Rheumatology

Question 1

What are some side effects of methotrexate?

Answer 1

Bone marrow suppression, leukopenia, pulmonary fibrosis, liver toxicity and teratogenic

Question 2

What are some side effects of leflunomide?

Answer 2

Raised blood pressure, peripheral neuropathy, bone marrow suppression and liver toxicity

Question 3

What are some side effects of sulfasalazine?

Answer 3

Temporary male infertility (reduced sperm count), bone marrow supression

Question 4

What are some side effects of hydroxychloroquine?

Answer 4

Nightmares, reduced visual acuity

Question 5

What are some side effects of anti-TNF medication?

Answer 5

Reactiviation of TB or Hep B

Question 6

What are some side effects of rituximab?

Answer 6

Night sweats and thrombocytopenia

Question 7

What is the acute management of rheumatoid arthritis not on any previous meds?

Answer 7

One DMARD (e.g methotrexate) and a bridging course of prednisolone

Question 8

What is the monitoring of methotrexate?

Answer 8

U+Es, FBC and LFTs every 3 months

Question 9

Mechanism of methotrexate?

Answer 9

Inhibits dihydrofolate reductase which is essential for synthesis of purines and pyrimidine

Question 10

When do patients take folic acid with methotrexate?

Answer 10

5mg every day other than the day they take the methotrexate

Question 11

Management of polymyalgia rheumatica?

Answer 11

Oral pred 15mg (usually good response within a month)

Question 12

What lab test can be used in monitoring of SLE?

Answer 12

Anti-dsDNA
Complement: C3, C4, C3d, C4d
ESR

Question 13

Investigations for anti phospholipid syndrome?

Answer 13

Lupus anticoagulant, anticardiolipin antibody