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Phase 2a > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What is rheumatology?

A

the medical management of musculoskeletal disease

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2
Q

What are the 4 pillars of inflammation?

A

rubor- red
dolor- pain
calor- hot
tumour- swollen

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3
Q

What are the two categories of joint pain?

A

inflammatory and degenerative

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4
Q

How does joint pain respond to NSAIDS?

A

inflammatory- does respond to NSAIDS
degenerative- less convincing response to NSAIDS

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5
Q

What is osteomyelitis?

A

infection localised to bone

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6
Q

What are the symptoms of acute osteomyelitis?

A

onset over several days
dull pain at the site
may be aggravated by movement

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7
Q

What are the signs of systemic osteomyelitis?

A

fever
rigors
sweats
malaise

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8
Q

What are the signs of local osteomyelitis?

A

For both acute and chronic:
tenderness, warmth, erythema, swelling

with chronic you may also get:
draining sinus tract, deep/ large ulcers that fail to heal despite extensive treatment, non-healing fractures

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9
Q

What is the differential diagnosis for osteomyelitis?

A

soft tissue infection
charcot joint
avascular necrosis of bone (e.g. due to steroids or sickle cell anaemia)
gout
fracture
malignancy

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10
Q

What is a Charcot joint?

A

bone and joint changes that occur secondary to loss of sensation and is most often associated with diabetes, syphilis, syringomyelia, spina bifida, traumatic spinal cord injury, and leprosy

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10
Q

What is a Charcot joint?

A

bone and joint changes that occur secondary to loss of sensation and is most often associated with diabetes, syphilis, syringomyelia, spina bifida, traumatic spinal cord injury, and leprosy

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11
Q

What is the management of infection due to a prosthesis?

A

antibiotic
debridement and retention of prothesis
excision arthroplasty
one stage exchange arthroplasty
two stage exchange arthroplasty
amputation

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12
Q

What is arthroplasty?

A

a surgical procedure to restore the function of a joint

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13
Q

Describe inflammatory arthritis

A

onset of new joint swelling
in sinovial joints
red and warm to touch
worst in morning

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14
Q

What are the causes of joint inflammation?

A

inflammatory arthritis
septic arthritis

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15
Q

What are the risk factors for gout?

A

beer
renal impairment
diuretics
aspirin
family history

16
Q

What joints are affected by psoriatic arthritis?

A

big joints asymmetrically
the odd digit
affects spine

17
Q

What joints are affected by rheumatoid arthritis?

A

affects small joints symmetrically
does not affect the spine

18
Q

Describe uric acid levels in gout?

A

during a flare up uric acid levels in the blood will be low/ normal and the uric acid is concentrated in the joint, not the blood

when not in a flare up the blood uric acid levels will be above normal

19
Q

Why does beer cause gout?

A

beer contains a lot of purine (namely guanosine) which the body converts to uric acid

20
Q

Describe the mechanism of which we base the treatment for gout.

A

the last two steps of uric acid synthesis is hypoxanthine to xanthine to uric acid

both of these two steps are catalysed by xanthine oxidise (XO)

the treatment for gout is based on inhibition of XO

the inhibitors are called allopurinol or febuxostat (more potent)

21
Q

What happens if gout goes untreated?

A

there are 4 clinical phases if left untreated:

  • asymptomatic hyperuricaemia
  • acute/ recurrent gout
  • intercritical gout
  • chronic tophaceous gout
22
Q

What is chronic tophaceous gout?

A

uric acid deposits in the skin

23
Q

What are the complications of gout?

A

disability and misery
tophi
renal disease

24
Q

Describe the x-ray of a patient with rheumatoid arthritis.

A

x-ray of affected limb will be normal until about 6 months of disease

25
Q

Describe the x ray changes over time in a patient with rheumatoid arthritis.

A

soft tissue swelling
periarticular osteopenia
joint space narrowing
bone erosion

26
Q

What is pleuritic chest pain?

A

chest pain upon inspiration

27
Q

What categories of illness cause multi system disease?

A

infection
autoimmune connective tissue diseases
metabolic disease
endocrine disease
cancer

28
Q

Name the inherited connective tissue diseases.

A

Marfan’s syndrome
Ehler Danlos syndrome

29
Q

What is SLE?

A

Systemic lupus erythematosus

29
Q

What is SLE?

A

Systemic lupus erythematosus

Phase 2a (18 decks)

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