Rheumatology Flashcards
Poor prognostic factors for rheumatoid arthritis
R - Rheumatoid factor positive
H - HLA DR4
E - Early erosions on XR
U - Unstable (poor functional status)
M - Manifestations (extra-articular)
A - AntiCCP
T - Timing (insidious onset)
Limited cutaneous systemic sclerosis
Raynaud’s may be the first sign
Scleroderma affects face and distal limbs predominantly
Subtype is CREST syndrome:
- Calcinosis
- Raynaud’s
- oEsophageal dysmotility
- Sclerodactyly
- Telangectasia
Drugs that cause drug induced lupus
Procainamide
Hydralazine
Less common - isoniazid, minocycline, phenytoin
Drug induced lupus features
Arthralgia, myalgia, malar rash, pulmonary involvement
Less common - renal/nervous system involvement
Stops on cessation of drug
Investigation results for drug induced lupus
ANA positive
dsDNA negative
Anti-histone antibodies positive in 80-90%
Anti-Ro and anti-Smith only positive in around 5%
Side effects of methotrexate
Myelosuppression
Liver cirrhosis
Pneumonitis
Side effects of sulfasalazine
Rashes
Oligospermia
Heinz body anaemia
Interstitial lung disease
Side effects of leflunomide
Liver impairment
Interstitial lung disease
Hypertension
Side effects of hydroxychloroquine
Retinopathy
Corneal deposits
Side effects of prednisolone
Cushingoid features
Osteoporosis
Impaired glucose tolerance
Hypertension
Cataracts
Side effects of penicillamine
Proteinuria
Exacerbation of myasthenia gravis
Side effects of etanercept
Demyelination
Reactivation of tuberculosis
Side effects of infliximab and adalimumab
Reactivation of tuberculosis
Side effects of rituximab
Infusion reactions are common
Behcet’s syndrome
Vasculitis
Painful mouth sores, genital sores, eye inflammation
Increase risk of VTE
