Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Station 5 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Causes of dupuytrens?

A

Familial, idiopathic, liver disease, diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How would you assess function in a patient with suspected RA?

A

Squeeze my fingers
Write a word
Pick up a coin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Investigations in RA?

A

RF, Anti-CCP, ANA, inflammatory markers, immunoglobulins

XRs of Chest, hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Radiological changes in RA? (4)

A

Soft tissue swelling
Loss of joint space
Articular erosions (associated with worse prognosis)
Periarticular osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would you treat a patient with rheumatoid arthritis?

A

Steroids for acute flare.

DMARDS- methotrexate (with folic acid) , hydroxycloroquine, sulfasalazine, luflonamide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Main side effects of methotrexate (3)

A

Fibrosis, hepatitis and neutropenia

WH during infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 2 ophthalmological complication of RA?

A

Dry eyes

Scleritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiac complications of RA?

A

Pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Serious side effect of hydroxychloroquine?

A

Retinopathy- should see optician every year.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical examination findings in pseudoxanthoma elastic? (4)

A

Plucked chicken skin appearance in neck axillae
Blue sclerae
HTN (premature coronary artery disease)
Mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presenting problems in Pseudoxanthoma elasticum?

A 
Hyperextensible joints 
Reduced acuity 
HTN 
MI or CVA 
Gastric bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where are the degenerative elastic fibres generally found in pseudoxanthoma elasticum?

A

Skin
Vessels
Eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cause of Ehlos Danlos?

A

Defect in collagen causing increased skin elasticity?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cardiac complications of Ehlos Danlos?

A

Mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examination finds in Ehlos Danlos on inspection?

A 
Fragile skin (bruising) 
Hyperextendible skin (tents when pulled- don't do) 
Joint hyper mobility and dislocation (scars from joint repair/replacement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inheritance of Ehlos Danlos?

A

AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common conditions associated with Raynauds?

A

Scleroderma

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In a patient with suspected CTD, what should you examine for? (systematic)

A

Hands- Raynauds and small joint inflammation (with stiffness), Jaccouds arthropathy.
Arms- discoid rash +/- scarring
Face- photosensitive rashes, hair loss, scleritis/dry eyes, ulcers in mouth.
Neck- difficulty swallowing
Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In a patient with suspected CTD, what should you examine for/ ask about in hands and arms? (systematic)

A

Hands- Raynauds and small joint inflammation (with stiffness+/- destruction), Jaccouds arthropathy (SLE)
Arms- discoid rash +/- scarring/scaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Face symptoms in suspected CLD?

A

Face- photosensitive rashes, hair loss, scleritis/dry eyes, ulcers in mouth.
Neck- difficulty swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Respiratory associations with SLE?

A 
Pleural effusion 
Fibrosing alveolitis (ILD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Neurological associations with SLE?

A

Ataxia

Chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Screening for lupus nephritis?

A

Urine ACR

BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diagnostic investigations in SLE?

A

ANA and anti-dsDNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Investigations to look for disease activity in SLE?
Inflammatory markers and elevated immunoglobulins. | Reduced complements.
26
Full list of investigations in suspected CTD?
ANA, dsDNA, inflammatory markers, anti-phospholipid, complements, urine dip
27
Management in cutaneous/joint SLE?
Topical steroids | Hydroxychloroquine
28
Treatment of moderate SLE?
Pred and Aza
29
Treatment of severe SLE?
Methylpred, mycophenylate (lupus nephritis), cyclophosphamide.
30
Serious side effects of cyclophosphamide? HHIT
Haemorrhagic cystitis Haematological Infertiluty Teratogenicity
31
Common causes of proximal myopathy?
Dermatomyositis Thyroid dysfunction Cushings
32
Complications associated with ankylosing spondylitis? (5)
``` Anterior uveitis Aortic regurgitation AV heart block- look for PPM Apical fibrosis Arthritis (may be psoriatic arthropathy) ```
33
What the bedside tests could you do in Ank Spond except Schobers?
Increased occiput-wall distance. >2cm is abnormal
34
Treatments for ankylosing spondylitis.
Physiotherapy Analgesia Anti-TNF - ertanacept/infliximab/adulimumab
35
Associations in gout/
``` Obesity HTN CKD Urate stones/nephropathy Lymphoproliferative disorders ```
36
Investigations in gout?
Bloods including urate (unreliable) | Joint aspiration to rule out infection and look for needle shaped negatively birefringent crystals
37
Treatment of acute attack of gout?
Treat cause Increase hydration High dose NSAIDs Colchicine
38
Classical XR appearance of gout
Punched out periarticular changes
39
Where do you usually see OA changes in the hand?
Interphalangeal joints with Heberdens nodes (and sometimes Bouchards at the PIP)
40
XR features in OA?
Loss of joint space, osteophytes, peri-articular sclerosis and cysts
41
Treatment of OA? (4)
Physio Analgesia Joint replacements Weight reduction (if affecting weight bearing joint)
42
Difference between Raynauds disease and Raynauds phenomenon
Raynauds disease is idiopathic | Raynauds phenomenon is associated with underlying CTD
43
What would you see in the hands in systemic sclerosis?
Sclerodactyl- prayer sign Calcinosis Raynauds Should assess function- holding a cup or pen
44
What would you see in the face of someone with scleroderma?
``` Tight skin Beaked nose Microstomia Perioral furrowing Alopecia Telangiectasia ```
45
Name the respiratory and cardiac complications of scleroderma?
Hypertension Pericarditis Pulmonary HTN Interstitial fibrosis (basal)
46
What does CREST stand for?
``` Calcinosis Raynauds (o)Esophageal dysmotility Sclerodactyl Teleangiectasia ```
47
What investigations would you do in scleroderma?
ANA (+ve in 90%), anti-centromere (limited), scl-70 (diffuse) Hand XRs calcinosis To look for respiratory complications: CXR, HRCT, spirometry Too look for GI disease- contrast scans, FBC and folate Renal disease, U&Es, urinalysis, microscopy and renal biopsy Cardiac disease: ECG and echo
48
What would you see in the face of someone with Marfans?
High arched palate with crowded teeth | Iridonesis with upward lens dislocation
49
What signs of Marfans might there be in the thorax?
Pectus carinatum or excavatum Scoliosis Scars from previous cardiac surgery of chest drains (PTX)
50
What are the common cardiac complications of Marfans?
Aortic regurgitation (may have metallic valve) Mitral valve prolapse Co-arctation Aortic dissection
51
What is the inheritance of Marfans syndrome?
Autosomal dominant on chromosome 15. Defect in the fibrilin protein
52
Describe the management of a patient with Marfans?
Surveillance of aortic root size with annual TTE Beta blockers and ARBs to slow aortic root dilatation and pre-emptive aortic root surgery to present dissection and aortic rupture. Screening of family members.
53
Investigations and treatment of GCA?
Bloods including ESR and CRP. ESR >80 highly specific as are platelets >400. (ideally take bloods prior to starting steroids) Temporal artery USS +/- biopsy if cranial features. PET-CT if non cranial features. Start 40-60mg Pred (+PPI) If visual symptoms refer to ophthalmology on same day. If no visual symptoms refer to Rheum to be seen in 1-3 days.
54
Investigations in suspected PMR?
FBC, CRP, ESR, LFTS, RF, Anti CCP, CK, TFT, Vitamin D
55
Which DMARDs are considered safe in pregnancy?
Sulfasalazine and hydroxychloroquine although you should avoid sulfasalazine in men TTC as it affects sperm.
56
How would you offer to measure RA disease activity?
DAS 28
57
How can you distinguish between psoriatic arthritis and rheumatoid arthritis?
DIPs spared in RA and involved in PA. Dactylitis in PA. Typically causes enthesitis (ligaments) in PA but tenosynovitis in RA)
58
What are typical hand XR findings in Psoriatic arthritis?
Pencil in cup deformity.
59
How would you manage psoriatic arthritis?
NSAIDs or COX-2 inh if mono or oligoarthritis or spondyloarthropathy. In multiple joints affective then DMARDs.
60
How is Ank Spond managed?
NSAIDs or Cox-2 and physio. Biologics if no response. | Steroids and DMARDs not usually effective in spondyloarthropathy.
61
Common causes of reactive arthritis?
GI- salmonella, shigella, campylobacter | GU- chlamydia
62
Treatment of reactive arthritis?
NSAIDs and steroids if refractory. If recurrent synovitis then start on DMARDs.
63
In what level of renal impairment would you avoid NSAIDs? When would you avoid colchicine?
eGFR <50 avoid NSAIDs and reduce colchicine to 500mg OD | eGFR <10 avoid colchicine and give prednisolone.
64
What is found on joint aspiration in pseudo gout?
Positively birefringent rhomboid crystals.
65
How might Pagets disease present?
Asymptomatic Bone pain Deafness
66
Treatment of Pagets disease?
Analgesia Hearing aids in deafness Bisphosphanates
67
When are biologics (anti-TNF) indicated in Ank Spond
When failed two NSAIDs taken for at least 4 weeks and as indicated by the BAS-DAI score
68
What investigations would you do in suspected ank spond?
Baseline bloods including CRP/ESR Consider HLA B27 (positive in 90%) XR lumbar spine and pelvis. If normal consider MRI Urine dip (IgA nephropathy and amyloidosis) and ECG (AV conduction block)
69
What are the clinical features and signs of osteogenesis imperfecta?
Features: deafness, joint problems, dental problems, bruising and fragile skin, aortic dissection Signs: blue sclera, hyper mobile joints, scoliosis
70
Diagnosis of osteogenesis imperfecta?
Clinical and FH (AD). Gene testing may support the diagnosis but not all genes have been identified.
71
Management of osteogenesis imperfecta?
Good diet and stopping smoking to maintain bone health. Bisphosphanates. MDT approach: OT/Physio/podiatry/geneticist Cardiology follow up re aortic root dilatation
72
How would you examine a patient with suspected ankylosis getting spondylitis?
Examine back- look for scoliosis, examine all back movements, examine for spinal tenderness. Occipital- wall and schobers. ``` Look at eyes Listen to heart and do collapsing pulse Listen for apical fibrosis Look for psoriasis Other arthropathy ```

Station 5 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions