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BPT Written > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

what is the most suggestive XR change of RA?

A

periarticular osteopaenia

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2
Q

which rheum condition has the lowest rates of infections related to TNF-i?

A

Ank spond

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3
Q

what medication should be avoided in an acute exacerbation of PsA?

A

Prednisolone

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4
Q

Radiology of RA

A

corner erosions, peri-articular osteoporosis, loss of joint space, DIPs spared

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5
Q

Radiology of OA

A

Joint space loss, sclerosis, osteophytes, subchondral cysts, ‘seagull’ in DIP

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6
Q

Radiology of haemachromatosis

A

OA changes of MCPs, esp 2nd/3rd

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7
Q

CPPD distribution

A

radiocarpal, patellofemoral

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8
Q

Radiology gout

A

punched out holes w. preserved cortex (intraosseous); inside capsule (destructive to joint), tophi

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9
Q

Psoriatic arthritis radiology

A

DIPs- pencil in cup. Mouse ear erosions, fusion of DIPs

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10
Q

Ank Spond radiology

A

romanus lesion, shiny corner sign, syndesmophytes, SIJ-ilitis

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11
Q

Felty’s syndrome

A

RA, splenomegaly, neutropaenia, leg ulcers

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12
Q

2 main MSK sites to get inflamed in RA other than joints (synovitis)

A

tenosynovitis, osteitis

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13
Q

Drug that accelerates RA nodules

A

methotrexate

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14
Q

HLA group for RA

A

DRB10404

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15
Q

Why is smoking a trigger for RA?

A

results in citrullinated peptides via PAD

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16
Q

Why is periodontitis a trigger for RA?

A

P. gingivalis has PAD

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17
Q

RA vasculitis typically found where?

A

Nailfolds

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18
Q

Main spinal issue in RA

A

atlantoaxial subluxation

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19
Q

RA poor prognostic features

A

extra-articular features, female, high titre RF/anti-CCP, later age of onset, more joints, imaging changes

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20
Q

Main SE of Leflunomide

A

Diarrhoea

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21
Q

Leflunomide MOA

A

Inhibits DHODH, purine synthesis

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22
Q

Above which dose of glucocorticoid does mortality increase?

A

8mg/day

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23
Q

Best TNFi for pregnancy

A

Certolizumab

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24
Q

Main viral infection that mimics RA

A

Parvovirus

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25
Q

What is Anti-centromere Ab protective for?

A

ILD

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26
Q

What 2 things is anti-RNA Pol III assoc. w. ?

A

Renal crisis, malignancy

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27
Q

2 drugs assoc. w. SScl renal crisis

A

Prednisolone, cyclosporin

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28
Q

3x XR features of SSc

A

Acro-osteolysis, calcinosis, pulp atrophy

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29
Q

Primary cause of death in SScl

A

Lung disease

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30
Q

Most common pattern of ILD in SScl

A

NSIP

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31
Q

Two drugs for SScl ILD

A

MMF or cyclophosphamide

32
Q

G1 pHTN is similar in both, but slightly more common in…

A

Limited cutaneous Sscl

33
Q

Cardiac MRI findings in SScl

A

delayed gad enhancement (Gad gets trapped in fibrosis)

34
Q

Which myositis gives perivascular inflammation on biopsy?

A

DM

35
Q

Which myositis gives degenerating and regenerating fibres, ghost cells and necrosis on biopsy?

A

IMNM

36
Q

Which myositis gives muscle focused inflammation on biopsy

A

PM

37
Q

Myositis assoc. w. Anti-SRP and HMGCR

A

IMNM

38
Q

Myositis assoc. w. Anti-Jo1

A

Anti-synthetase

39
Q

Myositis assoc. w. TIF1gamma

A

DM

40
Q

Myositis assoc. w. Anti-NXP2

A

DM

41
Q

Myositis assoc. w. Anti-cN1a

A

IBM

42
Q

Anti-MDA5 gives…

A

Amyopathic DM with a rapidly progressive ILD

43
Q

4 key parts of anti-synthetase syndrome

A

Myositis, ILD, mechanic’s hands, fever

44
Q

Typical ILD pattern of anti-synthetase syndrome

A

Mostly NSIP or organising pneumonia, but can get UIP

45
Q

Association of ALL forms of spondyloarthropathies

A

HLA-B27

46
Q

csDMARds used in periphal SpA

A

MTx, sulfasalazine, leflunomide

47
Q

If uveitis or IBD flavour to SpA use

A

Direct TNF-alpha inhibitors (No etanercept)

48
Q

Two MAB classes used in SpAs

A

TNF, IL-17

49
Q

Sacroilitis x3 XR changes

A

sclerosis, erosions, ankylosis

50
Q

DISH XR changes

A

chunky osteophytes, no sacroiliitis

51
Q

Most common infectious trigger of reactive arthritis

A

C. trachomatis

52
Q

Iatrogenic related trigger of reactive arthritis

A

Intravesical BCG

53
Q

2 key skin manifestations of reactive arthritis

A

EN and keratoderma blennorhagicum

54
Q

What proportion of PsA partients are HLA B27 +ve?

A

1/3rd

55
Q

What infection can cause a severe worsening of psoriasis/ can trigger onset in PsA?

A

HIV

56
Q

Medications that can worsen psoriasis

A

Steroids, TNF-alpha

57
Q

Best DMARD for peripheral arthritis of PsA

A

MTx

58
Q

Skin’ nail sign most predictive of PsA

A

pitting

59
Q

Which antibodies are likely to be present in CNS lupus?

A

ANti-Sm

60
Q

Key difference between Jaccoud’s and RA

A

Non-erosive, correctable

61
Q

Anti-Sm associations

A

SLE renal and neurological

62
Q

Anti-DFS70 significance

A

Negative predictor of SLE

63
Q

Biggest predictor of morality in SLE

A

renal lupus

64
Q

Belimumab MOA

A

Inhibits BLyS

65
Q

Best DMARD for SLE Renal vs. Joint

A

MMF vs. MTx

66
Q

3 obstetric criteria APLS

A

1 fetal death >10 weeks, 3 spont abortions <10 weeks, 1 premature birth <34 weeks

67
Q

Test for lupus anticoagulant

A

dliute russel viper test

68
Q

Classic Ab at highest risk of thrombosis

A

lupus anticoagulant

69
Q

New Ab which gives the highest thrombotic risk in APLS

A

B2 glycoprotein DOMAIN 1 Ab

70
Q

Who should get primary prophylaxis in APLS

A

Triple +ve; SLE and any Ab

71
Q

Mgmt of arterial embolism in APLS

A

Aspirin and Warfarin

72
Q

Maintenance rx for AAV

A

steroids and AZA

73
Q

Is PO or IV cyclophosphamide better in AAV?

A

PO because less relapse

74
Q

Target for urate in gout

A

tophi <0.3, non-tophaceous 0.36

75
Q

Avacopan MOA

A

C5a inhibitor

76
Q

Biopsying which 2 sites is rarely useful in AAV

A

skin and nasal mucosa

77
Q

Key cell type in GCA

A

CD4+

BPT Written (21 decks)

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