Rheumatology

Question 1

Cryoglobulinaemia Type 1

Answer 1

Cryoglobulins precipitate in cold temperatures -> vasculitis

Associations:
Multiple myeloma
-> (old CRAB - 65yo, calcium high, renal failure, abdo pain/dehydration, bone pain)
Waldenstrom’s macroglubulinaemia

Question 2

Serum ACE

Answer 2

Sarcoidosis

Question 3

p-ANCA

Answer 3

Eosinophilic granulomatosis with polyangiitis
Ulcerative colitis
Primary sclerosing cholangitis
Rheumatoid arthritis

Question 4

c-ANCA

Answer 4

Granulomatosis with polyangiitis

Question 5

Anti-dsDNA

Answer 5

SLE

Question 6

Anti-RNP

Answer 6

Mixed connective tissue disease

Question 7

Anti-Jo1

Answer 7

Polymyositis
with lung involvement (ILD)
and fever

Question 8

Pseudogout crystals

Answer 8

Weakly positive birefringent rhomboid shaped crystals

Question 9

Gout crystals

Answer 9

Negatively birefringent needle shaped crystals

Question 10

Symmetrical proximal muscle weakness
Raynaud’s
Respiratory muscle weakness
Interstitial lung disease

Condition?

Answer 10

Polymyositis

Question 11

Polymyositis investigations

Answer 11

CK
Muscle biopsy
EMG
Anti-Jo1

Question 12

Symmetrical proximal muscle weakness
Photosensitive
Macular rash over back and shoulders
Heliotrope rash in peri-orbital region

Answer 12

Dermatomyositis

Question 13

Dermatomyositis associations

Answer 13

Connective tissue disorders
Malignancy (ovarian, breast, lung)

Question 14

Marfan’s syndrome - abnormal protein

Answer 14

Fibrillin

Question 15

HOCM - abnormal protein

Answer 15

Myosin

Question 16

Joint hypermobility
Stretchy, fragile skin

Answer 16

Ehlers-Danlos syndrome

Question 17

Tall, thin, long arms/legs/fingers
Upward dislocation of lens
Aortic regurgitation

Answer 17

Marfan’s syndrome
Autosomal dominant

Question 18

Psoriatic arthritis criteria

Answer 18

• Inflammatory articular disease
• personal history of psoriasis
• negative RF
• Current dactylitis

Question 19

discoid lupus erythematosus treatment

Answer 19

1. Hydroxychloroquine

Question 20

Rheumatoid arthritis x-ray findings

Answer 20

Peri-articular osteoporosis/osteopenia

Question 21

AKI
Fever
Upper respiratory tract signs (epistaxis, earache, haemoptysis, crusting of nostrils, sinusitis/sinus pain, runny nose)

Answer 21

Granulomatosis with polyangiitis

Question 22

HLA-B5

Answer 22

Behcet’s disease

Question 23

HLA-B27

Answer 23

Ankylosing spondylitis
Reactive arthritis

Question 24

Anti-mitochondrial antibodies (M2 subtype)

Answer 24

Primary biliary cirrhosis
-> IgM

Question 25

Movement impaired in adhesive capsulitis

Answer 25

External rotation