Brainscape's Knowledge GenomeTM

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


See full index

Finals Flash Cards 🩺 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What joints are most commonly involved in Rheumatoid Arthritis

A

MCP, PIP joints

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

What joints are most commonly involved in Osteoarthritis?

A

Large weight-bearing joints (hip, knee)
Carometacarpal joints
DIP, PIP joints

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

What is the typical history for Osteoarthritis?

A

Pain following use, improves with rest
Unilateral symptoms
No systemic upset

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

What is the typical history for Rheumatoid Arthritis?

A

Morning stiffness, improves with use
Bilateral symptoms
Systemic upset

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

X Ray findings of Osteoarthritis?

A

Loss of joint space
Subchondral sclerosis
Subchondral cysts
Osteophytes forming at joint margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

X-Ray findings of Rheumatoid arthritis?

A

Loss of joint space
Juxta-articular osteoporosis
Soft tissue swelling
Periarticular erosions
Subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the mechanism of action of bisphosphonates?

A

Pyrophosphate analog which inhibits osteoclast activity

OSCE - a group of drugs used to treat thinning bones, allowing the bones to gain strength over time and ultimately reducing the risk of future fractures.“

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

How long does it take for bisphosphonates to have an effect?

A

6 Months

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

Which antibody is most associated with Sjogren’s syndrome?

A

ANA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some predisposing factors to Paget’s disease of the bone?

A

Increasing age
Male sex
Northern Latitude
Family History

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

What are the clinical features of Paget’s disease of the bone?

A

Only 5% of patients are symptomatic
- The stereotypical presentation is an older male with bone pain and an isolated raised ALP
- Bone pain (e.g. pelvis, lumbar spine, femur)
- Classical untreated features: bowing of tibia, bossing of the skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is osteomalacia?

A

Describes softening of the bones secondary to low vitamin D levels that in turn lead to decreased bone mineral content.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is HLA-A3 associated with?

A

Haemachromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is HLA-B51 associated with?

A

Behcet’s disease

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

What is HLA-B27 associated with?

A

Ankylosing spondylitis
Reactive arthritis
Acute anterior uveitis
Psoriatic arthritis

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

What is HLA-DQ2/DQ8 associated with?

A

Coeliac diseaseW

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

What is HLA-DR2 associated with?

A

Narcolepsy
Goodpastures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is HLA-DR3 associated with?

A

Dermatitis herpetiformis
Sjogren’s syndrome
Primary biliary cirrhosis

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

What is HLA-DR4 associated with

A

Type 1 diabetes mellitus*
Rheumatoid arthritis - in particular the DRB1 gene (DRB104:01 and DRB104:04 hence the association with DR4)

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

Risk factors for Pseudogout?

A

Pseudogout is strongly associated with increasing age. Patients who develop pseudogout at a younger age (e.g. < 60 years) usually have some underlying risk factor, such as:
haemochromatosis
hyperparathyroidism
low magnesium, low phosphate
acromegaly, Wilson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Examples of Large vessel vasculitis

A
  • Temporal arteritis
  • Takayasu’s arteritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Examples of medium vessel vasculitis

A

Polyarteritis nodosa
Kawasaki disease

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

Examples of small vessel ANCA associated vasculitides

A

Wegener’s granulomatosis
Churg-Strauss syndrome
Microscopic polyangiitis

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

Examples of small vessel immune complex small-vessel vasculitis

A

Henoch-Schonlein purpura
Goodpasture’s syndrome
Cryoglobulinaemic vasculitis
Hypocomplementemic urticarial vasculitis

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

What is the initial medical management of giant cell arteritis with no visual symptoms or jaw claudication?

A

40-60mg oral prednisolone daily

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

What are the characteristic presenting features of Behçet’s disease?

A

Recurrent oral ulcers
Genital ulcers

Also: Uveitis, Erythema nodosum, Vasculitis, Acneiform lesions
- Superficial thrombophlebitis

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

What characteristic spinal x-ray appearance is seen in the later stages of ankylosing spondylitis?

A

A “bamboo spine” with fusion of the sacroiliac and spinal joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What conditions belong to the seronegative spondyloarthropathy group?

A
  • Psoriatic arthritis
  • Reactive arthritis
  • Ankylosing spondylitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the key blood test finding in patients with Paget’s disease of bone?

A

Raised ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the classic x-ray finding in pseudogout?

A

Chondrocalcinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What name is given to osteoarthritic bony lumps in the distal interphalangeal joints?

What about similar lumps in the proximal interphalangeal joints?

A

Heberden’s nodes
Bouchard’s nodes

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

What pathology in the cervical spine can cause spinal cord compression in patients with rheumatoid arthritis?

A

Atlantoaxial subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What risks are associated with not following the specific procedure when taking oral bisphosphonates?

A

Reflux
Oesophageal erosions

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

Why is irreversible blindness in one eye a potential complication in Giant Cell arteritis?

A

The Temporal Artery supplies the Ophthalmic artery

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

How is swan neck in a rheumatoid hand formed?

A

Swan-neck is due to the rupture of the lateral slips and so, the PIPJ hyper-extends

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

What are the most commonly affected bones in Paget’s disease?

A

The most commonly affected bones are the pelvis, vertebrae, skull, femur and tibia.

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

What is the typical fracture caused by Paget’s disease?

A

Transverse fracture, perpendicular to the cortex

38
Q

What is the rare malignant complication of Paget’s disease?

A

Osteosarcoma

39
Q

What is the pathophysiology of Paget’s disease?

A

In Paget’s disease there is increased osteoclast activity at first and followed by increased osteoblast activity resulting in disorganised bone breakdown and formation.

40
Q

What is Behcets disease?

A

A rare multi-organ disease caused by a systemic vasculitis. The cause is unknown

41
Q

How do you Diagnose Behcets disease?

A
  • There is no specific test more done to rule out other causes
  • RF
  • ANA
  • ANCA
  • HLAB51
42
Q

What is the classical triad of Adult Onset Stills Disease?

A
  • Arthritis
  • Spiking fevers
  • A fleeting maculopapular salmon-pink rash
43
Q

How do you manage mild Adult onset Stills disease?

A

NSAIDs and Aspirin

44
Q

What is ankylosing spondylitis?

A

It is a seronegative inflammatory arthritis affecting the axial skeleton

45
Q

What are the key clinical features of Ankylosing Spondylitis?

A
  • Inflammatory back pain
  • Enthesitis (Achilles Tendonitis, Plantar Fasciitis)
  • Peripheral arthritis may occur
46
Q

What are the extra-articular manifestations of Ankylosing Spondylitis?

A
  • Anterior Uveitis
  • Aortitis which can lead to aortic regurgitation
  • Upper lobe pulmonary fibrosis
  • IgA nephropathy
47
Q

What would you see on a PELVIC Xray in someone with ankylosing spondylitis?

A

Sacroilitis may be seen
In advanced disease there is Ankylosis or fusion of the joint

48
Q

What would you see on a LUMBAR X-Ray in Ankylosing Spondylitis?

A
  • The vertebral bodies may become ‘squared’
  • In later stages, bony bridges called syndesmophytes form between adjacent vertebrae and there is ossification of spinal ligaments
  • In late disease there may be complete fusion of the vertebral column which is known as bamboo spine
49
Q

What antibodies are associated with drug-induced SLE?

A

Anti-Histone

50
Q

What antibodies are associated with SLE?

A
  • Anti-dsDNA
  • Anti-SM
  • ANA
51
Q

What can you use for the long-term management of gout in patients that cannot tolerate Allopurinol?

A

Febuxostat

52
Q

What is Felty’s syndrome?

A

Rheumatoid arthritis + splenomegaly+Low white cell count

53
Q

What is Dermatomyositis?

A

An inflammatory disorder causing symmetrical, proximal muscle weakness and characteristic skin lesions

54
Q

What are the causes of dermatomyositis?

A

Idiopathic
Associated with connective tissue disorders
Underlying malignancy (Ovarian, breast and lung cancer)
SCREEN FOR MALIGNANCY IF NEW DIAGNOSIS OF DERMATOMYOSITIS

55
Q

What are the signs of dermatomyositis?

A
  • Photosensitive
  • Macular rash over back and shoulder
  • Heliotrope rash in the periorbital region
  • Gottron’s papule - roughened red papules over extensor surfaces of fingers
56
Q

What are some commonly associated conditions with pseudogout?

A
  • Haemochromatosis
  • Hyperparathyroidism
  • Low magnesium, low phosphate
  • Acromegaly
  • Wilsons disease
57
Q

What features might you see in a patient with Marfans Syndrome?

A
  • Tall stature
  • High-arched palate
  • Arachnodactyly
  • Pectus Excavatum
  • Pes planus
  • scoliosis
58
Q

What is the antibody test for anti-phospholipid syndrome?

A

Anti-cardiolipin antibodies

Can also do Anti-Beta2 glycoprotein I or lupus anticoagulant

59
Q

What are the XRay findings in Psoriatic arthritis?

A
  • Often have the unusual combination of coexistence of erosice changes and new bone formation
  • Periostitis
  • ‘Pencil-in-cup’ appearance
60
Q

What can be used to manage acute flares of rheumatoid arthritis?

A

Methylprednisolone IM

61
Q

What points should you mention when counselling someone starting methotrexate about side effects?

A
  • Oesophageal irritation
  • Abdominal pain/nausea/GI upset
  • Joint and muscle pain
  • Osteonecrosis of the jaw
62
Q

What are some common drugs implicated in drug induced lupus?

A

Isoniazid, procainamide, hydralazine, minocycline and phenytoin

63
Q

What can help distinguish gout from pseudogout?

A

Chondrocalcinosis

64
Q

What is a useful rule out test in SLE?

A

ANA

65
Q

Which autoantibody is most associated with Primary Sjogren’s syndrome?

A

Anti-Ro

66
Q

What is the most common joint for septic arthritis?

A

Knees

67
Q

What are the risk factors for pseudogout?

A
  • Haemochromatosis
  • Hyperparathyroidism
  • Low magnesium, low phosphate
  • Acromegaly, Wilson’s disease
68
Q

What is osteogenesis imperfecta?

A

A group of disorders of collagen metabolism resulting in bone fragility and fractures.

69
Q

What is the inheritance of osteogenesis imperfecta?

A
  • Autosomal dominant
    Abnormality in type 1 collagen due to decreased synthesis of pro-alpha 1 or pro-alpha 2 collagen polypeptides
70
Q

What are the features of osteogenesis imperfecta?

A
  • Presents in childhood
  • Fractures following minor trauma
  • Blue Sclera
  • Deafness secondary to otosclerosis
  • Dental imperfections are common
71
Q

What are the features of osteomalacia?

A
  • Bone pain
  • Bone/muscle tenderness
  • Fractures: especially femoral neck
  • Proximal myopathy: may lead to waddling gait
72
Q

What is the first line drug for management of Raynaud’s phenomenon?

A

Calcium channel blockers e.g., nifedipine

73
Q

What should you warn a patient about when starting hydroxychloroquine?

A

Bull’s eye retinopathy

74
Q

What blood results would you expect in osteomalacia?

A

Low serum calcium, low serum phosphate, raised ALP and raised PTH

75
Q

What should be ruled out before starting Azathioprine?

A

Thiopurine methyltransferase deficiency

76
Q

What are the four seronegative spondyloarthropathies?

A
  • Ankylosing spondylitis
  • Reactive Arthritis
  • Psoriatic Arthitis
  • IBD associated Arthritis
77
Q

What crystals would you see in gout?

A

Monosodium urate

78
Q

What crystals would you see in pseudogout?

A

Calcium pyrophosphate

79
Q

What signs signs might you see in Rheumatoid Arthitis?

A

Ulnar deviation of MCP joints
Swan neck deformity
Boutonniere deformity
Z shape deformity of thumbs
MCP joint swelling
MCP joint subluxation
Muscle wasting
Ulnar deviation
Joint swelling

80
Q

What is Sarcoidosis?

A

A chronic graulomatous disorder. Granulomas are inflammatory nodules full of macrophages.

81
Q

What is Lofgren’s syndrome

A

Lofgren’s syndrome refers to a specific presentation of sarcoidosis with a classic triad of symptoms:

  • Erythema nodosum
  • Bilateral hilar lymphadenopathy
  • Polyarthralgia (joint pain in multiple joints)
82
Q

What blood tests should you do for Sarcoidosis?

A
  • Raised Angiotensin-converting enzyme (ACE)
  • Raised Calcium (Hypercalcaemia)
83
Q

What is the management of Sarcoidosis?

A

Conservative management
Oral steroids (for 6-24 months) are usually first-line where treatment is required
- Bisphosphonates to protect against osteoporosis
- Methotrexate

84
Q

What are the complications of Sarcoidosis?

A

Pulmonary fibrosis and pulmonary hypertension

85
Q

What is Osteomalacia?

A

Where defective bone mineralisation causes “Soft bones”

86
Q

What is Paget’s disease due to?

A

Excessive bone turnover due to increased osteoclast and osteoblast activity

87
Q

How might a person with Paget’s disease of the bone present?

A

Bone pain
Bone deformity
Fractures
Hearing lossW

88
Q

What is the main treatment of Paget’s disease of the Bone?

A

Bisphosphonates

89
Q

How should you monitor Paget’s disease?

A

Monitor the serum Alkaline phosphatase

90
Q

Indications for a Thoracotomy?

A

Indications for thoracotomy include loss of more than 1.5L blood initially or ongoing losses of >200ml per hour for >2 hours

Finals Flash Cards 🩺 (32 decks)

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