Rheumatology Flashcards

1
Q

Isolated 1st carpometacarpal joint swelling and pain in post meno female, most likely diagnosis

A

Oesteoarthritis

Note: RA and psoriatic arthritis also can be here but would be unlikely to be in isolation

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2
Q

What is the first line treatment of acute gout?

A

Colchicine or NSAID

NB colchicine is safe in renal failure

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3
Q

Allopurinol is first line in treatment of acute gout T/F

A

F - allopurinol is not used in acute gout

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4
Q

Anti hypertensive med of choice in scleroderma renal crisis

A

Oral ACEi

IV medications will drop BP to quickly and using an ACEi is associated with improved survival and preservation of renal fxn

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5
Q

Ocular toxicities with hydroxychloroquine

A

Keratopathy
Ciliary body involvement
Lens opacities
Retinopathy

NB most concerning is retinopathy

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6
Q

Treatment of diffuse proliferative glomerulonephritis (GN) (WHO class IV) in systemic lupus erythematosus (SLE).

A

Prednisolone and IV cyclophosphamide

Note: it is the commonest GN in SLE and also carries the worst prognosis

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7
Q

Which is associated with a positive RF - mixed cryoglobulinaemia or PAN?

A

Mixed cryoglobulinaemia

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8
Q

+ cANCA and + PR3 vs MPO, likely pathology

A

+ cANCA and + PR3: granulomatosis with polyangitis

+ cANCA and + MPO: microscopic polyangitis

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9
Q

Antiphospholipid antibodies cause raised aPTT which fails to correct after the addition of normal human plasma. T/F

A

T

Note: anticardiolipin and lupus anticoagulant cause coagulation defect in-vitro

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10
Q

Features of penicillamine toxicity

A

Nephrotic syndrome
Myasthenia syndrome

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11
Q

Which is a more common cause of abnormal LFTs in a patient with RA - methotrexate or AI hepatitis?

A

Methotrexate

Note: RA is associated with AI hepatitis but it is less common

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12
Q

Gout findings on xray?

A

Punched out lesions and/or tophi

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13
Q

Tx of granulomatosis with polyangitis?

A

Standard tx: IV cyclophosphamide and steroids. However in severe life threatening cases, or in patients with primarily renal involvement needing dialysis, plasmapheresis is used to rapidly remove the immune complexes.

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14
Q

Patients with polymyositis without any associated antibodies (for example, anti-Jo1, anti-Pm/Scl) should be screened for malignancies with CT TAP T/F

A

T

Also dermatomyositis has a stronger association with malignancy, polymyositis also has an association.

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15
Q

Febuxostat MOA

A

Non-purine, selective inhibitor of xanthine oxidase

Note: allopurinol is a purine analogue inhibitor of xanthine oxidase.

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16
Q

1st line investigation for poly myalgia rheumatica?

A

ESR

Note: if high indication to start tx with steroids

17
Q

Triad of Felty syndrome?

A

Splenomegaly
RA
Pancytopaenia (mainly neutropenia)

18
Q

Most likely AI disease associated with Grave’s

A

Vitiligo

19
Q

SLE tends to cause a mild non erosive arthritis T/F

A

T

20
Q

Before starting what drug should blood for thiopurine methyltransferase be checked?

A

Azathioprine