Rheumatology Flashcards
Calcification of the triangular fibrocartilage suggests chondrocalcinosis - which condition is this associated?
Pseudogout
most common cause of osteomyelitis (bacteria)
staph aureus
Rheumatoid factor is an Ig? antibody against Ig?
IgM Ab against IgG
Rheumatoid arthritis X ray findings:
a) early (3)
b) late (2)
a) Early
- loss of joint space
juxta-articular osteoporosis
soft-tissue swelling
b) Late
- periarticular erosions
- subluxation
Patients with aspirin allergy/ hypersensitivity should avoid what medication?
sulphasalazine
adult onset Stills management (3)
- NSAIDS
- Steroids
- Methotrexate, IL-1 inhibitor (Anakinra), TNF a
Mutation in Collagen type 1
osteogenesis imperfecta
Mutation in Collagen type 2 - give rise to
Chondrodysplasia
Mutation in collagen type 3 leads to
Elhers Danlos
Mutation in collagen type 4
Goodpastures + Alports
severe side effect of hydroxychoroquine (often used in SLE)
retinopathy due to ocular toxicity of hydrxychloroquine
Ank spon is associated with (6)
- Anterior uveitis
- AV node block
- Achilles tendonitis
- Apical fibrosis
- Amyloidosis
- Aortic regurgitation
Cubital tunnel syndrome is compression of which nerve?
ulna - paraesthesia of 4/5th fingers
Raynauds phenomena management (2)
- CCB - nifedipine
2. iv prostocycline (epoprostenol)
TNF a inhibitors can lead to reactivation of what condition
TB
Familial Mediterranean fever associated with (4)
Peritonitis - abdo pain
Pericarditis - chest pain
Synovitis - joint pain
fever
bisphosphonates mechanism
inhibits osteoclasts
pseudogout risk factors (6)
haemachromotosis Acromegaly wilsons hypomag hypophos hyper PTH
methotrexate mechanism
inhibits dihydrofolate reductase
lateral epicondylitis test (movement)
wrist extension/ supination whilst elbow fully extended exacerbates the pain
Limited (central) cutaneous systemic sclerosis associated with which antibody
anti-centromere
Denosumab (used for osteoporosis) mechanism
Denosumab is RANKL inhibitor preventing osteoclast development
Ottawa rules - Reasons for X ray in Ankle pain
- any malleolar zone pain
- bone tenderness lat mal
- bone tenderness med mal
- inability to walk after injury and on examination
Ank spon management (3)
1 - Exercise + NSAID
- DMARD (sulfasalazine)
- TNF a (eg etanercept) if persistence
rheumatoid arthritis management
- DMARD (monotherapy) + steroid
2. TNF a - if 2 failed DMARDs including methotrexate)
mixed connective tissue disease antibody is…
Anti-ribonuclear protein
Major target of pANCA is…
myeloperoxidase - neutrophil protein whose primary role is the generation of oxygen free radicals.
X ray findings of ank spon (4)
- syndesmophytes - ossification of outer fibres of annulius fibrosis
- squaring of lumbar vertebrae
- sacroillitis - subchondral erosions, sclerosis
- “bamboo spine” - late and uncommon
Drugs that cause drug induced lupus
Most common - procainamide, hydralazine
Less common - Isoniazid, phenytoin, minocycline
osteoporosis in men, you should test for…
testosterone - hypogonadism is highly linked with osteoporosis in men
Dermatomyositis associated with which antibody
Anti-Jo 1
methotrexate mechanism
inhibits dihydrofolate reductase
In Marfans, there is a defect of…
the Glycoprotein structure that normally wraps around elastin
Most common cause of death in systemic sclerosis (crest) (2)
RESP!
Interstitial lung disaese
Pul HTN
Adhesive capsulitis Feature (1)
External rotation impairment (shoulder)
Reactive arthritis
features (3)
cause (2 types)
synovial fluid (1)
uveitis, urethritis, arthritis (cant see, pee, knee)
chlamydia (sti related)
Shigella, campylobater, salmonella (dysentry related)
nil synovial fluid organism
Familial Mediterranean Fever Mx
Colchicine
Dermatomyositis antibodies (2)
ANA - most common
Anti-Mi2 - most specific (less common)
SLE antibodies (3)
ANA most sensitive
anti-Sm & anti-dsDNA most specific
Sjogren’s associated with what malignancy
Non-hodgkins lymphoma
Hydroxychloroquine main side effect
retinopathy
Osteomalacia features
bone pain proximal myopathy (waddling gait) Vit D deficiency (indoors all the time?)
Anti Jo 1 association
Polymyositis
Anti scl 70
diffuse cutaneous systemic sclerosis
anti centromere
limited cutaneous systemic sclerosis
Behcets features (3)
oral ulcer
genital ulcer
anterior uveitis
(meningitis, DVT)
Anti RNP (ribonuclear protein) association
mixed connective tissue disorder
Anti RNP (ribonuclear protein) association
mixed connective tissue disorder
De Quervains synovitis features
tender radial styloid process
HLA B27 association
ank spon
reactive arthritis
ant uveitis
Felty syndrome (3)
rheumatoid arthritis
splenomegaly
low white cell count
Polymyositis antibody
anti-Jo1
