Rheum 2 Flashcards

1
Q

what rash is associated with antiphospholipid syndrome

A

livedo reticularis

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2
Q

what type of endocarditis is associated with antiphospholipid syndrome and SLE

A

libmann sacks endocarditis

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3
Q

what happens to platelets in antiphospholipid syndrome

A

low

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4
Q

anticoagulation in antiphospholipid syndrome

A

warfarin

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5
Q

target INR antiphospholipid syndrome

A

2-3 on warfarin

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6
Q

anticoagulation in antiphospholipid syndrome when pregnant

A

LMWH and aspirin

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7
Q

sjogrens syndrome antibodies

A

anti ro and anti la

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8
Q

what test is done on examination for sjogrens syndrome

A

schrimer test

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9
Q

schrimer test method and results

A

place a piece of filter paper on the lower eyelid for 5 mins

distance travelled <10mm is significant for sjorgens

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10
Q

pilocarpine is used for and moa

A

stimulating tears and salivary gland secretion

stimulates muscarinic receptors and the parasympathetic nerves

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11
Q

what is polyarteritis nodosa

A

a medium vessel vasculitis

sx include
renal impairment
htn
tender skin nodules

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12
Q

what is kawasaki disease

A

a medium vessel vascultiis

sx
higher fever for 5 days
bilateral conjunctivitis
rash
adenopathy
strawberry tongue
hands and feet peeling

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13
Q

what is takayasu arteritis

A

large vessel vasculitis

sx include
aortic arch affected
pulseless

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14
Q

how to remember what antibody is associated with microscopic polyangitis

A

p-anca
p for petite like microscopic

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15
Q

what antibody is associated with HSP

A

IgA

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16
Q

what do patients with HSP need monitored

A

urine dipstick for renal involvement
blood pressure for hypertension

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17
Q

granulomatosis with polyangitis is also known as

A

wegners

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18
Q

wegners granulomatosis sx

A

nosebleeds
hearing loss
sinusitis
saddle shaped nose
glomerulonephritis

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19
Q

eosinophilic granulomatosis with polyangitis

A

severe asthma
sinusitis
allergic rhinitis

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20
Q

what infection is polyartertitis nodosa associated with

A

hep b

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21
Q

key complication of kawasaki disease

A

coronary artery aneurysm

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22
Q

kawasaki disease mx

A

aspirin and IVIG

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23
Q

how is takayasus arteritis diagnosed

A

CT or MRI angiography

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24
Q

takayasus arteritis sx

A

claudication
fever
malaise
muscle ache
lack of pulse

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25
Q

sx bechets disease

A

oral ulcers- painful, sharply circumscribed and have a red halo

genital ulcers

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26
Q

bechets disease is associated with what gene

A

HLA B51

27
Q

what test can be done to aid diagnosis of bechets disease

A

pathergy test

28
Q

how is bechets disease managed

A

steroids
colchicine

29
Q

bechets disease pattern

A

relapsing remitting

30
Q

types of ehlers danlos syndrome

A

classic
hypermobile
vascular

31
Q

autonomic dysfunction in ehlers danlos causes what

A

pots syndrome

tachycardia on sitting/standing
syncope

32
Q

what score is used to assess patients in ehlers danlos

A

beighton

33
Q

ehlers danlos is defect in

A

collagen

34
Q

features of marfans syndrome

A

high arch palate
long fingers- arachnodactyly
increased arm span

35
Q

what diet increases risk of gout

A

high purine (meat and seafood)

36
Q

what is seen on x ray in gout

A

maintained joint space
lytic lesions
punched out erosions

37
Q

allopurinol moa

A

xanthine oxidase inhibitor

38
Q

gout mx

A

nsaid (not in renal impairment)
colchicine
steroids 3rd line

39
Q

if a patient is on allopurinol or feburoxstat and gets active gout what happens to their prophylactic medications

A

continued

40
Q

gout prophylactic medications

A

allopurinol
febuxostat

41
Q

what is chondrocalcinosis

A

deposits of calcium in the joint cartilage

42
Q

how is pseudogout managed

A

it resolves by itself

symptomatic relief:
nsaids
colchicine
intra articular steroid injections
oral steroids

43
Q

t score osteopenia

A

-1 to -2.5

44
Q

t score osteoporosis

A

< -2.5

45
Q

what is osteopenia

A

a less severe form of osteoporosis

46
Q

what do qfracture and frax tools calculate

A

10 year risk of a major osteoporotic fracture and hip fracture

47
Q

what q fracture score indicated need for dexa scan

A

> 10%

48
Q

when do you not have to calculate qfracture score before doing dexa

A

patients over 50 with a fragility fracture

49
Q

osteoporosis mx

A

1st line= bisphosphonates

lifestyle adivce= increase exercise, reduce alcohol and smoking, weight loss

make sure calcium and vitamin D levels are normal and if not supplement them

50
Q

bisphosphonate side effects

A

reflux
atypical fractures
osteonecrosis of the jaw or external auditory canal

51
Q

advice given on how to take bisphosphonates

A

take on an empty stomach with a full glass of water

remain upright for 30 mins after taking them

52
Q

when should you reassess someone on bisphosphonates

A

after 3-5 years
if t score > -2.5 stop medication

53
Q

strontium ranelate moa

A

stimulates osteoblasts and blocks osteoclasts

54
Q

strontium ralenate side effects

A

increases risk of VTE and MI

55
Q

raloxifene moa

A

SERM
targets bone receptors not uterus or breast

56
Q

raloxifene side effect

A

increases risk of VTE

57
Q

what are looser zones

A

fragility fractures that go partially through bone

58
Q

how is osteomalacia treated

A

vitamin d supplementation

59
Q

when should serum calcium be checked after starting vitamin D supplementation in osteomalacia

A

within a month

60
Q

what causes osteomalacia

A

vitamin d insufficiency

61
Q

x ray findings in paegts disease

A

bone enlargement and deformity
osteoporosis circumscripta
cotton wool appearance of skull
v shaped osteolytic defects of long bones

62
Q

pagets disease mx

A

bisphosphonates
calcitonin when not suitable

63
Q

what cancer can those with pagets disease get

A

osteosarcoma