Rheumatology Flashcards
Spinal stenosis symptoms (4)
Back/buttock pain
Worse walk downhill, improve when sit/lean forward
Numb / paraesthesia
Pseudo / neurogenic claudication (intermittent leg pain from compression of nerves emanating from spinal cord)
what is the Classification that osteoarthritis falls under
Primary degenerative arthritis
Broad classification of arthritis
Inflammatory and degenerative
Sub -classification of inflammatory arthritis and examples (4)
Seropositive eg RA, SLE
Seronegative: symmetrical (AS) or asymmetrical (psoriatic)
Crystal eg gout
Infectious or septic eg Lyme disease
Hand clinical signs of osteoarthritis (5)
Heberden's nodes (DIP)
Bouchard's nodes (PIP) ("Bouchard" closer to "body")
Base of Thumb squaring (CMC)
Sparing of MCPJs
Asymmetrical!Which crystal causes gout
Uric acid
Which crystal causes pseudogout
Calcium crystals
Which joints are commonly affected in pseudogout
Wrist and knee
Common precipitants of gout (8)
Drugs are FACT Furosemide (loop diuretic) Aspirin Cytotoxic drugs ( antineoplastics) Thiazides and loop diuretics!
Food are SALT Seafood Alcohol Liver and kidney Turkey (meat)
What are gouty tophi and where do they occur (5)
Monosodium urate deposits in tissues (synovium = microtophi)
Commonly first MTPJ! , ear helix, Olecranon bursae, tendon insertions esp Achilles
Hypertrophic osteoarthropathy symptoms and signs (3)
Acute severe burning bone pain, worse by dependency
Clubbing
Periostitis of long bones
Arthritis
What is rheumatoid arthritis- like syndrome? (4)
A paraneoplastic condition associated with breast, colon, lung, ovarian, lymphoproliferative cancer. Presents similar to rheumatoid arthritis except is Rf negative and the condition is assymmetric polyarthritis
Name 7 cardiac manifestations of SLE
Pericarditis (SEROSITIS NB) Coronary artery disease Endocarditis (non bac:Libman-Sachs) Myocarditis Coronary Vasculitis - life -threat Malignant HT- life threat Tamponade - life threat
Vascular manifestations of SLE (4)
Raynaud’s phenomenon
Livedo reticularis
Thrombosis
Vasculitis
Investigations to do for SLE? (3)
ANA (very sensitive but not specific-screening )
Anti-dsDNA (specific)
Anti - Sm
Which cancers is the paraneoplastic lupus-like syndrome associated with? (2)
Ovarian and breast
Dermatological symptoms of dermatomyositis (6)
Heliotrope rash: violaceous over eyelids ,oedema
Gottron’s papules: pink-violaceous, flat-topped on dorsal IPJ (pathopneum!)
Gottron’s sign: erythematous patches over dorsal IP, MCPJ, elbows,knees, medial malleoli (pathopneum!)
Shawl sign: poikilodermatous erythematous rash neck, upper chest, shoulders
Mechanic’s hands: dark, dry, thick scale on palmar and lat digits
Periungual erythema
What classification does dermatomyositis fall under
Idiopathic inflammatory seropositive myopathy (connective tissue disorder)
Malignancies associated with dermatomyositis? ( 4 )
Breast, ovarian, lung, colon
Which classification does polymyalgia rheumatica fall under?
Generalised non-articular rheumatism
Polymyalgia rheumatica symptoms (4)
Constitutional: fever, weight loss, malaise
Pain and stiff of symmetrical prox muscles: shoulders and pelvic girdle, neck, thighs
Gel phenomenon (stiff after prolonged activity)
Tender muscles on examination, but no weak
Polymyalgia rheumatica complications (2)
Giant cell arteritis! (15%)
Anemia of chronic disease
How does swan neck deformity present?
Hyperextended PIP, flexed DIP
Rheumatoid arthritis
How does boutonnière deformity present?
Hyperextended DIP, flexed pIP
Rheumatoid arthritis
What is Paget’s disease?
Chronic disease of skeleton that disrupts replacement of old bone with new. Over time, bones fragile and misshapen.
Aka osteitis deformans,
