Rheumatology Flashcards
Which drug has side effects of pneumonitis, liver cirrhosis and myelosupression?
Methotrexate
What are the common side effects of sulfasalazine?
Rashes
Low sperm count
Heinz body anaemia
ILD
Luflunomide can cause which side effects?
Liver impairment
ILD
Hypertension
Which common rheumatology drug has ocular side effects and what are they?
Retinopathy
Corneal deposits
Hydroxychloroquine
Which rheumatology drugs cause proteinuria?
Gold and penicillamine
Which common rheum drugs cause reactivation of TB?
TABs and etanercept
Which antibodies test for Sjogrens?
Anti Ro (70%)
Anti La (30%)
ANA (70%)
RF (50%)
Anti smooth muscle antibodies can be tested for in what
Autoimmune Hepatitis
Anti centromere antibodies can be a sign of what
CREST
Anti Sm are specific for what?
SLE
How does methotrexate work
Inhibits dihydrofolate reductase
How long after stopping MTX should women abstain from pregnancy?
6 months
How often are bloods done in relation to MTX treatment?
LFT, UEs, FBC before and weekly until stable
Then every 2-3 months
Which drugs should not be prescribed with MTX
aspirin
trimethoprim
co-trimoxazole
Which enzyme is required to metabolise azathioprine?
Thiopurine methyltransferase (TPMT)
How does azathioprine work?
Inhibits purine synthesis
Bone marrow depression
Pancreatitis
None melanoma skin cancer
N+V
Side effects of which drug
Azathiprine
Around 80% of patients with dermatomyositis are positive to which antibody?
ANA
Which antibiotics are used in the management of septic arthritis?
- Flucloxacillin. Clindamycin if penicillin allergic
What are the T score results and what do they mean
> 0 = reassure
0 - -1.5 = repeat DEXA 1-3 years
< -1.5 = offer bone protection with aledronate (bisphosophonate +/- calcium and vitamin D)
Antiphosopjholipd syndrome results in which blood results
Anti phosphospholipid positive (30%)
Thrombocytopenia
Extended APTT
Crsytals in pseudo gout show what?
Positive bifringence
In young patients with pseudogout, which other conditions might they have?
Haemochromatosis
Hyperparathyroidism
Low Mg
Low phos
Acromegaly
Wilsons DIsease
When should aledronate be started in patients without DEXA
> 75 with fragility fracture
What are the types of Hypersensitivity reactions?
1 = anaphylaxis
2 = antibody cell complex
3 = antibody antigen complex
4 = cell mediated
Which antibodies are associated with drug induced lupus?
Antihistone (80-90%)
ANA (100%)
Which common drugs can cause drug induced lupus?
Procainamide
Hydralazine
What are the blood results seen in Osteomalacia?
Low vit D, Ca, Phos
High ALP, High PTH
Why does Vit D/Ca correction need to be given to patients receiving bisphosphonates?
It can make hypocalcaemia worse
Which foods are high in purine?
Liver, kidneys, seafood, yeast
Which bones are most affected in Paget’s disease?
Skull, spine, pelvis, leg bones
What causes Paget’s
Uncontrolled bone turnover
What are the 6 As of Anky Spond
Apical fibrosis
Anterior uveitis
Aortic regurg
AV node block
Achilles tendonitis
Amyloidosis
Which X-Ray changes are seen in OA
Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts
LOSSteoarthritis
What does Schooners test, test?
Forward flexion which is reduced. Normal is >5cm increase
Which drugs can be used in the management of Anky Spond, when conventional treatments have failed?
Etanercept
Adalimumab
What is second line in urate lowering therapy?
Febuxostat
Drug induced lupus is dsDNA negative
True
Which drugs less commonly cause lupus?
Isoniazid
Minocycline
Phenytoin
Which DMARDS are used in RA
Methotrexate
Sulfasalazine
Leflunomide
Hydroxychloroquine
Which is the most common connective tissue disease which can cause Raynauds
Scleroderma
First line treatment in Raynaud’s
CCB
What does CREST stand for?
Calcinosis
Raynauds
Oesophageal dysmotility
Sclerodactyly
Telangiactiasia
Which antibody test is useful in DIFFUSE cutaneous systemic sclerosis?
Anti SCL
Which antibody test is useful in LIMITED cutaneous systemic sclerosis?
Anti centromere
This antibody is positive in 90% of systemic sclerosis patients
ANA
What are second line options if patients are intolerant to alendronate
Risedronate
Etidronate
SLE is more common in which groups?
F, black
Which are the most common primary malignant and benign bone tumours?
Malignant: osteosarcoma
Benign: oesteochondroma
