Rheumatology Flashcards
What are the features of Henoch-Schonlein purpura?
IgA mediated small vessel vasculitis, seen in children following an infection.
palpable purpuric rash over buttocks and extensor surfaces of arms and legs, abdo pain, polyarthritis, features IgA nephropathy
What should be monitored in patients with henoch-schonlein purpura?
Blood pressure and urinalysis to detect progressive renal involvement
How do you manage bone protection in patients starting long-term steroids?
start immediate protection: oral alendronate + calcium and vitamin D repletion
What are the crystals in psuedogout?
calcium pyrophosphate dihydrate
positively bifringent rhomboids
What is the management of rheumatoid arthritis?
DMARD - weekly methotrexate
with short course of prednisolone
Which antibody test is most specific for SLE?
Anti-double stranded DNA
Which antibodies are present in anti-phospholipid syndrome?
anticardiolipin antibodies
What is the management of anti-phospholipid syndrome?
Low-dose aspirin
if thromboembolic event: lifelong warfarin with target INR 2-3
What are the features of polymyalgia rheumatica?
Older patient, onset 1 month. morning stiffness in proximal muscles. polyarthralgia, lethargy, depression, fever, anorexia, night sweats
What are the features of Still’s disease?
Arthralgia, elevated ferritin, salmon pink rash, swinging pyrexia, lymphadenopathy
What is the management of Still’s disease?
1st line: NSAIDs
If not working give steroids
What are the presenting symptoms of polymyositis?
proximal muscle weakness, tenderness, raynauds, respiratory muscle weakness, interstitial lung disease, difficulty swallowing and speaking
Polymyalgia rheumatica is associated with which gene?
HLA-DR4, associated with parvovirus or adenovirus
What are the features of polymyalgia rheumatica?
Painful tendons and joints, usually affects large joints. Pain and stiffness of shoulder/hip, worse in morning and night, better with activity. Can become bilateral after a few weeks. Autoimmune. Fever, weight loss, older women.
Polymyalgia rheumatica is associated with which other rheum condition?
Giant cell arteritis
What is the management of polymyalgia rheumatica?
Low dose corticosteroids - prednisolone
How can you differentiate polymyalgia rheumatica from polymyositis?
normal creatinine kinase in polymyalgia rheumatica
Chlamydia causes what type of arthritis?
reactive (gonorrhoea causes septic)
What are the blood results in osteoporosis?
Normal
Which antibodies are most sensitive for SLE and which are more specific?
Sensitive - ANA
Specific - Anti-DSDNA
