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MSK Phase 2 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Define rheumatology

A

Investigation, diagnosis and management of patients with arthritis and other MSK conditions affecting joints, bones and muscle

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2
Q

Constitutional symptoms of rheumatology

A 
Fatigue
Lethargy
Flu-like 
Loss of appetite 
Weight loss
Unexplained fever
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3
Q

Type of joint pain: articulate pain

A

Deep and diffuse pain relieved by active movement

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4
Q

Type of joint pain: periarticular

A

Pain on active movement

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5
Q

When do pts with inflammatory conditions experience stiffness

A

In the morning for over 1 hour

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6
Q

When do pts with non inflammatory conditions experience stiffness

A

Early morning for less than 30 minutes

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7
Q

Monoarticular conditions

A

Gout

Septic arthritis

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8
Q

Oligoarticular conditions

A

Seronegative spondylarthropathies

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9
Q

Polyarticular conditions

A

RA

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10
Q

Conditions affecting joints with a symmetrical pattern

A

RA

SLE

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11
Q

Conditions affecting joints with a asymmetrical pattern

A 
Axial SpA
Psoriatic arthritis
Reactive arthritis 
Gout
Bacterial arthritis
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12
Q

Conditions affecting joints with a intermittent pain pattern

A

Gout

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13
Q

3 samples to take when testing for rheumatic conditions

A

Blood
Urine
SF

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14
Q

What to look for in blood tests for rheumatic conditions

A

Anaemia of chronic disease
Leukopenia, thrombocytopenia

RA reduces immune system response which results in reduced RBC

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15
Q

Which liver condition mimics osteoarthritis

A

Metabolic liver disease

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16
Q

Effect of SLE on liver

A

Increase liver enzymes

Cause symptoms of liver disease

17
Q

Common inflammatory markers raised in rheumatic conditions

A

ESR

CRP

18
Q

Common antibodies present in rheumatic conditions

A 
ANA
ANCA
Rheumatoid factor
Anti-CCP
HLA-B27
dsDNA
19
Q

Which antibody does rheumatoid factor target

A

fcy chain of IgG

20
Q

Which conditions have elevated rheumatoid factor

A

RA
SLE
Sjogren syndrome
Cryiglobulinemia

21
Q

What is Anti-CCP

A

Anti cyclic citrullinated peptide antibodies

22
Q

3 effects of rheumatoid arthritic individual joints

A

Synovial membrane thickening
Increase synovial fluid
Destruction of joint
Reduced joint space as a result

23
Q

Aetiology of RA

A

Women> men

Age 30-55

24
Q

Joints most affected in RA

A

PIP» MCP&raquo_space; Wrist

25
Q

RA symptoms

A

Hot, swollen, tender joints

EMS > 45 mins

26
Q

RA signs

A 
Ulnar deviation
Swan neck deformity
Boutonnière deformity
Z thumb
MCP subluxation
Bone erosion
27
Q

RA systemic symptoms

A 
Weight loss
Fever 
Fatigue
Anaemia of chronic diseases 
Increased CVS risk
28
Q

What to do if pt with polymyalgia rheumatica does not respond to steroids

A

Consider alternative diagnosis as patients respond drastically to steroids.

Symptoms usually resolve within 2 weeks

29
Q

What happens when pt given methotrexate combined with trimethoprim

A

Bone marrow suppression and severe / fatal pancytopenia (deficiency in all 3 components of blood)

30
Q

RA scoring system

A

DAS 28 (disease activity score, 28)

31
Q

Prognosis for RA given pt has high CRP

A

Poor prognosis

32
Q

2 antibodies determining severity of RA

A

RF + anti-CCP

33
Q

What helps distinguish gout form pseudo gout

A

Chondrocalcinosis (calcification of hyaline and/or fibrocartilage in joint)

34
Q

What is the most sensitive test for detecting SLE

A

ANA

35
Q

Inflammatory markers for SLE

A

Raised ESR

CRP is usually normal. Raised CRP may indicate infection

36
Q

Pt has positive Tinel’s test. Cause out of these options:

Methotrexate use
RA
crohn’s 
Hyperthyroidism 
TB
A

RA as rheumatological diseases are common cause of carpel tunnel

37
Q

bisphosphonates be given to Pt prophylactically with which T score

A

T score of < -1.5 if they’re going to be on steroids for more than 3 months as steroids put pt at risk of osteoporosis

38
Q

Oral ulcers + genital ulcers + anterior uveitis =

A

Behçet’s disease

rare disorder that causes blood vessel inflammation throughout your body.

typically affecting men more than women in their 20s and 30s.

MSK Phase 2 (2 decks)

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