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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)

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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
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3
Q

In which joints do Heberden’s nodes form?

  • DIP joints
  • PIP joints
  • MCP joints
A
  • DIP joints
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4
Q

In which joints do Bouchard’s nodes form?

  • DIP joints
  • PIP joints
  • MCP joints
A
  • PIP joints
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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
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6
Q

Management options for osteoarthritis (5)

A
  • patient education
  • physiotherapy
  • stepwise analgesia to control symptoms
  • intra-articular steroid injections
  • joint replacement
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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)

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8
Q

What is capsaicin? and what is it used for?

A

= chilli pepper extract,

in osteoarthritis

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9
Q

Which joints are most typically affected by rheumatoid arthritis?

  • DIP joints
  • PIP + MCP joints
A
  • PIP + MCP joints
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10
Q

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

A

= osteosclerosis associated with secondary hyperparathyroidism of chronic renal failure

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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
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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
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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
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14
Q

What is osteoporosis?

A

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

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15
Q

Effect of oestrogen on bones?

A

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

(protective against osteoporosis)

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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

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17
Q

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

  • Z-score
  • T-score
A
  • T-score
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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

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19
Q

First-line pharmacological treatment for osteoporosis?

A

= Bisphosphonates

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20
Q

Side effects of Bisphophonates (3)

A
  • reflux + oesophageal erosions
  • atypical fractures
  • osteonecrosis: of jaw + external auditory canal
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21
Q

Alendronate, Risedronate + Zoledronic acid are all examples of?

A

= Bisphosphonates

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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

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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

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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)

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24
Q

What is rheumatoid arthritis?

A

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

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25
Q

Does rheumatoid tend to be symmetrical or symmetrical?

A

= symmetrical

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26
Q

Is rheumatoid arthritis more common in men or women?

A

= women

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27
Q

Genetic associations with rheumatoid arthritis (2)

A
  • HLA DR4
  • HLA DR1
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28
Q

Antibodies which can be measured if rheumatoid arthritis is suspected?

A
  • rheumatoid factor (RF)
  • anti-CCP antibodies
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29
Q

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

  • rheumatoid factor
  • anti-CCP antibodies
A
  • anti-CCP antibodies
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30
Q

Systemic features associated with rheumatoid arthritis? (4)

A
  • fatigue
  • weight loss
  • flu-like weakness
  • muscle aches + weakness
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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

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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)

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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)
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33
Q

What is psoriatic arthritis?

A

= inflammatory arthritis associated with psoriasis

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34
Q

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

A
  • uveitis
  • IBD
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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

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36
Q

What is PEST?

A

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

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37
Q

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

A

= psoriatic arthritis, particular association with arthritis mutilans

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38
Q

Classic triad of reactive arthritis

A
  • conjunctivitis
  • urethritis
  • arthritis

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

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39
Q

Important differential to exclude in patient with reactive arthritis

A

= septic arthritis

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40
Q

What is reactive arthritis?

A

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

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41
Q

Common triggers of reactive arthritis (2)

A
  • gastroenteritis
  • sexually transmitted infection
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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)

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43
Q

Investigation for reactive arthritis

A

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

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44
Q

What is ankylosing spondylitis?

A

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

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45
Q

Which gene is strongly associated with ankylosing spondylitis?

A

= HLA-B27 gene

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46
Q

Is ankylosing spondylitis more common in men or women?

A

= men

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47
Q

In ankylosing spondylitis does the pain

  • improve with rest
  • improve with activity
A
  • improve with activity
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48
Q

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

A

= vertebrae column joints + sacroiliac joints

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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
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50
Q

What is Schober’s Test used for?

A

= assess spinal mobility

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51
Q

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

A

= ankylosing spondylitis

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52
Q

First-line pharmacological management for ankylosing spondylitis?

A

= NSAIDs

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53
Q

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

A

= systemic lupus erythematosus (SLE)

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54
Q

What is Systemic Lupus Erythematosus (SLE)?

A

= inflammatory autoimmune connective tissue disorder

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55
Q

Is SLE more common in men or women?

A

= women

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56
Q

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

A

= Systemic Lupus Erythematosus (SLE)

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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
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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?

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?

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?

Year 4 (11 decks)

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