Rheumatoid

Question 1

Rheumatic markers

Answer 1

RAF (m.s)
Anti CCP (msp)

Question 2

Pauci articular D/D

Answer 2

Trauma (mc)

Septic arthritis

Pseudogout

(Gout)

Question 3

Polyarticular D/D (appendicular)

Axial = Ankspond

Answer 3

Symmetrical Small Joints- RA & pSA

Asymmetrical Large Joints- IBD & REITER

Question 4

Seronegative Spondyloarthropathies

Answer 4

Ank Spond
pSA
Reiters
IBD

HLA B27
Enthesitis
Doc-NSAIDS
Uveitis

Question 5

Reiters triad

Answer 5

Uveitis
UTI
Arthritis
Keratoderma blenorrhagica

Question 6

RA genetic

Answer 6

HLA DRB1 / DR4

Very rare inheritance
Mostly sporadic

Question 7

RA r/f

Answer 7

Mycoplasma

EBV

Question 8

Articular involvement of RA?

Answer 8

Wrist > MCP > PIP&raquo_space;»> DIP (very late)

If early - suspect pSA

Question 9

Inflammatory substance responsible for RA

Answer 9

Substance P

Question 10

Non Articular involvement in RA mnemonic

Answer 10

FUMMER

Felty Syndrome: RA + splenomegaly

UIP

Myositis

MR + Pericarditis

Episcleritis

Rheumatoid Nodules (pathognomonic)

Question 11

Non invasive test RA

Answer 11

Shake hand test

Question 12

Synovial fluid composition

Answer 12

A: phagocytosis
B: protein/hyal/PG

Question 13

Criteria for diagnosis RA

Answer 13

Pattern of joint involvement= 5
Presence of RAF/ccP = 3
Duration of disease = 1
ESR/CRP = 1

Question 14

DMAARDs RA

Answer 14

Mtx

SAAZ

Leflunomide

Question 15

Rx RA schedule

Answer 15

Mild- LDmtx HDmtx 2ndDM 3rdDM
Mod- 2DM 3rdDM
Sev- 3DM

No?

Tnf : certolizumab
IL1 : anakinra
T cell : Abatacept

IL6 : tocilizumab/sarimumab
B cell : rituximab

JAK1&3: TOFACITINIB BARICITINIB

Question 16

Gout vs Pseudogout Polarising Spectroscopy

Answer 16

Strong negative. Mild Positive

Question 17

Txoc gout in renal failure

Answer 17

Intra articular steroids

Question 18

Drugs gout

Answer 18

Acute: nsaid>colchicine>canakinumab

Chronic: allopurinol, febuxostat , pegloticase probenecid