Rheumatology Flashcards
Polyarteritis nodosa symptoms
fever, malaise, arthralgia
hepatitis symptoms (scleral jaundice, itchiness)
haematuria, purpura (vasculitic signs)
systemic sclerosis with evidence of pulmonary fibrosis (dry cough and SOBOE)
diffuse systemic sclerosis
myositis blood marker
Anti-Jo1
negative gram stain with elevated WBC (neutrophils)
does not rule out septic arthritis
methotrexate toxicity treatment
folinic acid
azathioprine and and allopurinol interaction, risk of
bone marrow suppression
bone protection if eGFR<30
denosumab
Marfans monitoring
echocardiogram- aortic aneurysm and dissection
Behcets disease
oral ulcers, genital ulcers, uveitis and systemic vasculitis
ank spondylitis second line
anti-TNF-alpha blockers e.g. etanercept and infliximab
Tx of renal complications of systemic sclerosis
ACEi- captopril
renal complications of systemic sclerosis
HTN, AKI
severe- microangiopathic haemolytic anaemia
Hypermobility assessment tool
Beighton score
septic arthritis organism in young adults
neisseria gonorrhoea
methotrexate drug interaction
trimethoprim or co-trimoxazole
–> BM aplasia
osteogenesis imperfects blood test results
normal calcium, phosphate, PTH and ALP
What should be corrected before giving bisphosphonates
Hypocalcemia/vitamin D deficiency
radial tunnel syndrome
presents similarly to lateral epicondylitis however, pain distal to epicondyle and worse on elbow extension and forearm pronation
Drug induced lupus
procainamide
hydralazine
isoniazid
minocycline
phenytoin
dermatomyositis association
malignancy (ovarian, breast, lung)
Schobers test positive
<5cm–> reduced lumbar flexion
ankylosing spondylitis early sign
reduced lateral flexion of lumbar spine
loss of lumbar lordosis, accentuate thoracic kyphosis
CKD vs osteomalacia- phosphate
low in osteomalacia
high in CKD (2 HPT)
psoriatic arthritis management
mild peripheral/axial disease –> NSAID
moderate/severe –> methotrexate
ustekinumab, secukinumab
osteoporosis risk factors (used in FRAX)
history of glucocorticoid use
rheumatoid arthritis
alcohol excess
history of parental hip fracture
low body mass index
current smoking
sulfasazline cautions
G6PD deficiency, allergy to aspirin or sulphonamides
acute flare of RA
oral or intramuscular steroids e.g. methylprednisolone
ankylosing spondylitis XR spine features
squaring of lumbar vertebrae
syndesmophytes
subchondral erosions and sclerosis
bamboo spine (late and uncommon)
osteitis fibrosa cystica
late stage primary hyperparathyroidism causing excessive bone resorption
septic arthritis length of Abx treatment
4-6 weeks
TNF-alpha s/e
reactivation of TB
CXR prior to screen for latent TB
polymyalgia rheumatic key investigation
raised inflammatory markers- ESR>40
discoid lupus erythematous Tx
topical steroids –> oral hydroxychloroquine
Pagets affects what bones
skull, spine/pelvis, long bones of lower extremities
CK in PMR
normal
Measure uric acid levels in suspected gout (i.e. in the acute setting)
a uric acid level ≥ 360 umol/L is seen as supporting a diagnosis
if uric acid level < 360 umol/L during a flare repeat the uric acid level measurement at least 2 weeks after the flare has settled
when starting allopurinol
NSAID or colchicine ‘cover’
Lateral epicondylitis- examination
worse on resisted wrist extension/suppination whilst elbow extended
CKD vs osteomalacia
low phosphate= Osteomalacia
high phosphate= CKD
reactive arthritis joint aspirate
no organism growth on gram stain
develops after an infection where the organism cannot be recovered from the joint
SLE: most specific vs most sensitive test
most specific= anti-dsDNA
most sensitive= ANA
