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rheumatology Flashcards

1
Q

Scoring system for RA

A

DAS-28

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2
Q

Test for herniated disc

A

Straight leg raise ie it is + if there is back pain

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3
Q

X-ray finding for osteoarthritis

A

loss of joint space, osteophytes, sub-articular sclerosis, subchondral cysts

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4
Q

What does CREST stand for

A

calcinosis
Raynauds
oEsophageal dysmotility
Sclerodactyly
Telangiectasia

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5
Q

Most common causative organism for septic arthritis

A

Staph aureus

(Strep is the next)

E.coli in drug users

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6
Q

Difference between gout and pseudo-gout

A

Gout = negatively birefringent crystals, needle shaped

Pseudo = positively birefringent and envelope shape

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7
Q

What seronegative spondylarthropathy is more associated with enthesitis

A

AS

Especially at the Achilles tendon
*enthesitis = inflammation of tendons, ligaments or joint capsules

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8
Q

Most specific antibody test for SLE

A

ANA (anti-nuclear antibody)

RF as well but not as specific

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9
Q

Scl-70 associated disease

A

CREST - systemic sclerosis

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10
Q

Treatment for acute flare up of gout if NSAIDs is not tolerated

A

colchicine 500mg BD or QDS

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11
Q

What is Behcets

A

A rare multi-organ disease caused by systemic vasculitis - idiopathic

Affects demographics = Turkey , Mediterranean and Japan

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12
Q

Features of Behcets

A

ulceration - oral and genital
Uveitis
Erythema nodosum

HLA B51 associated

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13
Q

Mode of action : sulfasalazine

A

It is a prodrug of 5-ASA which works through decreasing neutrophil chemotaxis alongside suppressing proliferation of lymphocytes and pro-inflammatory cytokines

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14
Q

Mode of action : methotrexate

A

An anti-metabolite that inhibits dihydrofolate reductase
- an enzyme essential for the synthesis of purines and pyrimidines

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15
Q

Adverse effects of methotrexate

A

Mucositis
Myelosuppression
Pneumonitis
Pulmonary fibrosis
Liver fibrosis

= always give methotrexate with folinic acid

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16
Q

What needs to be monitored for a patient on methotrexate

A

FBC and LFTs

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17
Q

Treatment for SLE nephritis

A

Prednisolone + Cyclophosphamide

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18
Q

Which part of the spine can rheumatoid arthritis affect

A

Cervical spine (lumbar and thoracic are usually spared) ie subluxation of the Atlanto-axial joint

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19
Q

Most common causative organism for urethritis

A

Chlamydia trachomatis

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20
Q

How to differentiate between eGPA and GPA

A

GPA = c-ANCA
eGPA = p-ANCA

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21
Q

Management of mono or oligo-articular disease (pseudo-gout)

A

(*accessible to injection)

Intra-articular injection of steroids

22
Q

Antibodies and associated conditions

A
23
Q

Interpretation of OA x-ray

A
24
Q

Is RA seropositive or seronegative

A

Seropositive

25
Q

Cut off values for DAS-28

A
26
Q

What are the seronegative inflammatory arthropathies

A

-AS
-psoriatic arthritis
-enteropathic
-reactive

27
Q

Seronegative arthropathy associated with IBDs

A

Enteropathic arthritis

28
Q

What is Reiters

A

Triad = urethritis, uveitis, conjunctivitis

29
Q

What complement levels are low in SLE

A

C3 + C4

30
Q

Management of skin disease and arthralgia SLE

A

Hydroxychloroquine
Topical steroids
NSAIDs

Are commonly used

31
Q

Severe organ disease SLE treatment (eg lupus nephritis, CNS lupus)

A

IV steroids and cyclophosphamide

32
Q

What do you need to monitor in someone with SLE

A

Anti-dsDNA and complement levels

Urinalysis - glomerulonephritis

CV risk - BP and cholesterol

33
Q

*parotid gland swelling

A

Sjogrens

34
Q

What is Sjogrens

A

Autoimmune condition characterised by lymphocytic infiltrates in exocrine organs —> causing dryness of eyes and mouth (sicca)

35
Q

What’s going on here

A

Schirmers - Sjogrens

36
Q

What criteria is used to diagnose Sjogrens

A

American-European consensus group classification

Need 4/6 for a diagnosis

37
Q

Diffuse systemic sclerosis associated Antibody

A

Anti-scl70

38
Q

Limited systemic sclerosis antibody

A

Anti-centromere

39
Q

Management of raynauds

A

CCBs
Iloprost
Bosentan

40
Q

*anti-RNP antibodies

A

= mixed connective tissue disease

41
Q

What is uric acid

A

The final compound in the breakdown of purines in DNA metabolism

42
Q

Definitive investigation for gout

A

Sampling synovial fluid with polarised microscopy

43
Q

Chondrocalcinosis refers to what

A

When calcium pyrophosphate deposition occurs in cartilage

= pseudogout

44
Q

What is seen

A

Chondrocalcinosis at the knee

45
Q

If serum creatinine kinase are crazily high what two conditions are you considering ?

A

Rhabdomyolysis

Polymyositis

46
Q

What immune cells are significant in polymyositis

A

CD8+

47
Q

Heberdens nodes associated with what disease

A

Osteoarthritis

48
Q

A 32 year old man is diagnosed with a pulmonary embolus with no clinical risk factors, anti-cardiolipin antibodies are raised

What is the most appropriate management

A

= life long warfarin

A thrombotic event in a patient with antiphospholipid syndrome is an indication for life-long anti coagulation

49
Q

Classic radiological findings on RA

A

Periarticular erosions
Loss of joint space

50
Q

T/F large vessel vasculitides are generally ANCA negatives

A

T - small vessel are more typically ANCA positive (GPA , eGPA)

51
Q

How is fibromyalgia diagnosed ?

A

Clinical picture only

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