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med > Rheum > Flashcards

Rheum Flashcards

1
Q

Signs of OA on XR

A

Loss of joint space
Osteophytes
Subchondral cysts
Subarticular sclerosis

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2
Q

Signs of RA on XR

A

Loss of joint space
Erosions
Softening (osteopenia)
Soft tissue swelling

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3
Q

Signs of RA in hands

A

Swollen joints
Ulnar deviation
Boutonierre and swan neck deformity
Z deformity of thumb

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4
Q

Extra-articular manifestations of RA

A

Nodules (elbow, lung, cardiac)
Lungs - ILD
Cardiac - IHD, pericarditis
Eye - episcleritis, scleritis

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5
Q

What triad forms felty syndrome?

A

Splenomegaly
Neutropenia
RA

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6
Q

Initial Ix in RA

A

RF
Anti-CCP
XR hands and feet

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7
Q

What score can you use to monitor disease activity in RA?

A

DAS28

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8
Q

What are the reasons for failure of biologic tx?

A

Develop Abs towards it
OA develops as well causing pain
Non-adherence

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9
Q

What side effect effects all DMARDS?

A

Myelosuppression

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10
Q

Outline the uric acid cycle

A

Purine - (xanthine oxidase) - xanthine - uric acid - monosodium urate crystals

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11
Q

Which foods predispose to gout?

A

Alcohol
Fructose
Red meat
Sea food

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12
Q

Which crystals cause gout?

A

Monosodium urate

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13
Q

What finding on joint microscopy indicates gout?

A

Negatively birefrigent needle shaped crystals under polarozed light

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14
Q

When should you measure serum urate in an acute gout attack?

A

6-8 weeks after (down in acute)

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15
Q

What are the conditions for starting allopurinol?

A

More than one attack in last 12 months

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16
Q

What drug is an alternative to allopurinol?

A

Febuxostat

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17
Q

Which drug is used to tx tumour lysis syndrome?

A

Rasburicase or allopurinol

18
Q

Which crystals cause pseudogout?

A

Calcium pyrophosphate

19
Q

What do the crystals look like in pseudogout?

A

Positively birefrigent RHOMBOID crystals

20
Q

Mx for acute pseudogout

A

Ice, rest

Consider intra-articular steroids

21
Q

Which auto Abs are most strongly associated with SLE?

A

ANA

Anti-dsDNA

22
Q

How is SLE managed?

A

Avoid sunlight exposure

23
Q

Which Ab is raised in antiphospholipid syndrome?

A

Anticardiolipin lupus anticoagulant

24
Q

Ix for sjogrens syndrome

A

Schirmer tear test
Rose-Bengal staining (may show keratitis)
Anti Ro and Anti La

25
Q

Tx for sjogrens syndrome

A

Artificial tears

Artificial saliva

26
Q

Features of CREST syndrome

A 
Calcinosis
Raynauds phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasia
27
Q

Which Abs are associated with limited cutaneous sclerosis?

A

Anti-centromere

ANA (90% positive)

28
Q

Which Abs are raised in diffuse systemic sclerosis?

A

Scl-70

anti-RNA polymerase

29
Q

Which Ix are required annually in diffuse systemic sclerosis?

A

Echocardiogram

Spirometry

30
Q

What is the leading cause of death in limited cutaneous sclerosis?

A

Pulmonary htn

31
Q

How can raynauds phenomenon be treated?

A

Keep hands warm

Nifedipine

32
Q

What is important to rule out in a patient presenting with polymyositis?

A

Neoplasm

33
Q

What signs are suggestivee of dermatomyositis?

A

Heliotrope rash
Periorbital oedema
Purplish Gottron papules over knuckles

34
Q

Ix for dermatomyositis

A 
Anti - Jo1
Increased CK
Muscle biopsy
EMG
Screen systematically for malignancy
35
Q

Mx for polymyositis

A

Prednisolone

36
Q

What conditions are associated with Ehler danos syndrome?

A

Mitral valve prolapse
Anuerysms
Aortic root dilation

37
Q

Extra-articular manifestations of seronegative arthropathy?

A

Enthesitis
Dactylitis
Anterior uveitis
IBD

38
Q

What area is inflamed in the joints of rheumatoid arthritis?

A

Synovial membrane

39
Q

What conditions is marfan syndrome assoc with?

A

AORTIC DISSECTION/DILATATION
Lens dislocation
Dural actasia

40
Q

Which Ix are done regularly in marfans?

A

Echo - aortic root width

MRI of spinal column

41
Q

What are seronegative arthropathies associated with?

A

HLA B27

Increased risk sacroiliitis

42
Q

Mx for fibromyalgia

A

exercise programmes
CBT
low dose amitriptiline

med (25 decks)

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