Rheumatology 1 Flashcards

1
Q

Main cytokine driver in RA?

A

TNF-a

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2
Q

Best treatment for RA?

Best treatment for seropositive RA?

A

Methotrexate

Rituximab

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3
Q

NSAIDS cause what in fetus?

A

Premature PDA closure

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4
Q

Ankylosing spondylitis has what clinical feautres?

A
Anterior Uveitis
Aortitis/Aortic dilatation
Aortic regurgitation
Achilles Enthesitis
IBD
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5
Q

Criteria to use TNF-a inhibitors in ankylosing spondylitis?

A

Uveitis
Enthesitis
Axial involvement - early phase

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6
Q

Clinical features specific for Psoriatic arthritis?

A

Nail oncholysis

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7
Q

Best treatment for psoriatic arthritis?

Best treatment for extra-articular Psoriatic arthritis?

A

Methotrexate
-UV light if has skin lesions

Ustekinumab/Secukinumab

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8
Q

Pathognomic for Reactive arthritis?

A

Keratoderma blenorrhagicum

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9
Q

How does sweet soft drinks increases gout?

A

Increases purine - and then purine to uric acid

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10
Q

When gout manifest?

A

Urate > 0.40

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11
Q

Xray of gout shows?

A

Tophi

Punched out lesions/sclerotic

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12
Q

Colchicine mechanism in gout?

A

Inhibit neutrophil chemotaxis towards uric crystals

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13
Q

Colchicine and clarithromycin?

A

NO - FATAL

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14
Q

pseudogout - which joint?

A

Knee (medial calcinosis > lateral) - chondrocalcinosis ( Calcium pyrophosphate deposition)

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15
Q

Contraindication for using pegloticase/rasburicase?

A

G6PD

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16
Q

how alcohol causes gout?

A

Increase lactic acid therefore increase uric acid

weak Xanthine dehydrogenase inhibitor - so more uric acid produced

17
Q

Fibromyalgia specific clinical signs?

A

Tenderness at B/L trapezius and gluteal upper quadrant

18
Q

Specific sign for GCA?

Specific sign in imaging for GCA?

A

Jaw claudication
(diplopia- most common)

‘Halo sign’ in ultrasound

19
Q

Takayasu a/w what HLA?

What bloods specific for takayasu?

A

HLA B52

Pentraxin-3 plasma - more accurate than CRP/ESR

20
Q

PAN histology?

A

Internal elastic lamina disruption - intimal fibroplasia and necrosis

21
Q

pANCA a/w what GN?

A

Rapidly progressive GN

22
Q

MTX in SLE when?

MMF in SLE when?

A

SLE + inflammatory arthritis

SLE + Lupus nephritis

23
Q

Scleroderma causes increase in what?

A

TGFB - more collagen

Endothelin - pHTN

24
Q

GI disease in Diffuse scleroderma?

A

GAVE - Gastric antral vascular Ectasia - Watermelon stomach

high risk of bleeding

25
Q

Most specific site for OA?

Most common site for OA?

A

1st- Carpo-metacarpal joint

Knee joint

26
Q

OA early stage pathophysiology?

A

Proteoglycans + collagen loss

27
Q

OA later stage pathophysiology?

A

Bony spurs/osteophytes
subchondral bone demineralization
[compensatory mechanism]

28
Q

Cheiroatropathy common in what disorder?

A

Type 1/2 DM - deposition of collagen

29
Q

After steroids in GCA - on histology what hallmark feature will remain?

A

Disruption of elastic lamina

30
Q

TNFa inhibitors a/w what?

A

Demyelination, MS