Rheumatology Flashcards
What is the triad of fat embolus?
- Respiratory symptoms
- Neurological symptoms
- Petechial rash (usually after the first 2 symptoms)
What is Felty’s syndrome?
- A triad of rheumatoid arthritis, splenomegaly and neutropenia (low white cell count)
- Patients present with recurrent and severe infections
What ca n differentiate between psoriatic arthritis and reactive arthritis?
- Psoriatic arthritis tends to have positive family history of arthritis, and is generally a polyarthritis
- Reactive arthritis tends to follow bacterial infection (e.g. gastroenteritis or STI) and is a mono- or oligoarthritis
What is the triad of Behçet’s disease?
- Mouth ulcers
- Genital ulcers
- Anterior uveitis
What antibodies are associated with SLE?
- Anti-Smith’s (most specific)
- ANA (most sensitive)
What antibiotic can induce SLE?
Isoniazid
What are the 6A’s of ankylosing spondylitis?
- Apical fibrosis
- Anterior uveitis
- Aortic regurgitation
- Achilles tendonitis
- AV node block
- Amyloidosis
What crystals are found in pseudogout?
Weakly-positively birefringent rhomboid-shaped calcium pyrophosphate crystals
What crystals are seen in gout?
Negatively birefringent needle shaped monosodium urate crystals
What specialty review is required before starting a patient on hydroxychloroquiene?
Ophthalmology
Oteogenesis imperfecta usually present with what blood results?
Normal (Adjusted calcium, PTH, ALP and PO4)
What are the X-ray findings on ankylosing spondylitis?
- Bamboo spine
- Subchondral erosions, sclerosis
and squaring of lumbar vertebrae
What X-ray finding is most supportive of ankylosing spondylitis?
Sacroilitis
What is the triad of reactive arthritis?
Urethritis + arthritis + conjunctivitis = reactive arthritis
What is the triad for reactive arthritis?
- Arthtitis
- Urethritis
- Conjunctivitis
What doe rheumatoid arthritis joint aspiration show?
- Yellow fluid with absence of crystals
- High WCC count (mainly polymorphonuclear neutrophils)
What antibodies are a marker of poor prognosis in rheumatoid arthritis?
- Anti-CCP antibodies
- Anti-CCP antibodies are with positive rheumatoid factor and the two together are strong predictors of early transformation from transient to persistent synovitis
What are some markers of poor prognosis in RA?
- Anti-CCP
- Insidious onset
- Female sex
What 2 signs are indicative of antiphospholipid syndrome?
(paradoxically) prolonged APTT + low platelets
What are signs of systemic sclerosis and what antibodies are associated with it?
- A history of tightening of the skin, as well as Raynaud’s phenomenon and telangiectasia, is suggestive of systemic sclerosis
- Anti-centromere antibodies
What is CREST syndrome?
A subtype of systemic sclerosis
What are the features of CREST syndrome?
- Calcinosis
- Raynaud’s phenomenon
- oEsophageal dysmotility
- Sclerodactyly
- Telangiectasia
What needs to be checked for before staring azathioprine?
Thiopurine methyltransferase deficiency (TPMT)
What are signs of poly myalgia rheumatic?
Pain and muscle stiffness in proximal joint that is worse in morning and improve with activity
What is the finding in Schober’s test for ankylosing spondylitis?
- Schober’s test <5cm is suggestive of ankylosing spondylitis
- Suggests reduced lumbar flexion
What is first line treatment for ankylosing spondylitis?
Exercise regime and NSAIDs
What are the signs of Paget’s disease of bone?
- Bone pain, headaches and hearing loss with a raised ALP
