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MSRA exam > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What 3 systems does vasculitis commonly affect?

A

Renal
Respiratory
ENT

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2
Q

What would you see on urine dip in an ANCA positive person

A

positive for protein and blood

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3
Q

What is c ANCA associated with

A

Granulomatosis with polyangiitis

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4
Q

What is p ANCA associated with?

A

eosinophilic granulomatous with polyangiitis
UC
PSC

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5
Q

What is Schober’s test ?

A

Reduced forward flexion

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6
Q

Name 3 As associated with ankylosing spondylitis

A

Anterior uveitis
Aortic regurg
Achilles Tendonitis
AV node block

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7
Q

4 predispositions associated with anti phospholipid syndrome?

A

Venous thromboses
arterial thromboses
recurrent foetal loss
thrombocytopenia

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8
Q

What happens to the APTT in anti phospholipid syndrome>

A

Rises

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9
Q

What is the treatment for anti phospholipid syndrome (primary and secondary thromboprophylaxis)

A

Primary: aspirin
Secondary: warfarin

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10
Q

What is a TPMT test done for?

A

To look if individuals are prone to azathioprine toxicity

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11
Q

3 adverse effects of azathioprine?

A

Bone marrow depression
Nausea/Vomiting
Pancreatitis

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12
Q

Is azathioprine safe to use in pregnancy ?

A

Yes

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13
Q

What is the triad of Bechet’s Disease?

A

Oral ulcers
Genital ulcers
Anterior uveitis

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14
Q

What is the pathophysiology behind Bechet’s disease?

A

autoimmune mediated inflammation of the arteries and veins

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15
Q

What do you need to correct before starting a bisphosphonate?

A

calcium and phosphate

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16
Q

What would happen to calcium phosphate, ALP and PTH in the following condition… osteomalacia?

A

Calcium decrease
Phosphate decrease
ALP increase
PTH increase

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17
Q

What would happen to calcium phosphate, ALP and PTH in the following condition… primary hyperparathyroidism?

A

Calcium increase
Phosphate decrease
ALP increase
PTH increase

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18
Q

What would happen to calcium phosphate, ALP and PTH in the following condition… CKD?

A

Calcium decrease
Phosphate increase
ALP increase
PTH increase

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19
Q

What would happen to calcium phosphate, ALP and PTH in the following condition… Paget’s Disease?

A

Calcium normal
Phosphate normal
ALP increase
PTH normal

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20
Q

is an osteochondroma benign or malignant?

A

Benign

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20
Q

is an osteochondroma benign or malignant?

A

Benign

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21
Q

What is seen on x ray of a giant cell tumour of bone?

A

double bubble or soap bubble appearance.. note it is benign

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22
Q

most common malignant bone tumour?

A

osteosarcoma

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23
Q

most common malignant bone tumour?

A

osteosarcoma

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24
what cancer do you get a codman triangle on?
osteosarcoma
25
what cancer does paget's disease increase your risk of having
osteosarcoma
26
what cancer will you see onion skin appearance in?
ewing's sarcoma
27
what is the management of ME?
graded exercise therapy pacing therapy low dose amitriptyline
28
what 3 malignancies is dermatomyositis associated with?
ovarian breast lung
29
Give two features seen in dermatomyositis ?
Gottron's papules and Heliotrope rash
30
What autoantibody are people with dermatomyositis normally positive for?
ANA
31
what blood test is normally positive in drug induced lupus?
ANA (note normally dsDNA negative)
32
Two main causes of drug induced lupus?
Procainamide Hydralazine
33
what type of collagen does EDS affect
type 3 collagen
34
what three medications trigger gout?
Thiazide diuretics Ciclosporin Furosemide Pyrazinamide
35
What is first line treatment for an acute gout attack ?
Colchicine NSAIDs
36
First and second line treatment for chronic gout?
Allopurinol Febuxostat
37
What do you typically give when starting a person on allopurinol ?
Colchicine
38
What is meralgia paraesthetica ?
compression of the lateral cutaneous nerve of the thigh. causing burning sensation over antero lateral aspect of the thigh.
39
what is an adverse effect of hydroxychloroquine?
Bull's eye retinopathy.
40
What is a type 1 gell and coombs classification?
Anaphylaxis (IgE)
41
What is a type 2 gell and coombs classification?
AI haemolytic anaemia, ITP and good pasture's syndrome Ig G or Ig M bound
42
What is a type 3 gell and coombs classification?
immune complex: SLE or extrinsic allergic alveolitis
43
What is a type 4 gell and coombs classification?
T cell mediated- TB, scabies, MS or graft vs host.
44
What is lateral epicondylitis
Tennis elbow
45
Where do you get pain in lateral epicondylitis?
pain and tenderness localised to lateral epicondyle. Pain worse on wrist extension against resistance and on supination of the forearm
45
Where do you get pain in lateral epicondylitis?
pain and tenderness localised to lateral epicondyle. Pain worse on wrist extension against resistance and on supination of the forearm
46
3 adverse side effects of methotrexate
Mucositis Myelosupression Pulmonary Fibrosis
47
For how long shall women avoid getting pregnant after stopping methotrexate?
6 months
48
4 features of rheumatoid arthritis on x ray
Loss of joint space Juxta articular osteoporosis Periarticular erosions Subluxation
49
What is the inheritance pattern of osteogenesis imperfecta ?
Autosomal Dominant abnormality in type 1 collagen.
50
Name 3 features of osteogenesis imperfecta
Blue sclera fractures after mild trauma deafness secondary to otosclerosis NOTE: normally bloods are normal
51
What is rickets referred to in adults?
Osteomalacia
52
What would be the blood results you would get in osteomalacia>
Low calcium Low phosphate Low Vit D High Alk Phosph
53
Management of osteoporosis in people > 75
Anyone that has a fragility fracture >75 yr old is assumed to have underlying osteoporosis without needing a DEXA scan
54
Management of osteoporosis in <75 yr olds
Anyone under the age of 75 that has a fragility fracture is to have a DEXA scan and to have a FRAX score calculated.
55
Name 5 causes of osteoporosis
SHATTERED Family Steroid use >5mg/day prednisolone Hyperthyroidism; hyperparathyroidism, hypercalciuria Alcohol and tobacco use Thin (BMI <22) Testosterone low (e.g. anti androgen in cancer of prostate) Early menopause Renal or liver failure Erosive/inflammatory bone disease (e.g. RA or myeloma) Dietary Ca low/malabsorption or Diabetes mellitus type 1 Family history
56
At what t score value should bone protection be offered in someone taking steroids>
T -1.5 or less
57
What T score confirms osteoporosis?
T score <-2.5 SD
58
How do you treat Paget's disease
Bisphosphonates
59
Name 3 complications of paget's disease
Osteosarcoma Skull thickening High output cardiac failure Deafness
60
What is medial epicondylitis
Pain on pronation or flexion of the wrist
61
What does Polyarteritis nodosa lead to?
aneurysm formation
62
What type of vasculitis is Polyarteritis nodosa?
It is a medium vessel vasculitis
63
What infection is polyarteritis nodosa associated with ?
Hep B
64
If given steroids for suspected PMR how should the person respond?
dramatically improve
65
what crystals do you get in pseudo gout?
calcium pyrophosphate ?
66
what x ray appearance would you have on pseudo gout ?
chondrocalcinosis
67
What is the management of raynaud's phenomenon ?
Nifedipine
68
Two skin lesions associated with reactive arthritis
Circinate balanitis painless Keratoderma blenorrhagica papules on the palms/soles
69
What is a SE of methotrexate
Myelosuppression Liver cirrhosis Pneumonitis
70
What is a SE of sulfasalzine
Rashes Oligospermia Heinz body anaemia Interstitial lung disease
71
What is a SE of gold
proteinuria
72
What medication exacerbates myasthenia gravis
penicilliamine
73
What drug can cause demyelination-
Etanercept
74
What is the most common antibody found in sjogren's syndrome
anti- ro antibody

MSRA exam (16 decks)

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