Rheumatology Flashcards
Treatment for suspected vision loss secondary to temporal arteritis?
IV Methylprednisalone
Weakness in polymyalgia rheumatica?
No true weakness of limb girdles, any weakness due to pain inhibition
Treatment for mod/severe psoriatic arthropathy?
Methotrexate
Manifestation of Wegner’s granulomatosis?
Renal impairment
Resp, systemic and ENT symptoms
Fundoscopy finding with Temporal Arteritis?
Swollen pale disc with blurred margins
Treatment of choice for SLE?
Hydroxychloroquine
X-ray findings in AnkSpond?
Subchondral erosions
Sclerosis
Squaring of lumbar vertebrae
Methotrexate and what AB = BAD and what happens when that is mixed?
C0-trimoxazole
May caus ebone suppression and severe pancytopenia
What must you do before starting someone on a biologic?
Chest x-ray to check for TB
What must be performed on all ptnts with sus RA?
X-ray of hands
Patient on paracetamol with thumb/knee arthritis. What do you next give them if that’s not effective?
Topical NSAIDs
Osteopenia detected in one site means what generally?
Generalised osteopenia, systemic process and cannot be localised
Table of blood levels for osteoporosis, osteomalacia, Primary hyperparathyroidism, CKD, and Paget’s?
-Calcium
-Phosphate
-ALP
-PTH
What does the Z score from DEXA scan incooporate?
Age
Gender
Ethnic factors
1st line treatment for SLE?
Hydroxychlorquinine
Primary Sogren’s Auto-AB?
Anti-Ro
What are you more at risk of if you have Sjogren’s?
Lymphoma (Lymphoid malignancies)
TNF-alpha inhibitors may have what effect on person’s immune system?
Reactivate TB
When starting a patient on allopurinol what do you also start?
Colchicine for 6 months
Treatment for patients with Anti-phospholipid syndrome who haven’t had a thrombosis?
Low-dose aspirin
WHat finding best supports diagnosis of ankspon?
Pelvic x-ray showing sacro-iliitis
WHta can cause drug-induced lupus (spoilers probably a type of drug?)
Isoniazid
Monitoring for patients on methotrexate?
FBC
U&Es
LFTs
Every 3 months
Out of these drugs which is safe for an SLE patient to take in pregnancy?
-Cyclophosphamide
-Azathioprine
-Methotrexate
-Mycophenolate
-Rituximab
Treatment options of SLE in pregnancy?
Azathioprine
Hydroxychloroquine
Steroids
Reactive arthritis treatment?
NSAIDs
Treatment of newly diagnosed RA NICE Guidelines?
Start ASAP with methotrexate (or sulfasalazine or leflunomide)
and
Oral steroids
Reactive arthritis comes on in what time frame following infection?
1-4 weeks
Biochemical picture of Paget’s?
Normal Ca, Ph, Vit D
Raised ALP
What do you give a patient who is osteoporotic and has normal levels calcium and vitamin D?
Just alendronate, no need to supplement what they have
What levels monitor an SLE flare?
Complement levels (C3,4)
They are usually low during active disease
Inflammatory arthritis involving DIPs and dactylitis points to what diagnsois?
Psoriatic arthritis
Biochem of osteogenesis imperfecta?
Normal ca, PTH, ALP and PO4
AnkSpond features + the way of remembering them?
THE A’S
-Apical fibrosis
-Anterior uveitis
-Aortic regurgitation
-Achilles tendonitis
-AV node block
-Amyloidosis
Septic arthritis most common organism?
Staph A
What should you always consider and rule out in diagnoses of dermatomyositis?
Internal malignancy
Namely:
-Breast
-Lung
-Ovarian
-GI
YA with septic arthritis…causative organism?
Neisseria Gonorrhoea
