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Things I don't know, but need to know, for fourth year > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

In drug induced SLE what antibody can be present?

A

Anti - Histone

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2
Q

First line investigation in Ankylosing Spondylitis

A

Lower Spine X - Ray

if negative but strong suspicion - use MRI to determine if early signs

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3
Q 
Fluctuating fever - spiking in the evening
Salmon pink rash
Arthralgia
Increased ferritin
Lymphadenopathy
A

Stills Disease

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4
Q

Stills Disease Diagnosis

A

Increased Ferritin

RF and ANA -ve

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5
Q

Stills disease - Management

A

NSAIDs - 1 week
Steroids + NSAIDs
Methotrexate
IL-1 or anti TNF

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6
Q

Commonest cardiac complication of SLE

A

Pericarditis

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7
Q

Causes of drug induced lupus

A

Procainamide
Hydralzine
Isoniazide
Phenytoin

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8
Q

Management of drug induced lupus

A

Stop offending agent

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9
Q

Management of Psoriatic arthritis

A

NSAIDs -> Intrarticular corticosteroid injections -> Methotrexate

AVOID oral steroids as can cause psoriasis flairs

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10
Q

Arthritis
Uveitis
Urethritis
Yellow waxy rash on soles of feet = keratoderma Blennorrhagica

A

Reactive Arthritis
Chlamydia
Shigella, Campylobacter, salmonella

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11
Q

Reactive arthritis diagnosis and management

A

Joint aspirate shows elevated WCC but no culture or gram stain
Chlamydia - STI
Campylobacter or salmonella if diarrhoea prodrome

NSAID + interarticular steroid
Methotrexate or sulfasalazine for persistent

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12
Q

Commonest Juvenile Idiopathic Arthritis

A

Pauciauricular or oligoarticular

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13
Q 
Child + systemically well
Tired
Arthritis affecting medium sized joints - knee ankle etc
Limp 
ANA +ve
Duration over 6 weeks
A

Oligoarticular Juvenile Idiopathic Arthritis

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14
Q 
Child
Pyrexia
Salmon Patches
Lymphandenopathy
Uveitis 
Arthritis 
Weight loss
A

Systemic Juvenile Idiopathic Arthritis

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15
Q

juvenile idiopathic arthritis management

A

NSAIDs
DMARDS
Intrarticular corticosteroids
Ensure physical activity is continued

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16
Q

Fuzzy brain
Poor sleep
Generalised pain -> focal very painful areas

A

Fibromyalgia

Explain diagnosis -> aerobic exercise -> CBT -> pregablin duloxetine

17
Q

In gout what should be started alongside allopurinol?

A

6 months cover of colchicine should be given. Even if no current flair up.

18
Q

Anti dsDNA vs ANA - SLE

A

Anti dsDNA - very specific not very sensitive

ANA - Very sensitive but not very specific

19
Q

Shobers test

A

Distance should increase by more than 5 cm
Find L5 - find and mark 10cm above and 5cm below this.
- ask patient to bend forward. The distance should increase by >5cm

20
Q

What pulmonary involvement is linked to Limited systemic Sclerosis

A

Pulmonary Hyertension

21
Q

What pulmonary involvement is linked to Diffuse Systemic Sclerosis

A

Pulmonary fibrosis

22
Q

In Polymyalgia Rheumatica with no GCA signs what is the management.

A

Prior to starting steroids screen for issues that can be compounded by long term steroid use.
Random Blood glucose and a HbA1c
DEXA scan if FRAX score is high

23
Q

What is used if there is ophthalmic artery involvement in GCA?

A

IV methyprednisilone

24
Q

1st line management of raynauds phenomenon

A

Nifedipine

25
Q

HSP management

A

NSAIDs and antihypertensives if required

Regular urine dip for 12 months post episode

26
Q

Management of SLE

A

NSAID + Hydroxychloroquine +/- steroid for flair up

Neuro/renal/haem involvement = cyclophosphamide + high dose steroid

27
Q

Rheumatoid Arthritis management

A

DMARD usually methotrexate + bridging steroid

Inadequate response to two DMARDs = Etanercept or Infliximab

28
Q

How is disease activity monitored in Rheumatoid Arthritis

A

DAS28 and CRP

29
Q

Small and medium vessel arteritis linked to hepatitis B

A

Polyarteritis Nodosa

30
Q

What vessels aren’t affected in polyarteritis nodosa?

A

Pulmonary

31
Q

Management of polyarteritis nodosa

A

Steroids + cyclophosphamide

32
Q

10-40 year old asian female
Absent limb pulses
Fatigue

A

Takayasu Arteritis - Large vessel arteritis

Steroids is mainstay of management

33
Q

Which DMARD can be used to manage a severe unremitting relapse of Rheumatoid arthritis in pregnancy?

A

Hydroxychloroquine

Sulfasalazine

34
Q

Mild psoriatic arthritis can be managed how?

A

NSAIDs

35
Q

Management of Sjogrens

A

Arthritis - hydroxychloroquine + NSAID

Rest is symptomatic - lubrication artificial tears etc

36
Q

What antibody has the highest specificity for Rheumatoid Arthritis?

A

Anti CCP

Rheumatoid Factor - as specific but not as sensitive as occurs more often in general population

Things I don't know, but need to know, for fourth year (31 decks)

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