Rheumatology 1 Flashcards
Main cytokine driver in RA?
TNF-a
Best treatment for RA?
Best treatment for seropositive RA?
Methotrexate
Rituximab
NSAIDS cause what in fetus?
Premature PDA closure
Ankylosing spondylitis has what clinical feautres?
Anterior Uveitis Aortitis/Aortic dilatation Aortic regurgitation Achilles Enthesitis IBD
Criteria to use TNF-a inhibitors in ankylosing spondylitis?
Uveitis
Enthesitis
Axial involvement - early phase
Clinical features specific for Psoriatic arthritis?
Nail oncholysis
Best treatment for psoriatic arthritis?
Best treatment for extra-articular Psoriatic arthritis?
Methotrexate
-UV light if has skin lesions
Ustekinumab/Secukinumab
Pathognomic for Reactive arthritis?
Keratoderma blenorrhagicum
How does sweet soft drinks increases gout?
Increases purine - and then purine to uric acid
When gout manifest?
Urate > 0.40
Xray of gout shows?
Tophi
Punched out lesions/sclerotic
Colchicine mechanism in gout?
Inhibit neutrophil chemotaxis towards uric crystals
Colchicine and clarithromycin?
NO - FATAL
pseudogout - which joint?
Knee (medial calcinosis > lateral) - chondrocalcinosis ( Calcium pyrophosphate deposition)
Contraindication for using pegloticase/rasburicase?
G6PD
how alcohol causes gout?
Increase lactic acid therefore increase uric acid
weak Xanthine dehydrogenase inhibitor - so more uric acid produced
Fibromyalgia specific clinical signs?
Tenderness at B/L trapezius and gluteal upper quadrant
Specific sign for GCA?
Specific sign in imaging for GCA?
Jaw claudication
(diplopia- most common)
‘Halo sign’ in ultrasound
Takayasu a/w what HLA?
What bloods specific for takayasu?
HLA B52
Pentraxin-3 plasma - more accurate than CRP/ESR
PAN histology?
Internal elastic lamina disruption - intimal fibroplasia and necrosis
pANCA a/w what GN?
Rapidly progressive GN
MTX in SLE when?
MMF in SLE when?
SLE + inflammatory arthritis
SLE + Lupus nephritis
Scleroderma causes increase in what?
TGFB - more collagen
Endothelin - pHTN
GI disease in Diffuse scleroderma?
GAVE - Gastric antral vascular Ectasia - Watermelon stomach
high risk of bleeding
Most specific site for OA?
Most common site for OA?
1st- Carpo-metacarpal joint
Knee joint
OA early stage pathophysiology?
Proteoglycans + collagen loss
OA later stage pathophysiology?
Bony spurs/osteophytes
subchondral bone demineralization
[compensatory mechanism]
Cheiroatropathy common in what disorder?
Type 1/2 DM - deposition of collagen
After steroids in GCA - on histology what hallmark feature will remain?
Disruption of elastic lamina
TNFa inhibitors a/w what?
Demyelination, MS
