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Medicine Year 5 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

anti Ro and anti La

A

Sjogern’s

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2
Q

anti Scl-70

A

Diffuse systemic sclerosis

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3
Q

anti centromere

A

limited systemic sclerosis

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4
Q

anti-jo and ANA

A

dermatomyositis

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5
Q

anti cardiolipin

A

antiphospholipid syndrome

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6
Q

antihistone

A

drug induced lupus

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7
Q

cANCA

A

granulomatosis with polyangitis

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8
Q

pANCA

A

eosinophilic granulomatosis with polyangitis

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9
Q

marker for poor prognosis in RA

A

anti ccp

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10
Q

early xray changes in RA

A

juxta articular osteoporsis/osteopenia

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11
Q

management of an acute flare of RA

A

steroid injection

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12
Q

feature of psoriatic arthritis

A

asymmetrical

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13
Q

triad in felty’s syndrome

A

RA
increased WCC
splenomegaly

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14
Q

needle crystals and negative

A

gout

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15
Q

rhomboid crystals and positive

A

pseudogout

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16
Q

when do you check urate levels in gout

A

after the flare

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17
Q

risk factor for pseudogout

A

hyperparathyroidism

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18
Q

red aspirate

A

haemoarthrosis

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19
Q

yellow green and cloudy aspirate

A

septic arthritis

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20
Q

increased WBC yellow and cloudy aspirate

A

rheumatoid arthritis

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21
Q

genetic association with reactive arthritis

A

HLA B27

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22
Q

2 causes of dactylitis

A

psoriatic arthritis
reactive arthritis

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23
Q

management of reactive arthritis

A

NSAID and steroid

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24
Q

sterile synovial fluid with increased WCC

A

reactive arthritis

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25
Q

organisms causing reactive and septic arthritis

A

reactive: chlamydia
septic: gonorrhoea or staph aureus

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26
Q

management of septic arthritis

A

IV flucloxacillin

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27
Q

reactive arthritis triad

A

can’t see pee or climb a tree

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28
Q

6 features of ankylosing spondylitis

A

Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis

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29
Q

first sign of ankylosing spondylitis

A

reduced lateral flexion of the lumbar spine

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30
Q

MRI findings in ank spond

A

sacroiliac joints

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31
Q

medication for ank spond

A

etanercept

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32
Q

specific antibody for SLE

A

anti double stranded DNA

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33
Q

what happens to complement levels in active SLE disease

A

reduce

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34
Q

what do raised CRP levels in SLE indicate

A

infection

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35
Q

what type of hypersensitivity is SLE

A

3

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36
Q

1st line medication for SLE

A

hydroxychloroquine

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37
Q

side effect for hydroxychloroquine

38
Q

arterial/venous thrombosis
livedo reticularis
miscarriage

A

antiphospholipid syndrome

39
Q

management of antiphospholipid syndrome with previous thrombus or no previous thrombus

A

no previous thrombus: low dose aspirin
previous thrombus: warfarin

40
Q

heart defect in ehlers dhanlos

A

aortic regurgiration

41
Q

score for hypermobility

A

beighton score

42
Q

ESR CRP and Creatinine Kinase in polymyalgia rheumatica

A

ESR and CRP raised
CK normal

43
Q

weakness in polymyalgia rheumatica

A

due to myalgia
not true weakness

44
Q

fundoscopy in temporal arteritis

A

swollen and pale disc with blurred margins

45
Q

anterior ischaemic optic neuropathy

A

temporal arteritis

46
Q

what condition increases the risk of malignancy

A

dermatomyositis

47
Q

gottorons papules

A

rough red patches on the knuckles in dermatomyositis

48
Q

fever rash and polyarthralgia

A

adult onset stills

49
Q

oral and genital ulcers with anterior uveitis associated with erythema nodosum

A

bechets disease

50
Q

what inheritance pattern does marfans show

A

autosomal dominant

51
Q

management of fibromyalgia

52
Q

treatment of scleroderma renal crisis

53
Q

treatment of raynauds

A

nifedipine

54
Q

systemic vasculitis with no resp signs but signs of hep B

A

polyarteritis nodosa

55
Q

renal impairment, respiratory symptoms and joint pain

A

wegener’s granulomatosis
granulomatosis with polyangitis

56
Q

what hypersensitivity is allergic contact dermatitis

57
Q

what hypersensitivity is ITP

58
Q

antibody in breastmilk

59
Q

what do you need to check before starting on azathioprine

A

TMPT levels

60
Q

what medication causes apthous ulcers

A

methotrexate

61
Q

are hydroxychloroquine and azathioprine safe in pregnancy

62
Q

what medication causes drug induced lupus

63
Q

side effect of colchine

64
Q

what class of drug is cotrimoxazole

65
Q

methotrexate + trimethoprim
azathioprine + allopurinol

A

bone marrow suppression and fatal pancytopenia

66
Q

difference between prednisolone and dexamethasone

A

prednisolone: high mineralocorticoid
dexamethasone: high glucocorticoid

67
Q

pain worse on wrist flexion/supination with the elbow extended

A

lateral epicondylitis

68
Q

4 muscles of the rotator cuff and their movements

A

subscapularis: internal rotation
supraspinatus: abduction
infraspinatus: external rotation
teres minor: external rotation

69
Q

high calcium, high ALP, high PTH and low phosphate

A

primary hyperparathyroidism

70
Q

treatment of primary hyperthyroidism

A

parathyroidectomy

71
Q

low calcium, high ALP, high PTH, high phosphate

A

secondary hyperparathyroidism (to CKD)

72
Q

pathophysiology of secondary hyperparathyroidism

A

reduced vitamin D / renal failure

73
Q

PTH in tertiary hyperparathyroidism

74
Q

first line bisphosphonate

A

Alendronic acid

75
Q

who can start zolendronic acid

A

specialist

76
Q

side effect of bisphosphonates

A

increased risk of atypical stress fractures (e.g. femoral)

77
Q

how do you take bisphosphonates

A

with water, standing or sitting, 30 mins before food or other meds

78
Q

what must you correct prior to starting bisphosphonates

A

calcium and vitamin D

79
Q

when do you need calcium supplements during bisphosphonate treatment

A

if dietary intake is inadequate

80
Q

blood values in osteporosis

81
Q

3 components of the z score

A

age gender ethnicity

82
Q

T score less then 1, between 1-2.5, more than 2.5

A

less than 1: normal
1-2.5: osteopenia
more than 2.5: osteoporosis

83
Q

what does a DEXA scan compare against

A

average healthy adult

84
Q

explain the criteria for a bisphosphonate holiday

A

repeat FRAX and DEXA at 5 years
if reduced risk then stop and review in 2 years

85
Q

what medication can you use alongside bisphosphonates to prevent pathological fractures in bone metastases

86
Q

first line management for osteoarthritis

A

paracetamol and topical NSAIDs

87
Q

calcium, phosphate, ALP and PTH in osteomalacia

A

reduced calcium and phosphate
increased ALP and PTH

88
Q

calcium, phosphate, ALP and PTH in osteogenesis imperfecta

89
Q

old man with bone pain and high ALP

A

pagets disease

90
Q

investigation for pagets disease

A

skull xray

91
Q

treatment for pagets disease

A

bisphosphonates

92
Q

malignant tumour in metaphyseal region of long bones before epiphyseal closure with a STARBURST pattern

A

osteosarcoma

Medicine Year 5 (27 decks)

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