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OBS and gynae > rheumatology > Flashcards

rheumatology Flashcards

1
Q

Which rheumatological condition has only pain and stiffness but no weakness

A

polymylagia rheumatica

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2
Q

Which rheumatological condition can lead to carpal tunnel syndrome

A

polymyalgia rheumatica

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3
Q

Which rheumatological condition is associated with polymyalgia rheumatica

A

giant cell arteritis

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4
Q

Which condition is a medical emergency

A

giant cell arteritis

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5
Q

which are the 5 features of GCA

A

bitemporal sudden onset headache, vision: amaurosis fugax, vision loss, scalp tenderness, intermittent jaw claudication

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6
Q

What condition shows a optic disc that is chalky white and swollen optic disc

A

GCA

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7
Q

Which condition has a diagnosis using a biopsy

A

GCA

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8
Q

Treatment of GCA

A

oral prednisolone

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9
Q

What is the main mechanism of vision loss in GCA

A

anterior ischaemic optic neuropathy

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10
Q

What do you see in the blood film of someone with GCA

A

normochormic normocytic anaemia

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11
Q

what type of aneurysm is GCA associated with

A

aortic aneurysm

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12
Q

Which joints in the hands is osteoarthritis common

A

interphalangeal joints

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13
Q

what is the most common joint disease in the uk

A

osteoarthritis

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14
Q

which condition are heberdens and bouchards nodes seen

A

osteoarthritis

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15
Q

features on the x-ray in osteoarthritis

A

L: loss of joint space O: osteophytes S: subarticular sclerosis S: subchondral cysts

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16
Q

What three features are needed for the diagnosis of osteoarthritis

A

aged over 45 and morning stiffness less than 30min and movement related joint space

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17
Q

What is the first line management of osteoarthritis but then in the knee and hand

A

paracetamol, nsaids but for the knee and hand it is topical nsaids

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18
Q

Difference between ankylosing spondylitis and arthritis of the lumbar spine

A

ankylosing spondylitis is an inflammatory condition and more stiffness in the morning

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19
Q

What are the risk factors of osteoporosis

A

S: steroids H: hyperparathyroidism A: alcohol and smoking T:thin T: low testosterone E: erosive bone disease R: poor renal function E: early menopause D: diabetes

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20
Q

What is the first step before doing a dexa scan

A

do q risk score, if it is more than 10% do a dexa scan

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21
Q

What is the t score

A

this is comparing the bone density to young adults of the same sex.

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22
Q

What is the z score

A

comparing the bone density to adults of the same age and sex

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23
Q

What score indicates osteopenia

A

T score is -1 to -2.5 less than the mean

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24
Q

What score indicates osteoporosis

A

Z score less than 2 SD of the mean

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25
Q

What is the first line treatment for osteoporosis

A

bisphosphonates, like alendronic acid

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26
Q

What is the mechanism of action of desonumab

A

causes the maturation of osteoclasts

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27
Q

What is the mechanism of action of raloxifene

A

binds to ER

28
Q

In which bone condition is the bone mineral: bone matrix reduced

A

osteomalacia

29
Q

In which condition is the serum calcium increased: osteomalacia, pagets, osteitis fibrosa cystica

A

Osteitis fibrosa cystica

30
Q

In which condition is the serum calcium decreased: osteomalacia, pagets, osteitis fibrosa cystica

A

osteomalacia

31
Q

In which condition is the serum calcium normal: osteomalacia, pagets, osteitis fibrosa cystica

A

pagets

32
Q

What is osteomalacia

A

deficiency in vitamin D or calcium or phosphate which results in a failure to mineralize bone

33
Q

bowing of legs, knock knees, costochondral swelling, skull softening and proximal muscle weakness are features of which condition

A

osteomalacia

34
Q

What is characterised a vitamin D deficiency

A

less than 25nmol/L of vitamin D

35
Q

radiolucent bones in a xray suggest what

A

osteomalacia

36
Q

What is the maintainence dose of vitamin D

A

800 IU

37
Q

How would you treat vitamin D deficiency

A

50000IU for 6 weeks, 20000 for 7 weeks, 4000IU for 10 weeks and then the maintenance dose of 800IU

38
Q

How would you treat vitamin D insufficiency

A

800IU maintenance dose

39
Q

Which arthritis affects the PIP joints and MCP joints

A

RA

40
Q

Which arthritis has a neutropenia and painful DIP and PIP joints

A

Psoriatic arthritis

41
Q

boutinnere’s deformity, wrist sublaxation, swan neck deformity and z shaped thumb suggest what

A

RA

42
Q

juxta-articular osteopenia and loss of joint space and on xray

A

RA

43
Q

What are the categories of DS28

A

less than 1.6: mild
16-3.2: moderate
3.2-5.1: severe if over 5.2 start DMARD treatment

44
Q

Examples of three DMARDS

A

methotrexate, hydrochloroquine and sulfaszine

45
Q

side effects of methotrexate

A

cough, dysponea and fever (pneumonitis)

46
Q

Which condition has an occult rash on the umbilicus, scalp and behind the ear and a pencil in cup deformity in the achilles tendon

A

psoriatic arthritis

47
Q

which condition presents with extra-rheumatological features like raynaud’s phenomenon, pleural effusions, seizures and hepatosplenomegaly

A

SLE

48
Q

which condition shows joint widening on a x-ray

A

rickets

49
Q

treatment of acute flares in RA

A

IV methylprednisolone

50
Q

hip pain with fever

A

transient synovitis same day referral

51
Q

ANA and anti-dsDNA specificity and senstivity for SLE

A

ANA: more sensitive anti-dsDNA: more specific

52
Q

which drug with aziathioprine has a severe interaction and can cause bone marrow suppression and agranulocytosis

A

allopurinol

53
Q

anti jo-1

A

dermatomyositis: purple rash on face

54
Q

anti-scl-70

A

diffuse systemic sclerosis: thickening of the skin

55
Q

what is marfans syndrome associated with

A

recurrent pneumothoraces

56
Q

what should be done before giving bisphosphonates

A

correct calcium and vitamin D level

57
Q

treatment for sjorgens

A

hypromellose

58
Q

aortic problems, young female which causes limb claudication

A

takayasu’s arteritis

59
Q

distinguishing factor for pagets disease

A

isolated raised ALP

60
Q

leg may be observed to be flexed at the hip, internally rotated and adducted.

A

posterior dislocation

61
Q

, the leg can be positioned as externally rotated, but this is usually accompanied by significant abduction,

A

anterior dislocation

62
Q

urethritis, arthritis and infective illness

A

reactive arthritis

63
Q

joint aspirate is yellow and cloudy with the absence of crystals

A

RA

64
Q

difference between pseudogout and gout

A

chondrocalcinosis

65
Q

Bisphosphonates and denosumab can be used to prevent pathological fractures in bone metastases. If the eGFR < 30, denosumab is preferred

A
66
Q

treatment for pagets disease

A

bisphosphonates

67
Q

first line treatment for gout

A

nsaids and colchine

OBS and gynae (17 decks)

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