Rheumatology Flashcards

1
Q

problems with joints

A

OA
Crystal arthritis (gout, pseudogout)
RA
Spondyloarthritis (AS, Psoriatic arthritis, IBD, reactive arthritis)

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2
Q

multi-system problems

A
  • connective tissue disease (SLE, Sjogrens, systemic sclerosis)
  • vasculitis (takayasu’s, GCA, polyarteritis nodosa, HSP)
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3
Q

bone/soft tissue problems

A
  • metabolic bone disease (osteoporosis, osteomalacia)
  • inherited disorders of connective tissue
  • soft tissue disease (Bursitis, tendiopathy)
  • fibromyalgia
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4
Q

signs of OA

A

Herberden’s
Bouchard’s
Squaring at base of thumb
joints: DIP, PIP, CMC

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5
Q

mx of OA

A

pain management
physio
aids for daily living
injection
surgery

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6
Q

which joints are affected in RA?

A

wrist joints
MCP joints
PIP joints
>10 joints in total

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7
Q

management of RA

A
  • analgesic
  • NSAID
  • steroid prep
  • csDMARDS (e.g. methotrexate)
  • biological DMARDs
  • tsDMARDS (e.g. JAK inhibitors)
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8
Q

X-ray findings of AS

A

bilateral sacroiliitis
sclerosis
erosive damage
fusion of joint
reduced joint space

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9
Q

treatment of AS

A

doesn’t respond to conventional DMARDs
use biologicals e.g. TNFa or IL17

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10
Q

signs of psoriatic arthritis

A

small joints of PIP/DIP
psoriatic nail changes (oncycholysis, pitting, subungal hyperkeratosis)

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11
Q

connective tissue diseases are all…

A

ANA +ve

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12
Q

dsDNA

A

SLE

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13
Q

ENA

A

Sjogrens (Ro, La)

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14
Q

cytoplasmic

A

Myositis (t-RNA, Jo1)

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15
Q

limited vs diffuse sclerosis

A

limited = skin changes limited to forearm/calf, more distal and to peri oral area
= anti-centromere

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16
Q

cANCA is against

A

enzyme proteinase 3

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17
Q

pANCA is against

A

myeloperoxidase

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18
Q

score system for osteoporosis and treatment

A

FRAX score
Tx: bisphosphonate, anti-RANK ligand PTH analogue

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19
Q

RA disease monitoring

A

Disease Activity Score 28 (DAS28)
CRP monitoring

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20
Q

X-ray loss of joint space RA vs OA

A

RA: loss of joint spaces in proximal joints
OA: loss of joint spaces in distal joints

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21
Q

RA X-ray changes (LESS)

A

loss of joint space
erosions (periarticular)
soft tissue swelling
subluxation and deformity

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22
Q

X-ray findings in Gout

A

punched out erosion
rat bites

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23
Q

X-ray in AS

A

Bamboo spine (squaring of lumbar vertebrae)
Dagger sign (supraspinatus tendon ossification)
Syndesmophytes

24
Q

Abs in SLE

A

ANA
anti-dsDNA
anti-Smith

25
Q

monitoring SLE

A

anti-dsDNA titres
C3 and C4 levels
ESR

26
Q

anti-RNP

A

mixed connective tissue diseases

27
Q

diffuse systemic sclerosis organ involvement

A

fibrosis of GIT, lung, cardiac, renal

28
Q

what are the myositis panel of Abs

A

Anti-Jo1
Anti-Mi2
Anti-SRP

29
Q

ANCA -ve small vessel vasculitides

A

Goodpasture’s
Cryoglobulinaemia
HSP

30
Q

Wegener’s symptoms

A

URT: rhinitis, saddle nose
LRT: haemoptysis and cough
Renal: rapidly progressive glomerulonephritis

31
Q

Churg Strauss symptoms

A

eosinophilia
asthma
rapidly progressive glomerulonephritis

32
Q

Microscopic polyangiitis symptoms

A

palpable purpura
glomerulonephritis
haemoptysis

33
Q

associations of pseudogout

A

hypothyroidism
chondrocalcinosis
haemochromatosis
hyperparathyroidism

34
Q

lifestyle changes in SLE

A

sunscreen
stop oestrogen containing meds
avoid smoking
exercise

35
Q

definition of polyarthritis

A

> 5 joints

36
Q

causes of symmetrical arthritis

A

RA, OA

37
Q

causes of asymmetrical arthritis

A

reactive
psoriatic

38
Q

L2

A

hip flexion

39
Q

L3

A

knee extension
knee jerk

40
Q

L4

A

foot inversion and dorsiflexion
knee jerk

41
Q

L5

A

great toe dorsiflexion

42
Q

S1

A

foot eversion
ankle jerk

43
Q

definition of OA

A

degenerative joint disorder
progressive loss of hyaline cartilage

44
Q

extra RA signs on hands

A

ulnar deviation of fingers
dorsal subluxation of ulnar styloid

45
Q

scoring system for RA

A

DAS28

46
Q

Differential diagnosis of rheumatoid hands

A

psoriatic
chronic crystal arthritis

47
Q

management of pseudogout

A

analgesia
NSAIDs
steroids

48
Q

skin changes of reactive arthritis

A

keratoderma blenorrhagica (plaques on soles/palms)
circinate balanitis (penile ulceration)

49
Q

CREST skin involvement

A

face, hands, feet

50
Q

organ fibrosis in diffuse systemic sclerosis

A

GI
Lung
Cardiac
Renal

51
Q

Extra skin findings in dermatomyositis

A

shawl sign (macular rash)
mechanic hands (painful rough skin, cracking of fingertips)

52
Q

antibodies in SLE

A

ANA
dsDNA
anti-Smith

53
Q

large vessel vasculitides

A

GCA
Takayasu

54
Q

medium vessel vasculitides

A

polyarteritis nodosa
Kawasaki

55
Q

PMR symptoms

A

pain/stiffness
no weakness