Rheumatology

Question 1

Investigation that helps to distinguish pseudogout from gout

Answer 1

X-ray chondrocalcinosis in pseudogout

Question 2

Suspecting polymyalgia rheumatica, commenced on prednisolone 15 mg. After 3 weeks, no improvement in symptoms, next step:

Answer 2

Alternative diagnosis, patients with PMR respond dramatically to steroids

Question 3

Arthritis, conjunctivitis and uretritis after an STI or gastrointestinal infection, dx and mx

Answer 3

Reactive arthritis, NSAIDs

Question 4

Supplementation for all pregnant and breastfeeding women

Answer 4

Vitamin D

Question 5

Azathioprine in pregnancy:

Answer 5

Safe

Question 6

Adverse effect of hydroxychloroquine:

Answer 6

Retinopathy

Question 7

1st line management for ankylosing spondylitis

Answer 7

Exercise regimes and NSAIDs

Question 8

Bone protection approach for patients over the age of 65 who are starting long-term corticosteroid therapy

Answer 8

Start oral alendronate + ensure calcium and vitamin D replete

Question 9

X-ray finding that suggests RA over other arthropathies:

Answer 9

Juxta-articular osteoporosis/osteopenia, also called periarticular erosions?

Question 10

X-ray changes of osteoarthritis (LOSS)

Answer 10

Loss of joint space
Osteophytes forming at joint margins
Subchondral sclerosis
Subchondral cysts

Question 11

Young, malignant tumour that occurs most frequently in the metaphyseal region of long bones prior to epiphyseal closure, Codman triangle and sunburst appearance on X ray:

Answer 11

Osteosarcoma

Question 12

How long antibiotics are given in septic arthritis?

Answer 12

4-6 weeks