Rheumatology

Question 1

What HLA antigen is RA assoc with?

Answer 1

HLA-DRB1, HLA-DR4

Question 2

What respiratory complications can RA present with?

Answer 2

1. pulmonary fibrosis/nodules, pleural effusion
2. Caplan’s syndrome (fibrosis + nodules)
3. bronchiolitis obliterans

Question 3

What haem complications can RA present with?

Answer 3

1. lymphoma
2. Felty syndrome - neutropaenia, splenomegaly
3. anaemia of chronic disease

Question 4

X-ray findings in RA?

Answer 4

1. loss of joint space
2. juxta-articular osteopenia
3. soft tissue swelling
4. late signs - periarticular erosions, subluxation

Question 5

1st line management in RA?

Answer 5

DMARD (e.g. methotrexate) + bridging steroids

Question 6

HLA antigens assoc with SLE?

Answer 6

HLA-DR2, HLA-DR3, HLA-B8

Question 7

one highly sensitive, two high specific autoimmune antibodies in SLE?

Answer 7

highly sensitive: ANA
highly specific: anti-dsDNA, anti-Smith

Question 8

mainstay of SLE treatment?

Answer 8

hydroxychloroquine, steroids +/- other DMARDs e.g. mycophenilate, azathiorpine, methotrexate

Question 9

What autoimmune Ab and clinical problem is SLE in pregnancy/neonatal SLE assoc with?

Answer 9

autoimmune Ab: anti-Ro
clinical: congenital heart block

Question 10

treatment in discoid SLE?

Answer 10

steroid TOP, hydroxychloroquine

Question 11

What autoimmune Ab is particularly seen in drug-induced lupus?

Answer 11

anti-histone

Question 12

What is the most common and severe form of lupus nephritis?

Answer 12

Class IV-S: diffuse proliferative

Question 13

1st line treatment for lupus nephritis?

Answer 13

steroids + mycophenilate/cyclophosphamide

Question 14

4 X-ray findings in ankylosing spondylitis?

Answer 14

1. sacroilitis
2. squaring of lumbar vertebrae
3. syndesmophytes
4. bamboo spine

Question 15

3 cardio/pulmonary manifestations of AS?

Answer 15

1. AV regurgitation
2. AV block
3. apical pulmonary fibrosis