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BPT Sadness 😔 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What are 5 key autoantibodies found in SLE?

A

ANA, dsDNA, anti-Smith, anti-Ro, anti-La

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2
Q

What does adalimumab target, and which conditions does it treat?

A

TNF
- RA
- Psoriasis
- Ank spond
- IBD

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3
Q

Which drug works against IL1?

A

Anak1nra (and canakinumab, rilonacept)
- Treatment for gout, FMF

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4
Q

What type of arthritis is described
- Joint tenderness <3 in first 6 months incl. DIP
- Symptoms worse in morning
- Swelling of entire joint

A

Psoriatic arthritis
- Oligoarthritis
- Involves DIP
- Dactylitis (sausage fingers)

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5
Q

A positive pathergy test and HLA B51 is associated with?

A

Behcet’s
- HLA B51

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6
Q

Renal failure with epistaxis/haemoptysis and cANCA should make you think of?

A

GPA

Think ABC
- AKI
- Bleed
- cANCA

PR3
- Pulmonary
- Renal
- 3NT

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7
Q

Which Ab is associated with increased risk of renal crisis in systemic sclerosis, and how is it treated?

A

Anti-RNA-polymerase III Ab
- Tx ACEI

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8
Q

What are the immunological criteria for SLE?

A
  1. ANA above laboratory reference range.
  2. Anti-dsDNA above laboratory reference rang
  3. Anti-Sm
  4. Antiphospholipid antibody: any of the following
  5. Low complement
  6. Direct Coombs test in the absence of hemolytic anemia
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9
Q

Anti-mi2 Ab is associated with what?

A

Dermatomyositis

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10
Q

Which cells make synovial fluid?

A

Type B synoviocytes

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11
Q

Most common extra-articular manifestation of ankylosing spondylitis?

A

Anterior uveitis

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12
Q

Early syndesmophyte is called?

A

Romanus lesion
- Shiny corner sign

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13
Q

Features of DISH vs. AS

A

Normal SIJ, normal disc height, calcification of anterior longitudinal ligament >4 thoracic vertical bodies

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14
Q

Which mode on MRI do you use to look for myositis?

A

STIR = short tau inversion recovery
- Suppresses all signals apart from water
- White = water/oedema/inflammation

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15
Q

Strongest genetic association with RA?

A

HLA DRB1
- Dr Biscuit 1

Also STAT4

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16
Q

Most common place for discoid lupus & characteristics?

A

80% above the neck
- Scarring, hypopigmentation
- Progression to SLE 5-25%

If below neck - higher chance of progression to systemic lupus

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17
Q

Which antibody has a negative associated with auto-immune rheumatic diseases?

A

Anti-dense fine speckled-70 Ab
- Anti-DFS 70

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18
Q

Genetic factors RF SLE

A

Complement deficiency
• Low C’ activity > defective phagocytosis of apoptotic material
• C1q def - risk for SLE

TREX1 gene mutation

TLR7 gene - gain of Fx variant

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19
Q

Common drugs causing drug-induced SLE

A

Procainamide
Hydralazine
Diltizem
Isoniazid
Quinidine

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20
Q

Auto-Ab in drug-induced SLE

A

Anti-DsDNA, anti-histone
- Arthritis and serositis more common; renal + CNS involvement rare

TNF-induced SLE

SLE withdrawal with cessation of drug

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21
Q

Type of arthritis which mimics RA?

A

Jaccoud’s arthropathy
- Reversible deformity of hands and feet in SLE

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22
Q

Most common cardiac presentation of SLE?

A

Pericarditis

23
Q

Non-bacterial endocarditis associated with SLE?

A

Libman-Sacks endocarditis
- Verrucous (warty) sterile lesion
- AKA murantic endocarditis

Associated SLE, APLS, malignancy

24
Q

Disease activity measures lab in SLE?

A

ESR/CRP, increased DsDNA, low C3/C4

25
Q

Which DMARD has highest risk SCC?

A

Azathioprine

26
Q

Hepatitis B is strongly associated with which rheumatological condition?

A

PAN

27
Q

Diffuse vs. limited sclerosis

A

Limited
- Centromere
- Pulmonary HTN

28
Q

Sulfasalazine is good for which type of arthritis?

A

Peripheral arthritis

29
Q

HLA DRB1 disease association?

A

RA

30
Q

Bechet HLA?

A

HLA B51

31
Q

GCA and PMR marker association

A

CXCL9 and IL6

32
Q

Aggrecanase is involved in which pathway?

A

Breakdown of cartilage in OA

33
Q

Which IPF is associated with RA?

A

UIP&raquo_space;> NSIP
- RhUmatoid
- All other CTD is NSIP

34
Q

Which CTD is associated with cryptogenic organising pneumonia?

A

Sjogrens

35
Q

Subacute cutaneous lupus characteristics

A
  • Photosensitive
  • Papulosquamous (red, scaly that look like pimples) or psoriasisform annular lesions (look like psoriasis)
  • Usually non-scarring
  • Ro60 Ab positive
36
Q

Discoid lupus features

A
  • More common in pigmented skin
  • Assciated with scarring and alopecia; hyper/hypopigmentation
37
Q

Treatment of ANCA vasculitis?

A
  • Low dose glucocorticoids have similar efficacy to standard dose (PEXIVAS)
  • Oral cyclophosphomide has higher fertility and bladder Ca risk than IV
  • Rituximab is equivalent to PO cyclophosphomide for induction (RAVE) trial
  • Plasma exchange does not improve renal outcomes; consider in pulmonary haemorrhage
38
Q

Contraindications to anti-TNF

A

Heart failure NYHA 3 or 4
Active infection
Untreat latent or active TB

(Maybe demyelinating illness)

39
Q

Which anti-TNF is LEAST likely to cause anti-drug antibodies?

A

Etanercept

40
Q

Mutations in MEFV gene predisposes to what?

A

Familial Mediterranean fever (FMF)
- Tx colchicine
- Fever, abdominal pain, rash, and arthritis
- Pyrin

MEditerranean FeVer

41
Q

Colchicine in gout MOA?

A

Inhibits microtubule formation and uncouples inflammasome activation

Urate crystals activate NLRP3 > caspase 1 > IL1B > acute inflammation

42
Q

Abatacept MOA?

A

Selective T cell costimulation blocker
- Blocks CD80 / CD86 on APC

43
Q

Lofgren’s syndrome triad

A

Erythema nodosum, hilar adenopathy, migratory polyarthritis

44
Q

Treatment of PsA and ankylosing spondylitis

A

Treat with IL-17 e.g. secukinumab, ixekinumab
- NB: can exacerbate IBD

45
Q

Periostitis is seen in which rheum condition

A

PsA

46
Q

Which non-gout specitic drugs can help with gout

A

CCB
Fenofibrate
Losartan
SGLT2

47
Q

Guselkumab MOA and indication

A

Anti IL-23

Use to Tx PsA

48
Q

How to treat myocarditis in scleroderma?

A

Immunosuppression
- Mycophenolate or cyclophosphamide

49
Q

Vasculitis by vessel affected

A
50
Q

When is fracture seen in glucocorticoid-induced osteoporosis?

A

3-6 months after initiation
- Usually vertebral fractures
- Increased bone turnover in early stage > low bone turnover late stages

51
Q

Limited vs. diffuse scleroderma?

A

Limited is C
- CREST
- Centromere
Pulmonary HTN

52
Q

Most common murmur associated with ankylosing spondylitis

A

Aortic regurgitation

53
Q

Biggest RF for SUDEP in uncontrolled seizures

A

Uncontrolled generalised tonic clonic seizures

54
Q

6 As of ankylosing spondylitis

A

BPT Sadness 😔 (20 decks)

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