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Finals > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Which crystal is deposited in gout?

A

Monosodium urate

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2
Q

Which crystal is deposited in pseudogout?

A

Calcium pyrophosphate dihydrate

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3
Q

Name some of the cases of gout

A
  • Renal impairment
  • Malignancy
  • Hypertension
  • Alcohol
  • Drugs
  • Hypothyroidism
  • Severe psoriasis
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4
Q

What is Lesch Nyan syndrome and how does it present?

A
  • X linked HGPRT deficiency
  • Intellectual disability
  • Aggressive and impulsive behaviour
  • Self mutilation
  • Gout
  • Renal disease
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5
Q

How can an acute flare up of gout be managed?

A
  • NSAIDs
  • Colchicine
  • Steroids
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6
Q

Give examples of drugs that lower uric acid

A
  • Allopurinol
  • Febuxostat
  • Uricosuric agents e.g. sulphinpyrazone
  • Canakinumab
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7
Q

How can pseudogout be managed?

A
  • NSAIDs

- I/A steroids

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8
Q

How does polymyalgia rheumatica present?

A
  • Sudden onset of shoulder +/- pelvic girdle stiffness
  • F>M
  • ESR > 45
  • Anaemia
  • Malaise, weight loss, fever or depression
  • Arthralgia/synovitis
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9
Q

How is polymyalgia rhemumatica managed?

A
  • Prednisolone 15mg per day initially
  • 18-24 month course
  • Bone prophylaxis
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10
Q

What result on a DXA scan is found in osteoporosis?

A
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11
Q

Name some of the endocrine causes of osteoporosis

A
  • Thyrotoxicosis
  • Hyper and hypoparathyroidism
  • Cushings
  • Hyperprolactinaemia
  • Hypopituitarism
  • Early menopause
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12
Q

Name the rheumatic causes of osteoporosis

A
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Polymyalgia rheumatica
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13
Q

Name the GI causes of osteoporosis

A
  • IBD
  • PBC, CAH, Alcoholic cirrhosis and viral cirrhosis
  • Chronic pancreatitis, Coeliac disease, Whipples disease, short gut syndrome and ischaemic bowel
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14
Q

Name some medications which cause osteoporosis

A
  • Steroids
  • PPI
  • Anti-epileptics
  • Aromatase inhibitors
  • GnRH inhibitors
  • Warfarin
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15
Q

Name the management options for osteoporosis

A
  • HRT
  • SERMs
  • Bisphosphonates
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16
Q

Name some of the side effects of bisphosphonates

A
  • Oesophagitis
  • Iritis/uveitis
  • ONJ
  • Atypical femoral shaft fratures
  • Denosumab
  • Teriparatide
17
Q

Name some of the non -pharmacological management options for osteoporosis

A
  • Thermotherapy
  • Electrotherapy
  • Aids and devices
  • Manual therapy
18
Q

Name some of the pharmacological management options for osteoporosis

A
  • Paracetamol and NSAIDs
  • Topical NSAIDs and capsaicin (knee and hand)
  • Intra-articular injections (steroids, hyaluronic acid)
19
Q

Name the changes seen on an x-ray in someone with osteoarthritis

A
  • Loss of joint space
  • Osteophytes
  • Subchondral cyst
  • Subchondral sclerosis
20
Q

Name the criteria for SLE

A
  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Oral ulcers
  • Arthritis in >1 joint
  • Pleurisy/pericarditis
  • Proteinuria or cellular casts in urine
  • Seizures or psychosis
  • Low WCC, platelets, lymphocytes and haemolytic anaemia
  • Anti ds-DNA, SM, cardiolipin, anticoagulant and low complement
  • ANA
21
Q

Name the complications of scleroderma

A
  • Pulmonary hypertension
  • Pulmonary fibrosis
  • Renal crisis
  • Small bowel bacterial overgrowth
22
Q

Name the clinical features of Sjogren’s syndrome

A
  • Dysphagia
  • Abnormal oesophageal motility
  • Interstitial lung disease
  • Seizures
  • Hemiplegia, ataxia and cranial nerve lesions
  • Renal tubular acidosis
  • Sensory neuropathy
  • Mononeuritis multiplexo
23
Q

Name the classification criteria for GCA

A

3 of the following

  • Age > 50
  • New headache
  • Temporal artery redness/reduced pulsation
  • ESR > 50
  • Abnormal temporal biopsy
24
Q

Name the types of ANCA associated vasculitis

A
  • Wegener’s vasculitis
  • Microscopic polyangiitis
  • Eosinophillic granulomatosis with polyangiitis
25
Q

What is Wegeners vasculitis and where does it affect?

A
  • Necrotising granulomatous inflammation

- Upper and lower respiratory tract

26
Q

Where does microscopic polyangiitis affect?

A
  • Small vessels

- Necrotising glomerulonephritis is common

27
Q

Which conditions is eosinophillic granulomatosis with polyangiitis associated with?

A
  • Asthma

- Eosinophilia

28
Q

Name the treatment options for multi-system autoimmune diseases

A

Mild: hydroxychloroquine
Moderate: Azathioprine, methotrexate and mycophenolate
Severe: Cyclophosphamide and rituximab

29
Q

How does rheumatoid arthritis present?

A
  • Morning stiffness
  • Arthritis of hand joint
  • Rheumatoid nodules
  • Raised serum rheumatoid factor
30
Q

Which x-ray changes can be seen in rheumatoid arthritis?

A
  • Loss of joint space
  • Erosions
  • Osteopenia (soft bone)
  • Soft tissue swelling
  • Anti CCP antibodies, ACPA
31
Q

How can rheumatoid arthritis be managed?

A
  • NSAIDs
  • DMARDs
  • Biologics
  • Oral/IM/IA steroids
32
Q

How does ankylosing spondylitis present?

A
  • Young males
  • Inflammatory back pain
  • Limitation of anterior-posterior and lateral planes of the lumbar spine
  • Limitation of chest expansion
  • Bilateral sacroiliitis
  • Other features; achilles tendonitis, uveitis, cardiac disease etc.
33
Q

How can ankylosing spondylitis be managed?

A
  • Physiotherapy
  • NSAIDs
  • Sulfasalazine
  • Anti-TNF
  • Anti-IL-17
  • Treatment of osteoporosis
  • Joint replacements and spinal surgery
34
Q

How does psoriatic arthritis present?

A
  • Inflammatory pain and peripheral joint swelling
  • Night pain in the axial skeleton and tendon insertions
  • Psoriatic nail disease
  • Conjunctivitis and anterior uveitis
35
Q

How can psoriatic arthritis be managed?

A
  • DMARDS
  • Steroids
  • Physio and OT
  • Cyclosporine
  • Anti-TNF
  • Anti-IL-17 and IL-23
36
Q

Name the three components of Reiter’s syndrome

A
  • Arthritis
  • Urethritis
  • Conjunctivitis
37
Q

How can reactive arthritis be treated?

A
  • Acute: NSAID, joint injection and DMARDs

- Chronic: NSAIDs and DMARDs

38
Q

How can enteropathic arthritis be managed?

A
  • Sulfasalazine
  • Steroids
  • Methotrexate
  • Anti-TNF
  • Bowel resection

Finals (18 decks)

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