Rheumatology Flashcards
What is classically impaired in adhesive capsulitis (frozen shoulder)? Which patient population is more likely to get this?
Pain upon external rotation both on active and passive movement
Diabetes is major RF - 20% of diabetics develop this
Drug causes of gout?
diuretics: thiazides, furosemide
ciclosporin
alcohol
cytotoxic agents
pyrazinamide
aspirin
RFs for avascular necrosis of hip?
long-term steroid use
chemotherapy
alcohol excess
trauma
Differences between limited cutaneous systemic sclerosis and diffuse cutaneous systemic sclerosis?
Limited:
- Mainly affected proximal limbs + face
- Anti-centromere antibodies
Diffuse:
- Mainly affects trunk + proximal limbs
- Anti Scl-70 antibodies (higher risk of severe interstitial lung disease)
Features of systemic sclerosis? (scleroderma, limited cutaneous systemic sclerosis and diffuse cutaneous systemic sclerosis)
Condition of unknown aetiology characterised by hardened, sclerotic skin and other connective tissues.
It is four times more common in females
Main cause of death in diffuse cutaneous systemic sclerosis?
Respiratory involvement seen in 80% - ILD and PAH
other complications include renal disease (start on ACEi) and HTN
Examples of TNF-inhibitors?
Etanercept
Infliximab
Adalimumab
Inhertiance of Familial Mediterranean Fever?
Autosomal recessive
Features of familial mediterranean fever? mx?
Reoccurring episodes of abdo pain, fever, arthralgia and chest pain
Colchicine can help
DMARD safe in pregnancy and breastfeeding?
Sulfasalazine
Adverse effects of Sulfasalazine?
Oligospermia
SJS
Pneumonitis / lung fibrosis
Myelosuppression
May colour tears / contact lenses
Reactive arthritis features?
classic triad of urethritis, conjunctivitis and arthritis
(can’t see, pee or climb a tree)
Defined as arthritis develops following infection where organism can’t be recovered from joint
Features of osteomalacia?
Bone pain, tenderness and proximal myopathy (-> ?waddling gait)
Which individuals are susceptible to azathiopurine? Safe in pregnancy?
TPMT deficient people
Safe in pregnancy
Behcets triad?
oral ulcers, genital ulcers and anterior uveitis (HLA B51)
Also get thrombophelbitis and DVTs +
arthritis
neurological involvement (e.g. aseptic meningitis)
GI: abdo pain, diarrhoea, colitis
erythema nodosum
Behcets epidemiology?
Eastern mediterraneans
Men»_space; with more severe disease
Young adults 20-40y
30% have FHx
What is deposited in pseudogout?
calcium pyrophosphate dihydrate (CPPD) crystals
RFs for pseudogout?
Increasing age (main)
If younger:
Haemochromatosis
Wilsons
Hyperparathyroidism
low Mg, low PO4
acromegaly
Inflammatory arthritis involving DIP swelling + dactylitis (finger/toe swelling looks like sausages)-> ????
Psoriatic arthritis
Can also cause spinal stiffness and reduced cervical spine mobility
Type of collagen in osteogenesis imperfecta?
Type 1 collagen
What are Heberden’s nodes and Bouchard’s nodes? Which disease are they found in?
Heberdens node (painless bony swelling at DIP)
Bouchards node (painless bony swelling at PIP)
Found in OA due to osteophyte formation
Think about which letter is proximal / distal in alphabet
When to be careful giving sulfasalazine to patients?
If they have G6PD deficiency (Tito)
Allergy to aspirin / sulphonamides due to cross reactivity
What are the issues for SLE and pregnancy?
Risk of maternal autoantibodies crossing placenta -> neonatal lupus erythematosus
Complications inc. congenital heart block (associated strongly with anti-Ro ab) - Ro block!
Anti-ribonuclear protein (anti-RNP) is found in which disease? How do they present?
Mixed connective tissue disease
Present with:
- Raynauds before most sx (90%)
- Polyarthralgia / arthritis
- Myalgia + Dactylitis
M:F - 1:3
30-40y avg age