Rheumatology Flashcards
What do you use for bone protection for a patient on long-term steroids?
In over 65s:
Oral alendronate
Ensure calcium and vitamin D replete
What would you expect from bone profile in Paget’s disease?
High ALP
Normal Calcium
Normal Phosphate
What does CREST stand for? (limited cutaneous systemic sclerosis)
Calcinosis
Raynaud’s
E- oesophageal dysmotility
Sclerodactyly
Telangiectasias
What antibodies are associated with limited cutaneous systemic sclerosis?
Anti-centromere
NOTE:
ANA positive in 90%
RF positive in 30%
What antibodies are associated with diffuse cutaneous systemic sclerosis?
anti scl-70
NOTE:
ANA positive in 90%
RF positive in 30%
What are the possible complications of diffuse cutaneous systemic sclerosis?
More commonly (80%)
1) interstitial lung disease (ILD)
2) pulmonary arterial hypertension (PAH)
Also:
renal disease
hypertension
What would coag look like in Antiphospholipid syndrome?
Prolonged APTT
Low platelets
Which antibody has the highest specificity for Rheumatoid arthritis?
Anti-CCP
What are the antibodies for SLE?
99% ANA posiive
anti-dsDNA highly specific\anti-Smith highly specific
What is an early X-Ray feature of Rheumatoid arthritis?
Juxta-articular osteoporosis/osteopenia
What is the treatment of Raynaud’s?
Nifedipine
T scores from Dexa scans and the appropriate management?
> 0: reassure
0 and -1.5: Repeat bone density scan in 1-3 years
<-1.5: Offer bone protection
What is the management of reactive arthritis?
symptomatic: NSAIDs, intrarticular steroids
occasionally if persistent: sulfasalazine and methotrexate
What is the treatment of ankylosing spondylitis?
NSAIDs
Also exercise encouraged
What antibodies are associated with drug-induced lupus?
Antihistone
What is the management of PMR?
Prednisolone 15mg OD
What are the X-Ray findings in pseudogout?
chondrocalcinosis
- in the knee this can be seen as linear calcifications of the meniscus and articular cartilage
What X-Ray findings are associated with rheumatoid arthritis?
peri-articular erosions
What are the ankylosing spondylitis associated features?
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
What antibody is associated with dermatomyositis?
Anti-Jo-1
What are some causes of drug-induced lupus?
Most common causes:
procainamide
hydralazine
Less common causes:
isoniazid
minocycline
phenytoin
What are the prominent features of lateral epicondylitis?
- pain and tenderness localised to the lateral epicondyle
- pain worse on wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended
What is the treatment of osteomalacia?
Vitamin D supplementation
Calcium supplementation
What is the treatment for Paget’s disease of the bone?
Bisphosphonate
