normal
-Myopathy’s will have raised CK levels as well as weakness, not pain
How is osteoarthritis diagnosed?
Clinically if pt >45 and activity related pain and no morning stiffness or stiffness lasting less than 30 minutes
Ix scan for osteoperosis?
DEXA
What scan should be done on pt if they’ve just been diagnosed with PMR?
DEXA to assess for fracture risk and development of osteoperosis
What should be started after high dose steorids in giant cell arteritis?
Bisphosphonates to prevent glucocorticoid related bone loss
What are anti-ro and anti-La antibodies in SLE associated with
Neonatal lupus syndrome and neonate may get congenital heart block if they have bradycardia
what is renal biopsy finding of lupus nephritis?
full house immunofluorescence pattern
