Rheumatology Flashcards

1
Q

Hot, Swollen, Painful Knee

A

Septic arthritis

Ix - blood cultures and mc+s of joint aspirate

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2
Q

Rheumatoid nodules

A

Indicate severe disease - necrotising granuloma

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3
Q

A 21 year old man had an attack of urethritis 7 days ago. He now has a swollen left ankle and a painful right knee. He also has bilateral conjunctivitis

A

Reactive arthritis - likely to resolve within 6 months

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4
Q

Ankylosing spondylitis presentation

A

Pain and stiffness at night and first thing in the morning

Mx - anti TNF

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5
Q

Most common cause of dactylitis

A

Swelling of whole digit

Psoriatic arthritis

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6
Q

Allopurinol use

A

Titrate to achieve a serum urate level below lower limit of normal range

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7
Q

Methotrexate side effect

A

Nausea

Teratogenic

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8
Q

Side effect of alendronic acid

A

Indigestion and epigastric pain

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9
Q

A 27 year-old lady reports fatigue and frequent mouth ulcers.
She has developed a rash to her cheeks worse in sunlight - which ab is most likely to be present

A

SLE - ANA

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10
Q

A 63 year old man presents with a 4 day history of severe headache of sudden onset.
He has also had transient visual loss to his left eye. He reports jaw cramping when chewing and has been feeling unwell for about 3 weeks - diagnostic test

A

Giant cell arteritis

  • CRP
  • USS and biopsy
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11
Q

Which anti-hypertensives should be avoided in Raynaud’s phenomenon

A

Bisporolol

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12
Q

61 year old man presents with 6 weeks of pain to his shoulder and hip girdles that came on suddenly. There is marked morning stiffness but no weakness. Shoulder movements are globally restricted due to pain - blood results

A

Polymyalgia rheumatica

Bloods:
- normal creatine kinase and raised CRP

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13
Q

When is a urine dipstick considered essential in assessing disease activity

A

SLE

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14
Q

Lady has gritty eyes, Raynaud’s phenomenon and her oral mucosa appears dry.
What is the most likely diagnosis?

A

Sjogren’s

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15
Q

Septic arthritis risk factors

A
Immunosuppression
Diabetes
IV drug abuse
Pre-existing joint disease
Extremes of age
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16
Q

Pathophysiology of septic arthritis

A

Haematogenous spread - bacteraemia

Bacteria settle in synovium leading to rapid cartilage breakdown

Can get direct infection due to orthopaedic surgery or penetrating injury

17
Q

Reactive arthritis associated conditions

A

Psoriasis
Enthesitis - Achilles tendinitis
Ankylosing spondylitis

18
Q

Baseline tests required for methotrexate use

A

U+E

LFT

19
Q

What needs to be addressed before taking methotrexate

A
Alcohol consumption
Plans to have children
Need for contraception
Avoidance of breast feeding
Ability to attend for regular blood test monitoring
20
Q

SLE blood results

A

Low WCC
Low platelet count
Raised plasma viscosity relative to CRP

21
Q

SLE urine analysis

A

Blood and/or protein

22
Q

Polymyalgia rheumatica progression

A

Resolution within an average of 2 years

No long lasting damage to muscles or joints

Symptoms likely to improve rapidly with corticosteroids

23
Q

Mx of PMR

A

Prednisolone
Calcium and vitamin D
Alendronic acid

24
Q

Asymmetrical

A

Reactive arthritis

Psoriatic arthritis