Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP Part 1 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Reactive arthritis triad

A

classically presents as part of a triad including urethritis, conjunctivitis, and arthritis (though not all features need to be present)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

keratoderma blennorrhagicum

A

keratoderma blennorrhagicum on the soles of his feet - a waxy yellow rash pathognomonic for reactive arthriti

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dermatomyositis antibodies

A

ANA most common, anti-Mi-2 most specific

DerMI-2myositis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anti-scl-70 antibodies

A

associated with systemic sclerosis (scleroderma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anti-Jo-1 antibodies,

A

idiopathic inflammatory myopathies, particularly polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anti-centromere bodies

A

limited cutaneous systemic sclerosis (also known as CREST syndrome: Calcinosis, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cytokines is the most important in the pathophysiology of rheumatoid arthritis?

A

TNF alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Leflunomide

A

Leflunomide is a disease modifying anti-rheumatic drug (DMARD) mainly used in the management of rheumatoid arthritis. It has a very long half-life which should be remembered considering it’s teratogenic potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

McArdle’s disease

A

McArdle’s disease is a phenotypically mild glycogen storage disorder that presents in late adolescence or early adulthood with exertional rhabdomyolysis with a textbook ‘second wind phenomenon’, in which patients develop muscle cramps and fatigue with subsequent recovery with continued exercise. The description of the patient’s muscle cramping that spontaneously resolves during the race harkens to this second wind phenomenon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MMF MoA

A

inhibits inosine monophosphate dehydrogenase, which is needed for purine synthesis
as T and B cells are particularly dependent on this pathway it can reduce the proliferation of immune cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Reactive arthritis is associated with which one of the following HLA antigens

A

HLA b27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HLA-A3:

A

Hemochromatosis, Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

HLA-DR4:

A

Rheumatoid Arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HLA-B51:

A

Behcet’s disease

B51 = Behcet = Be5ce1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

HLA-DR3:

A

SSLE

early-onset Myasthenia Gravis, Hashimoto’s thyroiditis, primary sclerosing chloangitis
And also HLA DR3 associated with
dermatitis herpetiformis
Sjogren’s syndrome
primary biliary cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common target of pANCA

A

Myeloperoxidase is a neutrophil protein whose primary role is the generation of oxygen free radicals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common target of cANCA

A

Serine proteinase 3 (PR3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

treatment of choice for SLE

A

Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Typical findings of AION on fundoscopy

A

a swollen, pale optic disc with blurred margins. This is a sight-threatening condition and requires immediate admission and treatment with high-dose corticosteroids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

underlying malignancies associated with dermatomyositis

A

typically ovarian, breast and lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anti-dsDNA antibodies are associated

A

systemic lupus erythematosus (SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Circinate balanitis

A

Circinate balanitis is a well-documented mucocutaneous manifestation of reactive arthritis, particularly in male patients. It presents as serpiginous white plaques on the glans penis and is considered highly characteristic of the condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Denosumab

A

RANK ligand inhibitor for secondary prevention of osteoporosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

neonatal lupus erythematosu

A

can result from maternal autoantibodies crossing the placenta. It is strongly associated with anti-SSA/Ro antibodies and complications commonly include congenital heart block, skin rashes and hepatosplenomegaly

Ro Ro Ro your boat gently (ie. slowly for CHB) down the spleen
megaly megaly megaly megaly, lupus is but a dream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Collagen defect in classical ehlers danlos

A

vascular - type 3 collagen, classical - type 4 collagen

Collagen types

1 is in bONE
2 is in carTWOlage (catilage)
3 vEssEls
4 is in the floor, that is basement membranes of lungs an

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What serum marker shows active disease in SLE and can be used for monitoring active disease?

A

Complement levels - low in active disease

ESR is generally used
High anti-dsDNA antibody levels typically suggest active disease in SLE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

HLA B8

A

Grave’s disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

polyarteritis nodosa antibodies

A

Perinuclear-antineutrophil cytoplasmic antibodies (pANCA)

Polyarteritis nodosa (PAN) is a vasculitis affecting medium-sized arteries with necrotizing inflammation leading to aneurysm formation. PAN is more common in middle-aged men and is associated with hepatitis B infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Anti-cyclic citrullinated peptide antibodies are associated

A

withrheum arthrtiis

30
Q

Marfans genetics

A

Marfan’s syndrome is an autosomal dominant connective tissue disorder. It is caused by a defect in the FBN1 gene on chromosome 15 that codes for the protein fibrillin-1.

31
Q

McArdle’s disease

A

Glycogen storage disease - presents in adolescance

McArdle sounds Scottish. Famously, Scottish people can walk 500 miles then walk 500 more. This is because of their second wind!

32
Q

Teriparatide

A

a recombinant form of human parathyroid hormone (PTH) that may be used in the treatment of osteoporosis

33
Q

Antiphospholipid syndrome blood findings

A

Antiphospholipid syndrome: (paradoxically) prolonged APTT + low platelets

34
Q

Rickets XR

A

Rickets can present as widening of the wrist joints due to an excess of non-mineralized osteoid at the growth plate

35
Q

Marfan’s syndrome is caused by a mutation in a protein called

A

fibrillin-1

MarFAN , 1 FAN in the ceiling with 5 blades
CHROMOSOME 15
UPWARD LENS DISLOCATION
HIGH ARCHED PALATE
Fibrillin1
(Think ceiling fan which is 1 and high/up on the ceiling)

36
Q

fibrillin-1 mutation

A

Marafans syndrome

MarFAN , 1 FAN in the ceiling with 5 blades
CHROMOSOME 15
UPWARD LENS DISLOCATION
HIGH ARCHED PALATE
Fibrillin1
(Think ceiling fan which is 1 and high/up on the ceiling)

37
Q

Hydroxychloroquine monitoring

A

Visual acuity/fundoscopy

Hydroxychloroquine - may result in a severe and permanent retinopathy

38
Q

gout vs psuedogout

A

Chondrocalcinosis helps to distinguish pseudogout from gout

gout - -vely birifinegent needle shaped cystals
psuedogout -weakly-positively birefringent rhomboid-shaped crystals

39
Q

Rheumatoid arthritis: x-ray changes

A

RA
L – loss of joint space
E – erosions
S – soft tissue swelling
S – soft bones (osteopenia)

A - juxta-Articulat osteoporosis and joint subluxation

40
Q

OA X ray changes

A

OA:
L – loss of joint space
O – osteophytes
S – subchondral sclerosis
S – subchondral cysts

41
Q

mixed connective tissue disease Ab

A

Anti-ribonuclear protein (anti-RNP) = mixed connective tissue disease

Mixed connective tissue disease is a multisystem rheumatological disorder typically affecting females between 30 and 40 years of age. Raynaud’s phenomenon is the initial symptom in 90% of cases and patients can have a multitude of symptoms and signs. Usually, anti-nuclear antibodies are positive and anti-U1RNP must be positive for a diagnosis to be made. Anti-U1RNP can be seen in other disorders such as systemic sclerosis and systemic lupus erythematosus, and so antibodies for these conditions, anti-centromere and anti-Scl70 along with anti-dsDNA, respectively, must be negative.

42
Q

ultrasound scan conforms the presence of an effusion and states the ‘double contour’ sign was observed. What is the most likely diagnosis?

A

gout

43
Q

Anakinra MoA

A

Anakinra is IL-1
Easily remembered as the story of Anakin starts with episode 1

44
Q

L3 nerve root compression

A

Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

45
Q

3rd line treatment of psoratic athritis

A

apremilast: phosphodiesterase type-4 (PDE4) inhibitor → suppression of pro-inflammatory mediator synthesis and promotion of anti-inflammatory mediators

46
Q
A
47
Q

Ankylosing spondylitis extra features

A

Ankylosing spondylitis features - the ‘A’s
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis

48
Q

RA extra-articular complications

A

respiratory: pulmonary fibrosis, pleural effusion, pulmonary nodules, bronchiolitis obliterans, methotrexate pneumonitis, pleurisy
ocular: keratoconjunctivitis sicca (most common), episcleritis, scleritis, corneal ulceration, keratitis, steroid-induced cataracts, chloroquine retinopathy
osteoporosis
ischaemic heart disease: RA carries a similar risk to type 2 diabetes mellitus
increased risk of infections
depression

Less common
Felty’s syndrome (RA + splenomegaly + low white cell count)
amyloidosis

49
Q

Gonococcal arthritis presents with a triad of

A

Dermatitis
Tenosynovitis
Migratory polyarthritis.

50
Q

risk factor for pseudogout

A

heamochromatosis

51
Q

what antibodies are a marker of poor prognosis in rheumatoid arthritis

A

Anti-CCP

52
Q

XR findings of Ank spond

A

Ankylosing spondylitis:
Syndismocytes formation
Subchondoral erosions
Sclerosis
Squiring of vertebra
Romanus leasion
Bamboo spine

53
Q

X-ray finding of:

1- pseudogout: chondrocalcinosis

2- gout: larg punched out erosions in x-ray (tophi), double contour sign on US

3- Psoriatic arthritis:
Erosive changes and new bone formation
Periostitis
Pencil in cup appearances

4- Ankylosing spondylitis:
Syndismocytes formation
Subchondoral erosions
Sclerosis
Squiring of vertebra
Romanus leasion
Bamboo spine

5- Rheumatoid arthritis:
Soft tissue swelling
Subchondoral osteoporosis
Joint space narrowing
Subluxation and Ankylosis

6- Osteoarthritis:
Joint space narrowing
Osteophytes
Subchondoral cyst

7- Paget’s disease:
Lytic and sclerotic lesions on skul e.g.

8- Rickets:
Winding of wrist joint
Cupping, fraying and ……
Widening of epiphysis

9- osteopetrosis:
Bone on bone lesions

10- Osteomalacia:
Translucent bands (looser’s zones or pseudofracture)

A
54
Q

Osteoporosis treatment

A

bisphosphonates are the first-line drug treatment for patients at risk of fragility fractures
oral bisphosphonates such as alendronate and risedronate are typically first-line. These are often taken weekly are need taking in a particular way to minimise the risk of oesophageal side-effects
however, the NOGG recommend IV zoledronate as the first-line treatment following a hip fracture. This is given yearly
denosumab is generally used as a second-line treatment
other possible treatment options include:
strontium ranelate
raloxifene
teriparatide
romosozumab

55
Q

Septic arthritis - most common organism

A

: Staphylococcus aureus

56
Q

urinary/serum hydroxyproline

A

increased in Pagets (its a marker of bone destructions) §

Hydroxyproline is mostly used as a diagnostic marker of bone turnover and liver fibrosis.

57
Q

Anti-Smith antibody

A

Anti-Smith antibody is another highly specific antibody for SLE.

58
Q

Limited (central) systemic sclerosis =

A

anti-centromere antibodies

59
Q

Diffuse systemic sclerosis

A

Anti-Scl-70 antibodies

60
Q

Bone pain, tenderness and proximal myopathy (→ waddling gait) → ?

A

?osteomalacia

61
Q

SLE SPECIFIC Ab

A

SLE: ANA is 99% sensitive - anti-Sm & anti-dsDNA are 99% specific

62
Q

SLE antibodies

A

SLE antibodies

-Most sensitive&raquo_space;> ANA (ANA : -ve > unlikly to be SLE = ana is negative predictive value)
-Most specific&raquo_space; Anti Smith
-Used during flare&raquo_space; Anti-dsDNA (rise during flare) , c3/c4 (decreased)
-drug-induced lupus (eg: hydralazine )» antihistone
-neonatal lupus erythematosus(congenital heart block): anti-Ro or anti-La antibodies

63
Q

anti-synthetase syndrome.

A

proximal myopathy in combination with mechanic hands, which are associated with anti-synthetase syndrome.

Anti-synthetase syndrome is related to dermatomyositis/polymyositis. Findings include relatively acute disease onset, constitutional symptoms (eg, fever and weight loss), myositis, the Raynaud phenomenon, mechanic’s hands, arthritis that is generally nonerosive, and interstitial lung disease. Patients have antibodies towards tRNA synthetase.
Consider the diagnosis if antisynthetase Ab positive PLUS 2 of the following: ILD, inflammatory myopathy, inflammatory polyarthritis.

64
Q

Srojens increases what cancer risk?

A

Lymphoma

Patients with Sjogren’s syndrome have an increased risk of lymphoid malignancies

65
Q

Drug-induced lupus

A

In drug-induced lupus not all the typical features of systemic lupus erythematosus are seen, with renal and nervous system involvement being unusual. It usually resolves on stopping the drug.

ANTI HISTONE AB

Most common causes
procainamide
hydralazine

Less common causes
isoniazid
minocycline
phenytoin

66
Q

Osteopetrosis

A

also known as marble bone disease
rare disorder of defective osteoclast function resulting in failure of normal bone resorption
results in dense, thick bones that are prone to fracture
bone pains and neuropathies are common.
calcium, phosphate and ALP are normal
stem cell transplant and interferon-gamma have been used for treatment

67
Q

three antiphospholipid antibodies

A

lupus anticoagulant, beta-2 glycoprotein antibody, and cardiolipin antibody

68
Q

What is the greatest predictor of future thrombosis in patients with anti-phospholipid syndrome?

A

lupus anticoagulant

69
Q

Osteopetrosis is due to a defect in:

A

osteoclast function

70
Q

Discoid lupus erythematous

A

Scalp rashes WORSE in sun

Discoid lupus erythematous - topical steroids → oral hydroxychloroquine

71
Q

What is unusual in drug-induced lupus

A

Glomrulonephritis

72
Q
A

MRCP Part 1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions