Brainscape's Knowledge GenomeTM

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


See full index

Orthopaedics > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What are classed as the seropositive arthritides?

A

Rheumatoid arthritis
SLE
Scleroderma
Vasculitis
Sjogren’s syndrome

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

What are classed as seronegative arthritides?

A

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis
IBD arthritis

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

What are the crystal-induced arthritides?

A

Gout
Pseudo-gout

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

What makes a condition seropositive?

A

When autoantibodies within the serum can be associated with disease presence.

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

Which antibody is associated with rheumatoid arthitis?

A

Anti-CCP

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

ANA, anti-dsDNA, anti-Sm, anti-Ro, and anti-RNP are all associated with which condition?

A

Systemic lupus erythematous

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

What antibodies are associated with Sjogren’s syndrome?

A

ANA
Anti-Ro
Anti-La

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

ANA, and anti-centromere antibody are associated with which condition?

A

LIMITED systemic sclerosis

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

Anti-Scl-70 is associated with which condition?

A

DIFFUSE systemic sclerosis

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

Which antibody is associated with myositis?

A

Anti-Jo-1

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

What antibodies are associated with anti-phospholipid syndrome?

A

Anti-cardolipin

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

What are features of inflammatory arthritis?

A

Joint pain with associated swelling
Morning stiffness (>30mins)
Improvement with exercise
Raised inflammatory markers
Extra-articular symptoms

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

Which is commonly positive in seronegative patients?

A

HLA-B27

Will be accompanied by raised CRP and ESR.

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

What is the most common form of arthritis?

A

Osteoarthritis

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

What x-ray findings may be observed in osteoarthritis?

A

Loss of joint space
Osteophytes
Sclerosis
Subchondral cysts

Think ‘LOSS’

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

How should osteoarthitis be treated?

A

Manage pain with analgesia
Give physiotherapy
Advise weight loss

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

What is the most prevalent seropositive inflammatory arthropathy?

A

Rheumatoid arthritis

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

How is rheumatoid arthritis treated?

A

Very aggressively - give a DMARD.

Methotrexate is first-line.

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

What is a side-effect of DMARD therapy?

A

Bone marrow suppression

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

If DMARDs are ineffective in rheumatoid arthritis, what may be used instead?

A

Biologics

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

What is a risk in those taking biologics?

A

Reactivation of latent TB

Perform a CXR prior to commencing therapy.

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

What scoring system is used to decide whether biologics are indicated in rheumatoid arthritis?

A

DAS28

Indicated if shown to have high disease activity.

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

What is ankylosing spondylitis?

A

A chronic inflammatory disease of the spine and sacro-iliac joints.

May lead to fusion of the intervertebral and sacro-iliac joints.

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

In which condition are 90% of patients HLA-B27 positive?

A

Ankylosing spondylitis

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

How may ankylosing spondylitis present on an X-ray?

A

Sclerosis and fusion of the SI joints and the formation of syndesmophytes (bony spurs) on the vertebral bodies.

Often dubbed a ‘bamboo spine’.

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

How is ankylosing spondylitis treated first-line?

A

Physiotherapy
Exercise therapy
NSAIDs

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

If first-line therapy is ineffective, what is indicated as second-line in ankylosing spondylitis?

A

Anti-TNF inhibitors

Important to note that DMARDs do not have any impact on spinal disease.

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

Can surgery be used in ankylosing spondylitis?

A

Only in those with hip/knee disease.

Surgery too risky on the spine to be a viable option.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How prevalent is psoriatic arthritis?

A

Occurs in 30% of patients with psoriasis.

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

How does psoriatic arthritis present?

A

Asymmetrical symptoms
Spondylitis
Dactylitis
Enthesitis

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

How is psoriatic arthritis treated?

A

DMARDs (usually give methotrexate)
If no response, give anti-TNF.

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

What is enteropathic arthritis?

A

An inflammatory arthritis involving the peripheral joints.

Tends to be asymmetrical.

Affects 10-20% of IBD patients.

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

What is reactive arthritis?

A

A form of arthritis that occurs n response to an infection - commonly of urinary/GI/sexual origin.

Presents with a triad of: uveitis/conjunctivitis, urethritis, and arthritis.

Think ‘can’t see, can’t pee, can’t climb a tree’.

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

How is reactive arthritis treated?

A

Treated underlying infection, and provide symptomatic relief (e.g. steroids).

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

How is SLE treated?

A

Manage the manifestations of the individual.

In skin disease/arthralgia give hydroxychloroquine, topical steroids or NSAIDs.

If organ involvement, or symptoms of inflammatory arthritis, give immunosuppression (e.g. azathioprine).

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

How is SLE monitored?

A

Continuously check anti-dsDNA and complement levels.

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

What is Sjogren’s syndrome?

A

An autoimmune disorder characterised by lymphocytic infiltration of the exocrine organs.

38
Q

How does Sjogren’s syndrome present?

A

Dryness of the eyes and mouth is most common.

May also have arthralgia, fatigue, vaginal dryness, and parotid gland swelling.

39
Q

How is Sjogren’s syndrome diagnosed?

A

Positive Schirmer’s test (identifies ocular dryness)
Presence of anti-La, and anti-Ro
Positive lip biopsy

40
Q

How is Sjogren’s syndrome treated?

A

Lubricating eye drops
Saliva replacement
Regular dental check ups (as increased risk of cavities)
Hydroxychloroquine

41
Q

Where is affected in limited systemic sclerosis?

A

Skin of the face, hands, forearms, and feet.

42
Q

What antibody is linked to limited systemic sclerosis?

A

Anti-centromere antibody

43
Q

How does ankylosing spondylitis impact the spine?

A

Loss of movement through decreased lumbar lordosis and increased thoracic kyphosis.

44
Q

What is Schober’s test?

A

A test used in the diagnosis of ankylosing spondylitis.

Involves measuring 5cm below the posterior superior iliac crests, and 10cm above, whilst patient is standing upright.

Upon bending forward, in normal movement, gap between should be >20cm.

45
Q

What conditions may occur alongside ankylosing spondylitis?

A

Anterior uveitis
Pulmonary fibrosis
Amyloidosis

46
Q

What is involved in diffuse systemic sclerosis?

A

Significant early progression to organ damage.

47
Q

Which antibody is linked to diffuse systemic sclerosis?

A

Anti-Scl-70 antibody development

48
Q

What antibody is linked to mixed connective tissue disease?

A

Anti-RNP

49
Q

What can be used to treat Raynaud’s phenomenon?

A

Calcium channel blockers

50
Q

What is antiphospholipid syndrome?

A

A disorder resulting in recurrent arterial/venous thrombosis/fetal loss.

51
Q

What condition may present alongside anti-phospholipid syndrome?

A

SLE

52
Q

How is anti-phospholipid syndrome treated in those with no previous thrombosis?

A

Low-dose aspirin

53
Q

If patient has suffered a VTE, how is antiphospholipid syndrome managed?

A

Lifelong warfarin therapy

54
Q

What is gout?

A

A crystal arthropathy caused by the deposition of urate crystals within a joint.

Results from hyperuricaemia.

55
Q

What form of crystals are involved in gout?

A

Urate

56
Q

What condition is associated with ‘pencil in cup’ appearance on X-ray, and ‘sausage fingers’?

A

Psoriatic arthritis

57
Q

Which rheumatological condition may produce a malar rash?

A

SLE

Finding is also associated with mitral stenosis.

58
Q

What is an important differential to exclude in gout?

A

Septic arthritis

Both present with an intensely painful, red, hot, swollen joint.

59
Q

How is gout diagnosed?

A

Sampling of the synovial fluid.

Will show negatively birefringent, needle-shaped uric acid crystals.

60
Q

How is an acute episode of gout treated?

A

Colchicine or NSAIDs are first-line.

Always give gastro-protection if giving NSAIDs.

61
Q

What medication may be used to prevent gout reoccurence?

A

Allopurinol

62
Q

What is pseudo-gout?

A

A form of acute arthritis caused by calcium pyrophosphate crystals.

63
Q

How does pseudo-gout present in the synovial fluid?

A

Weakly positive birefringent rhomboid-shaped crystals.

64
Q

How is an acute attack of pseudo-gout treated?

A

NSAIDs or steroids.

65
Q

What is polymyalgia rheumatica?

A

A common chronic inflammatory disease characterised by proximal myalgia of the hip and shoulder girdles.

66
Q

How does polymyalgia rheumatica present?

A

Proximal myalgia of the hip/shoulder girdles
Morning stiffness lasting less than 1 hour

67
Q

What condition is associated with polymyalgia rheumatica?

A

Giant cell arteritis

68
Q

How is polymyalgia rheumatica treated?

A

Low dose steroids (15mg prednisolone)

Take this daily and taper dose over 18 months.

69
Q

What is the most common form of systemic vasculitis?

A

Giant cell arteritis

70
Q

How is Giant cell arteritis investigated?

A

Inflammatory markers (e.g. ESR, CRP)
Temporal artery biopsy - definitive

Important to note that creatine kinase and EMG will be normal.

71
Q

What are symptoms of temporal arteritis?

A

Visual symptoms
Headache
Jaw claudication
Scalp tenderness
Fatigue
Malaise

72
Q

What is a potential complication of GCA?

A

Visual loss

73
Q

How is GCA treated?

A

High-dose corticosteroids (prednisolone)

If no visual involvement then 40mg, although if visual involvement is present then 60mg.

Lower dose over a 2-year period.

74
Q

What is polymyositis?

A

An idiopathic inflammatory myopathy causing symmetrical muscle weakness.

75
Q

What antibodies are specific to polymyositis?

A

anti-Jo-1
anti-SRP

76
Q

How can PMR and polymyositis be differentiated?

A

Polymyositis will have raised inflammatory markers AND elevated creatine kinase.

Polymyalgia rheumatica will have raised inflammatory markers ONLY.

77
Q

How is polymyositis diagnosed?

A

Inflammatory markers (elevated)
Creatine kinase level (elevated)
Abnormal EMG
Muscle biopsy

78
Q

How is polymyositis treated?

A

Prednisolone
Immunosuppression

79
Q

What is dermatomyositis?

A

A condition similar to polymyositis, although the skin is involved.

Associated with other connective tissue disorders, or underlying malignancy.

80
Q

What skin features are seen in dermatomyositis?

A

Heliotrope rash
V-shaped rash over the chest
Gottron’s papules

81
Q

What may cause dermatomyositis?

A

Idiopathic
Connective tissue disorders
Underlying malignancy

Due to risk, screen for malignancy at the time of diagnosis.

82
Q

What cancers are commonly linked to dermatomyositis?

A

Ovarian
Breast
Lung

83
Q

What is fibromyalgia?

A

An unexplained condition causing widespread muscle pain and fatigue.

Most commonly seen in middle-aged women.

84
Q

What is vasculitis?

A

Inflammation of the blood vessels, leading to the thickening, stenosis, occlusion and eventual ischaemia.

85
Q

What are the 2 main forms of large vessel vasculitis?

A

GCA
Takayasu arteritis

86
Q

How is large vessel classified?

A

Due to it predominately affecting the aorta and its major branches.

87
Q

In which age-group is GCA mostly seen?

A

Before 50 years of age.

88
Q

In which age-group is Takayasu arteritis mostly seen?

A

Under 50 years of age.

89
Q

How are forms of large-vessel vasculitis treated?

A

High-dose corticosteroids

90
Q

How can small vessel vasculitis be treated?

A

ANCA positive
ANCA negative

91
Q

What are examples of small vessel vasculitis?

A

GCA
Eosinophilic GPA
Microscopic polyangiitis
Henoch-Schonlein Purpura

92
Q
A

Orthopaedics (13 decks)

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