Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What 4 key x-ray changes can be seen in patients with osteoarthritis?

(HINT: LOSS)

A

L - loss of joint space
O - osteophytes
S - subchondral sclerosis (increased density of the bone along the joint line)
S - subchondral cysts (fluid-filled holes in the bone, aka geodes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In osteoarthritis:

  • joint pain + stiffness may be worsened by activity, OR
  • activity improves symptoms
A
  • joint pain + stiffness may be worsened by activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In which joints do Heberden’s nodes form?

  • DIP joints
  • PIP joints
  • MCP joints
A
  • DIP joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In which joints do Bouchard’s nodes form?

  • DIP joints
  • PIP joints
  • MCP joints
A
  • PIP joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is osteoarthritis diagnosed?

A

= can be made without investigations if,

  • patient > 45
  • has typical activity related pain
  • has no morning stiffness OR, stiffness lasting < 30 mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management options for osteoarthritis (5)

A
  • patient education
  • physiotherapy
  • stepwise analgesia to control symptoms
  • intra-articular steroid injections
  • joint replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In the stepwise analgesia approach to control symptoms in osteoarthritis, what is used first?

A

= oral paracetamol and topic NSAIDs OR, topical capsaicin (chilli pepper extract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is capsaicin? and what is it used for?

A

= chilli pepper extract,

in osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which joints are most typically affected by rheumatoid arthritis?

  • DIP joints
  • PIP + MCP joints
A
  • PIP + MCP joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Rugger Jersey Spine? and what is it associated with?

A

= osteosclerosis associated with secondary hyperparathyroidism of chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following best describes bone changes associated with ‘osteoporosis’?

  • deficient matrix, normal mineralisation
  • normal matrix, deficient mineralisation
  • normal matrix, normal mineralisation, increased reabsorption
A
  • deficient matrix, normal mineralisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following best describes bone changes associated with ‘osteomalacia’?

  • deficient matrix, normal mineralisation
  • normal matrix, deficient mineralisation
  • normal matrix, normal mineralisation, increased reabsorption
A
  • normal matrix, deficient mineralisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of the following best describes bone changes associated with ‘hyperparathyroidism’?

  • deficient matrix, normal mineralisation
  • normal matrix, deficient mineralisation
  • normal matrix, normal mineralisation, increased reabsorption
A
  • normal matrix, normal mineralisation, increased reabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is osteoporosis?

A

= condition where there is a reduction in the density of bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Effect of oestrogen on bones?

A

= essential to bone health because it promotes the activity of osteoblasts

(protective against osteoporosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is FRAX tool used for? and what does it calculate?

A

= used in assessing risk of osteoporosis

gives prediction of the risk of fragility fracture over the next 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When assessing bone density, which of the following scores is more clinically relevant?

  • Z-score
  • T-score
A
  • T-score
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When doing a DEXA scan to assess bone density, where is a key location to scan for classification + management of osteoporosis?

A

= hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

First-line pharmacological treatment for osteoporosis?

A

= Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects of Bisphophonates (3)

A
  • reflux + oesophageal erosions
  • atypical fractures
  • osteonecrosis: of jaw + external auditory canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Alendronate, Risedronate + Zoledronic acid are all examples of?

A

= Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is osteoarthritis?

A

= referred to as ‘wear and tear’ in the joints, usually synovial joints and as a result of genetic factors, overuse and injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If oral paracetamol, topical NSAIDs or topical capsaicin does not work what is the next step, in the stepwise analgesia?

A

= add oral NSAIDs, consider PPI to protect stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the 3rd step in analgesia to control symptoms in osteoarthritis? (after oral NSAIDs + PPIs)

A

= consider opiates (cautiously as Sessions include: dependence + withdrawal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is rheumatoid arthritis?

A

= autoimmune condition that causes chronic inflammation of the syndical lining of joints, tendon sheaths + bursa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Does rheumatoid tend to be symmetrical or symmetrical?

A

= symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Is rheumatoid arthritis more common in men or women?

A

= women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Genetic associations with rheumatoid arthritis (2)

A
  • HLA DR4
  • HLA DR1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Antibodies which can be measured if rheumatoid arthritis is suspected?

A
  • rheumatoid factor (RF)
  • anti-CCP antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which of the following antibodies is more sensitive + specific to rheumatoid arthritis:

  • rheumatoid factor
  • anti-CCP antibodies
A
  • anti-CCP antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Systemic features associated with rheumatoid arthritis? (4)

A
  • fatigue
  • weight loss
  • flu-like weakness
  • muscle aches + weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Palindromic Rheumatism?

A

= rare type of inflammatory arthritis, where symptoms like those of rheumatoid arthritis – joint inflammation, pain and swelling – come on suddenly and then disappear just as quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is atlantoaxial subluxation?

A

= radiologically identified increased mobility or laxity between the body of the first cervical vertebra (atlas) and the odontoid process of the second cervical vertebra (axis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Rheumatoid arthritis - classical signs in the hands (4)

A
  • Z-shaped deformity to thumb
  • Swan neck deformity (hyperextended PIP and flexed DIP)
  • Boutonnieres deformity (hyperextended DIP with flexed PIP)
  • Ulnar deviation of the fingers at the knuckle (MCP joints)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is psoriatic arthritis?

A

= inflammatory arthritis associated with psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Extra-articular manifestations associated with psoriatic arthritis? (2)

A
  • uveitis
  • IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is arthritis mutilans? and what does it cause?

A

= most severe form of psoriatic arthritis, commonly affects phalanges

Osteolysis of the bones around the joint, leads to progressive shortening of the digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is PEST?

A

= Psoriasis Epidemiological Screening Tool - screening tool for psoriatic arthritis in patients with psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does a ‘pencil-in-cup’ appearance on x-ray suggest?

A

= psoriatic arthritis, particular association with arthritis mutilans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Classic triad of reactive arthritis

A
  • conjunctivitis
  • urethritis
  • arthritis

HINT: can’t see, pee or climb in a tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Important differential to exclude in patient with reactive arthritis

A

= septic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is reactive arthritis?

A

= involves synovitis in 1 or more joints in response to an infective trigger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Common triggers of reactive arthritis (2)

A
  • gastroenteritis
  • sexually transmitted infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which of the following sexually transmitted infection is most likely to cause reactive arthritis?

  • Chlamydia
  • Gonorrhoea
A
  • Chlamydia

(Gonorrhoea typically causes septic arthritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Investigation for reactive arthritis

A

= joint aspiration - synovial fluid sent for microscopy, culture and sensitivity testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is ankylosing spondylitis?

A

= inflammatory condition affecting the facial skeleton (mainly spine + sacroiliac joints) - causing stiffness and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which gene is strongly associated with ankylosing spondylitis?

A

= HLA-B27 gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Is ankylosing spondylitis more common in men or women?

A

= men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

In ankylosing spondylitis does the pain

  • improve with rest
  • improve with activity
A
  • improve with activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What joints are mostly affected by ankylosing spondylitis? (2)

A

= vertebrae column joints + sacroiliac joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

5As - associations of ankylosing spondylitis

A
  • anterior uveitis
  • aortic regurgitation
  • AV block (heart block)
  • apical lung fibrosis (fibrosis of upper lobes)
  • anaemia of chronic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is Schober’s Test used for?

A

= assess spinal mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is ‘bamboo spine’ a typical x-ray finding for?

A

= ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

First-line pharmacological management for ankylosing spondylitis?

A

= NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Patient presents with malar rash which is ‘butterfly’ shaped across the nose + cheeks. What is the diagnosis?

A

= systemic lupus erythematosus (SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is Systemic Lupus Erythematosus (SLE)?

A

= inflammatory autoimmune connective tissue disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Is SLE more common in men or women?

A

= women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Anti-nuclear antibodies (ANA) are associated with what condition?

A

= Systemic Lupus Erythematosus (SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Which of the following antibodies are associated with Sjögren’s syndrome:

  • anti-Ro and anti-La
  • anti-Scl-70
  • anti-Jo-1
A
  • anti-Ro and anti-La
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the leading cause of disease in those with SLE?

A

= cardiovascular disease

59
Q

First-line pharmacological options for treating SLE? (3)

A
  • Hydroxychloroquine
  • NSAIDs
  • Steroids (e.g., Prednisolone)
60
Q

Which of the following antibodies are associated with systemic sclerosis:

  • anti-Ro and anti-La
  • anti-Scl-70
  • anti-Jo-1
A
  • anti-Scl-70
61
Q

What is Discoid Lupus Erythematosus (DLE)?

A

= autoimmune chronic skin condition

62
Q

What can be used to confirm a diagnosis of discoid lupus erythematosus (DLE)?

A

= skin biopsy

63
Q

Clinical features of Limited Cutaneous Systemic Sclerosis (CREST syndrome) (5)

A

C - calcinosis
R - Raynaud’s phenomenon
E - oEsophageal dysmobility
S - Sclerodactyly
T - Telangiectasia

64
Q

Medical emergency associated with systemic sclerosis

A

= Scleroderma renal crisis

65
Q

What is Raynaud’s disease?

A

= where Raynaud’s phenomenon occurs without an associated systemic disease. Idiopathic and makes up 80-90% of patients with this phenomenon

66
Q

Most important secondary cause of Raynaud’s disease?

A

= systemic sclerosis

67
Q

What is Nailfold Capillaroscopy? and what is it used for?

A

= technique to magnify + examine the peripheral capillaries where the skin meets the base of the fingernail (nail fold)

Used to distinguish cause of Raynaud’s phenomenon - Raynaud disease vs. systemic sclerosis

68
Q

First-line pharmacological management for Raynaud’s phenomenon?

A

= Nifedipine (ca channel blocker)

69
Q

What type of drug can worsen symptoms of Raynaud’s?

A

= beta-blockers

70
Q

Which of the following autoantibodies are associated with ‘limited cutaneous systemic sclerosis’?

  • anti-centromere antibodies
  • anti-Scl-70 antibodies
A
  • anti-centromere antibodies
71
Q

Which of the following autoantibodies are associated with ‘diffuse cutaneous systemic sclerosis’ and more severe disease?

  • anti-centromere antibodies
  • anti-Scl-70 antibodies
A
  • anti-Scl-70 antibodies
72
Q

Medical management options in ‘diffuse cutaneous systemic sclerosis’ (2)

A
  • DMARDs (e.g., Methotrexate)
  • biological therapies (e.g., Rituximab)
73
Q

Important lifestyle factor modification which should be encouraged in patients with Rheumatoid arthritis?

A

= smoking cessation

(increased risk of developing rheumatoid arthritis with cigarette smoking)

74
Q

What is a DAS28 score?

A

= Rheumatoid arthritis severity score

75
Q

What kind of arthritis is associated with onycholysis on clinical examination?

(= when your nail separates from its nail bed)

A

= psoriatic arthritis

76
Q

What is polymyalgia rheumatica? Which part of the body is usually affected?

A

= inflammatory condition that causes pain + stiffness in the shoulders, pelvic girdle and neck

77
Q

What other condition is polymyalgia rheumatica strongly associated with?

A

= giant cell arthritis

78
Q

Characteristic features of pain and stiffness in polymyalgia rheumatica:

  • worse in the morning and somewhat improves with activity
  • worse in the evenings, better on rest
A
  • worse in the morning and somewhat improves with activity
78
Q

Risk in abruptly stopping steroids?

A

= adrenal crisis

78
Q

Pharmacological treatment for polymyalgia rheumatica?

A

= steroids (15mg Prednisolone daily)

79
Q

What is giant cell arteritis also known as?

A

= temporal arteritis

80
Q

Key complication in giant cell arteritis (temporal arteritis)?

A

= vision loss - which is often irreversible

81
Q

Elderly white patient presents with unilateral headache, scalp tenderness, jaw claudication, blurry vision and a PMHx of polymyalgia rheumatica - what do you think is the diagnosis?

A

= giant cell arthritis

82
Q

Which test can help diagnosis a patient with suspected giant cell arteritis (temporal arteritis)?

A

= temporal artery biopsy

83
Q

Pharmacological treatment for giant cell arteritis (temporal arteritis)?

A

= steroids

84
Q

Giant cell arteritis (temporal arteritis: which of the following would you give to a patient with visual symptoms OR, jaw claudication?

  • 40-60mg Prednisolone daily
  • 500mg-1000mg Methylprednisolone daily
A
  • 500mg-1000mg Methylprednisolone daily
85
Q

Giant cell arteritis (temporal arteritis: which of the following would you give to a patient with NO visual symptoms OR, jaw claudication?

  • 40-60mg Prednisolone daily
  • 500mg-1000mg Methylprednisolone daily
A
  • 40-60mg Prednisolone daily
86
Q

Which specialists are involved in managing patients with giant cell arteritis (temporal arteritis)? (3)

A
  • rheumatology (diagnosis + management)
  • vascular surgeons (temporal artery biopsy)
  • ophthalmology (review for visual symptoms)
87
Q

What is polymyositis + dermatomyositis?

A

= autoimmune disorders causing muscle inflammation (myositis)

88
Q

Gottron papules + heliotrope rash are characteristic skin changes seen in which autoimmune condition?

A

= dermatomyositis

89
Q

What is important to investigate and rule-out in patients with polymyositis or dermatomyositis?

A

= underlying cancer - they are paraneoplastic syndromes

90
Q

What blood test is critical in investigation a patient with polymyositis or dermatomyositis?

A

= creatine kinase (CK)

91
Q

Which of the following conditions is associated with anti-Jo-1 antibodies?

  • SLE
  • giant cell arteritis
  • polymyositis
  • diffuse cutaneous systemic sclerosis
  • limited cutaneous systemic sclerosis
A
  • polymyositis
92
Q

First-line treatment in both polymyositis + dermatomyositis?

A

= corticosteroids

93
Q

The following antibodies: Lupus anticoagulant, Anticardiolipin antibodies, Anti-beta-2 glycoprotein I antibodies - are associated with which condition?

A

= antiphospholipid syndrome

94
Q

Patient presents with thrombosis (blood clot), and has a history of recurrent miscarriages - what is likely the diagnosis?

A

= antiphospholipid syndrome

95
Q

What is catastrophic antiphospholipid syndrome?

A

= rare complication associated with antiphospholipid syndrome - with rapid thrombosis in multiple organs within a few days. Has a high mortality rate

96
Q

Pharmacological treatment for antiphospholipid syndrome

A

= long-term Warfarin - used to prevent thrombosis

97
Q

What may be used in patients with antiphospholipid syndrome who are pregnant? (2)

A

= low-molecular weight Heparin + aspirin - used to reduce the risks

(Warfarin is contraindicated in pregnancy)

98
Q

What is Sjögren’s syndrome? and what symptoms as associated with this condition?

A

= = autoimmune condition affecting the exocrine glands, notably the lacrimal + salivary glands

Causes symptoms of dry mouth, eyes, and vagina

99
Q

What are ‘sicca symptoms’?

A

= dry eyes + mouth

100
Q

Primary vs secondary Sjögren’s syndrome?

A

Primary Sjogren’s – where the condition occurs in isolation

Secondary Sjogren’s – where it occurs due to other disease such as SLE and rheumatoid arthritis

101
Q

Anti-Ro and Anti-La are associated with which condition?

A

= Sjögren’s syndrome

102
Q

Sjögren’s syndrome: Describe the Schirmer Test

A

= involves inserting folded filter paper under the lower eyelid with the end hanging out. Moisture from the eye will travel by diffusion along the filter paper

After 5 minutes, the distance that the moisture travels along the filter paper is measured

In a healthy young adult, 15mm is expected. Less than 10mm is significant

103
Q

What is Pilocarpine used for?

A

= stimulates muscarinic, stimulating the parasympathetic nerves and promoting salivary and lacrimal gland secretion - used in Sjögren’s syndrome

104
Q

Treatment options in Sjögren’s syndrome (5)

A

Artificial tears (e.g., polyvinyl alcohol eye drops during the day and carbomer gel at night)

Artificial saliva

Vaginal lubricants

Pilocarpine (oral) – can be used to stimulate tear and saliva production

Hydroxychloroquine may be considered, mainly in patients with associated joint pain

105
Q

What is Behçet’s disease? and what are the main features?

A

= complex inflammatory condition affecting blood vessels + tissues

Main features: recurrent oral + genital ulcers

106
Q

What is vasculitis?

A

= inflammation of the blood vessels

107
Q

Which of the following are ANCA positive? (3)

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • takayasu’s arteritis
A
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
108
Q

Which of the following types of vasculitis was previously known as Wegener’s granulomatosis?

  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
A
  • Granulomatosis with polyangiitis
109
Q

Which of the following types of vasculitis was previously known as Churg-Strauss Syndrome?

  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
A
  • Eosinophilic granulomatosis with polyangiitis
110
Q

Which of the following types of vasculitis is an IgA vasculitis?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Henoch-Schoenlein Purpura
111
Q

Which of the following types of vasculitis’ main feature is renal failure caused by glomerulonephritis?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Microscopic polyangiitis
112
Q

Which of the following types of vasculitis is associated with a ‘saddle-shaped nose’ due to nasal bridge collapse?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Granulomatosis with polyangiitis
113
Q

Which of the following types of vasculitis typically presents with severe asthma in middle aged patients?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Eosinophilic granulomatosis with polyangiitis
114
Q

Which of the following types of vasculitis typically presents in children under 5, with widespread erythematous maculopapular rash, skin peeling on palms + soles, conjunctivitis + strawberry tongue?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Kawasaki disease
115
Q

Which of the following types of vasculitis is a large vessel vasculitis, which mainly affects the aorta and it’s branches. Can also lead to ‘pulseless disease’ due to reduction in pulse due to stenosis or occlusion of vessels?

  • Henoch-Schoenlein Purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Eosinophilic granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Kawasaki disease
  • Giant cell arteritis
  • Takayasu’s arteritis
A
  • Takayasu’s arteritis
116
Q

What is Ehlers-Danlos Syndrome?

A

= group of genetic conditions involves defects in collagen, causing hypermobility in the joints and abnormalities in the connective tissue of the skin, bones, blood vessels and organs

117
Q

Which of the following types of EDS, is most common and the least severe type?

  • hypermobile EDS
  • classical EDS
  • vascular EDS
  • kyphoscoliotic EDS
A
  • hypermobile EDS
118
Q

Which of the following types of EDS, presents with stretchy skin and serve joint hyper-mobility?

  • hypermobile EDS
  • classical EDS
  • vascular EDS
  • kyphoscoliotic EDS
A
  • classical EDS
119
Q

Which of the following types of EDS, presents with translucent skin and blood vessel rupture?

  • hypermobile EDS
  • classical EDS
  • vascular EDS
  • kyphoscoliotic EDS
A
  • vascular EDS
120
Q

What is the Beighton Score used for?

A

= used to assess for hypermobility and support the diagnosis of Ehlers-Danlos Syndrome

121
Q

What scores you points on the Beighton Score used to assist diagnosis of Ehlers-Danlos Syndrome? (5)

A
  • place palms flat on floor with straight legs
  • hyperextend elbows
  • hyperextend knees
  • bend thumb to touch forearm
  • hyperextend little finger past 90 degrees
122
Q

True or false: postural orthostatic tachycardia (POTS) can occur with hyper mobile Ehlers-Danlos Syndrome?

A

= true

123
Q

What is gout?

A

= a type of crystal arthropathy associated with chronically high blood uric acid levels, rate crystals deposited in joint, causing it to become inflamed

124
Q

What are gouty tophi?

A

= subcutaneous uric acid deposits (typically seen on the hands, elbows and ears)

125
Q

Critical differential diagnosis essential to exclude in patient with suspected gout or pseudogout?

A

= septic arthritis

126
Q

Most affected joints by gout? (2)

A
  • metatarsophalangeal joint (base of big toe)
  • carpometacarpal joint (base of thumb)
127
Q

Which of the following on crystals on joint fluid aspiration indicates gout?

  • rhomboid-shaped and positively birefringent
  • needle-shaped and negatively birefringent
A
  • needle-shaped and negatively birefringent
128
Q

First-line pharmacological treatment option for acute flare of gout?

A

= NSAIDs (e.g., Naproxen) with PPI for gastro-protection

129
Q

Second-line pharmacological treatment option for acute flare of gout?

A

= Colchicine

130
Q

What is used for prophylaxis of gout?

A

= Allopurinol

(xanthine oxidase inhibitors)

131
Q

Lifestyle changes to reduce your risk of gout? (4)

A
  • lose weight
  • stay hydrated
  • minimise consumption of alcohol
  • avoid purine-based foods (e.g., meat + seafood)
132
Q

Is prophylaxis for gout continued during an acute attack?

A

= yes

133
Q

What is pseudogout?

A

= crystal arthropathy caused by calcium pyrophosphate crystals collecting in the joints

134
Q

What is calcium pyrophosphate deposition disease (CPPD) also known as?

A

= pseudogout

135
Q

Which joints are typically affected by pseudogout? (4)

A
  • knees
  • shoulders
  • hips
  • wrists
136
Q

What investigation is used to confirm diagnosis of pseudogout?

A

= joint aspiration

137
Q

Which of the following on crystals on joint fluid aspiration indicates pseudogout?

  • rhomboid-shaped and positively birefringent
  • needle-shaped and negatively birefringent
A
  • rhomboid-shaped and positively birefringent

(calcium pyrophosphate crystals)

138
Q

Chondrocalcinosis is a classic x-ray change in which condition?

A

= pseudogout

139
Q

Typical acute presentation of pseudogout? (age)

A

= over 65 years old

140
Q

First-line treatment option for pseudogout?

A

=NSAID (e.g., Naproxen), with PPI for gastroprotection

141
Q

Second-line treatment option for pseudogout?

A

= Colchicine

142
Q

How long do symptoms need to be present to diagnose Chronic Fatigue Syndrome?

A

= 3 months

143
Q

Which type of murmur is associated with Ehlers-Danlos?

A

= aortic regurgitation

144
Q

What can be prescribed alongside Methotrexate to avoid bone marrow suppression?

A

= folate

145
Q
A

Year 4 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions