Rheumatology Flashcards
Side effects of trimethoprim and methotrexate
Bone marrow suppression and fatal pancytopenia
What gene is Dermatitis herpetiformis
HLA-DR3
What problems can bisphosphonates cause?
Oesophageal problems
Alendronic Acid
Side effect of hydroxychloroquine
Severe and permanent retinopathy
Risk factor for pseudogout
Hyperparathyroidism
Investigation for osteoporosis in a man
Check testosterone
What bones does Paget’s Disease affect?
Skull, spine, pelvis and long bones of the lower extremities
Investigation for Pagets disease
Isolated rise in alkaline phosphatase
How long should patients with antiphospholipid syndrome be on anticoagulation for after the first VTE
and what anticoagulation
Lifelong warfarin
Renal impairment, respiratory symptoms, joint pain, systemic features
ANCA associated vasculitis
Interferon alpha
Flu-like Sx
Cardiac complications of Ehlers Dhanlos
Aortic regurgitation
Before starting biologics for RA what do you investigate?
CXR to look for TB
Arterial/venous thromboembolism, miscarriage, livedo reticularis
Antiphospholipid syndrome
Key investigation for polymyalgia rheumatica
Raised inflammatory markers
Elderly and gout - management
NSAIDs avoided due to GI haemorrhage
Give Colchicine instead
What type of hypersensitivity reaction is SLE
3
Joint aspirate in RA
High WBC count, predominantly PMNs
Appearance is cloudy with an absence of crystals
Antibody in Dermatomyositis
Anti-Jo
Osteoporosis blood test values
Normal
Sjogren’s syndrome increased risk of…
Lymphoid malignancies e.g. lymphoma
Investigation before starting on azathioprine
Check TPMT
2 features of Marfan’s syndrome
Pectus excavatum and pes planus
ABx for septic arthritis
IV flucloxacillin
triad in behcet’s
Oral ulcers
Genital ulcers
Anterior uveitis
Patients who are allergic to aspirin may also react to…
sulfasalazine
Diagnosis of ankylosing spondylitis
Sacro-ilitis on a pelvic xray
What type of hypersensitivity reaction is ITP
2
Bone pain, tenderness and proximal myopathy (–> waddling gait)
Osteomalacia
Treatment of suspected visual loss secondary to temporal arteritis
IV methylprednisolone (otherwise oral if no vision change)
Prolonged APTT
Antiphospholipid syndrome
Investigation for ankylosing spondylitis
Plain radiography of the pelvis
What does haemochromatosis increase the risk of?
Gout
What forms the basis of the T score from the DEXA scan?
The T score is based on the bone ass of a young reference population
Features of reactive arthritis
Develop 4 weeks after precipitating infection and run a relapsing remitting course
3 features of temporal arteritis
Constant throbbing headache
Pain on chewing (jaw claudication)
Tender scalp (when brushing hair)
5 features of ankylosing spondylitis on xray
Syndesmophytes Bamboo spine (late sign rarely seen in practise)
Subchondral erosions
Sclerosis
Squaring of the lumbar vertebrae
Side effect of bisphosphonates
Osteonecrosis of the jaw
Swollen first finger and wrist pain with fatigue, 1st degree relative with psoriasis
Psoriatic arthritis
dactylitis
Sjogrens disease
Feature
Test
Antibodies
Reduced saliva, joint arthralgia, fatigue
Positive Schirmer’s test
Anti-Ro/Anti-La
Interaction between allopurinol and azathioprine
Bone marrow suppression
Malignancy and raised creatinine kinase
Polymyositis
Lytic lesion in the diaphysis of pelvis and long bones with an ‘onion appearance’
Ewing’s Sarcoma
Which test would be useful to rule out SLE?
ANA
Pharmacological treatment of Raynaud’s
Nifedipine
1st line treatment for SLE
Hydrochloroquine
2 side effects of methotrexate
Mucositis (apthous-like ulcers)
Pulmonary fibrosis