Rheumatology Flashcards
what is sjogren’s syndrome?
autoimmune disorder affecting exocrine glands, resulting in dry mucous membranes
what are signs and symptoms of sjogren’s syndrome?
dry eyes
dry mouth
vaginal dryness
arthralgia
Raynaud’s
myalgia
sensory polyneuropathy
recurrent parotitis
renal tubular acidosis
positive Schirmer’s test
which antibodies are present in sjogren’s?
anti-ro and anti-la
ANA
rheumatoid factor
sjogren’s is associated with increased risk of what?
lymphoma
what effect does PTH have on calcium, phosphate, and ALP?
PTH causes:
increased calcium
decreased phosphate
increased ALP
what does ALP do to bone?
increases bone mineralisation and growth
how do you manage patients at risk of steroid induced osteoporosis?
1) >65 or previous fragility fracture –> bone protection (vit D, calcium, alendronate)
2) <65 DEXA scan and bone protection if T-score <-1.5
what is the T-score?
compares bone density to that of a young healthy adult
+1 to -1 = normal
-1 to -2.5 = osteopenia
< -2.5 = osteoporosis
how do bisphosphonates work?
inhibit osteoclasts to prevent bone demineralisation
HLA-B27 is associated with which arthropathies?
1) ankylosing spondylitis
2) reactive arthritis
3) psoriatic arthritis
what are the features of reactive arthritis?
conjunctivitis
arthritis
urethritis
(develops after an infection)
how is rheumatoid arthritis managed?
1) DMARD (e.g. methotrexate) long-term
2) Steroid (PO or IM) for flares
what are adverse effects of methotrexate?
myelosuppression
pneumonitis
liver cirrhosis
pulmonary fibrosis
taken weekly, FBC, U&E, LFT monitored regularly, folic acid co-prescribed
what X-ray features are seen in osteoarthritis?
LOSS:
loss of joint space
osteophytes
subchondral sclerosis
subchondral cysts
what is antiphospholipid syndrome?
predisposition to thrombosis, recurrent foetal loss, and thrombocytopenia
may be primary, or secondary to conditions such as SLE
