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MRCP Part 2 > Rheum > Flashcards

Rheum Flashcards

1
Q

IgA nephropathy (Berger’s diseae) with systemic vasculitic involvement =

A

IgA vasculitis (Henoch-Schonlein Purpura)

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2
Q

Features of IgA Vasculitis (Henoch-Schonlein Purpura)

A

Purpura on extensors/buttocks

Abdo pain (GI bleeding)

Nephritis

(Polyarthritis)

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3
Q

IgA vasculitis (HSP) usually presents in

A

Children following an infection

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4
Q

anti-scl-70 (anti-topoisomerase) is highly specific for:

A

Diffuse cutaneous systemic sclerosis (+ increased risk pulmonary fibrosis)

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5
Q

anti-centromere is highly specific for:

A

Limited cutaneous systemic sclerosis

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6
Q

anti-dsDNA is highly specific for:

A

SLE

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7
Q

anti-Smith is highly specific for:

A

SLE

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8
Q

anti-Mi-2 is highly specific for:

A

Dermatomyositis

but only present in 25%

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9
Q

anti-Jo-1 is seen in

A

Polymyositis (in disease with lung involvement, Raynauds & fever)

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10
Q

Indications for plasma exchange (plasmapharesis)

A

Guillain-Barre

Myasthenia gravis

Goodpastures

ANCA vasculitis with rapidly progressive GN

ANCA vasculitis with pulmonary haemorrhage

TTP/HUS

Cryoglobulinaemia

Hyperviscosity (eg in MM)

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11
Q

Anti-Ro are seen in

A

Sjogrens

Also SLE

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12
Q

SLE and pregnant - Which antibody signifies risk of neonatal heart block

A

Anti-Ro

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13
Q

Initial management of RA

A

DMARD monotherapy (usually methotrexate)

+/- bridging steroids

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14
Q

Other DMARD options in RA

A

Sulfasalazine
Leflunomide
Hydroxychloroquine

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15
Q

Management of RA - inadequate response to DMARDs

at least 2 DMARDs, including MTX

A

TNF-inhibitors:
Etanercept
Infliximab
Adalimumab

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16
Q

Before starting TNF-inhibitor

A

Screen for TB, Hep B

(+/-Hep C if risk) due to risk of re-activation

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17
Q

Abatacept (anti-CTLA4) used in

A

RA not controlled with anti-TNF therapy

18
Q

Canakinumab (anti-IL1) used in

A

Gout flares

Resistant Still’s disease

19
Q

Management of RA - next step after TNF inhibition

A

Rituximab (anti-CD20)

20
Q

Tocilizumab (anti-IL6) used in

A

RA not controlled with anti-TNF therapy

21
Q

Management of dermatitis herpetiformis

A

GF diet

Topical dapsone

22
Q

Side effect of dapsone

A

Haemolytic anaemia

Peripheral neuropathy

23
Q

Management of scalp psoriasis

A

Potent topical corticosteroid (Beclomethasone)

24
Q

Features of Adult Onset Still’s Disease

A

Daily fevers
Salmon-pink rash
Oligoarthritis
Serositis

25
Q

Management of Still’s disease

A 
NSAIDs ->
Steroids ->
MTX ->
anti-TNF  ->
anti-IL1 (canakinumab) ->
anti-IL6 (Tocilizumab)/anti-CD20 (rituximab)
26
Q

1st line therapy for plaque psoriasis

A

Topical steroids / Vit D analogues / Dithranol / Coal tar

27
Q

2nd line therapy for plaque psoriasis

A

UVB light therapy

Ciclosporin/MTX

28
Q

3rd line therapy for plaque psoriasis (or with arthritis)

A

anti-TNF (infliximab)

29
Q

Aspirate findings in pseudogout

A

Positively birefringent rhomboid crystals

30
Q

Aspirate findings in gout

A

Negatively birefringent needle-shaped crystals

31
Q

Management of pseudogout

A 
NSAIDs
>
Steroids
>
Colchicine
32
Q

Management of gout

A 
NSAIDS/colchicine
->
Oral steroids
->
IM steroid
33
Q

Alemtuzumab (anti-CD52) is used in

A

Multiple sclerosis

34
Q

Commonest causes of drug-induced lupus

A

Hydralazine
Procainamide
Isoniazid
Phenytoin

35
Q

Typical antibodies in drug-induced lupus

A

anti-dsDNA negative

anti-histone positive

36
Q

Features of thromboangiitis obliterans

A 
Young men, smokers
Peripheral limb ischaemia
Cockscrew vessels
Lack of CVD RF
Lack of multisystem inflammation
37
Q

Features of antiphospholipid syndrome

A 
VTE
Thrombocytopenia
Prolonged APTT
Livedo reticularis
Recurrent fetal loss
Pre-eclampsia, pulmonary HTN
38
Q

Management of antiphospholipid syndrome (no previous VTE)

A

Low-dose aspirin

39
Q

Management of antiphospholipid syndrome (previous VTE)

A

Lifelong warfarin with INR target 2-3

40
Q

Management of antiphospholipid syndrome (recurrent VTE whilst on warfarin)

A

Lifelong warfarin INR 3-4

Add aspirin

41
Q

Management of antiphospholipid syndrome (previous arterial thrombosis)

A

Lifelong warfarin INR 2-3

MRCP Part 2 (15 decks)

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