Rheumatology

Question 1

osteoporosis management?

Answer 1

initiate bisphosphonate therapy
> postmenopausal with osteoporotic vertebral fracture

Question 2

scleritis is associated with which rheumatological condition?

Answer 2

RA

red eye
PAINFUL
watering and photophobia

Question 3

dermatomyositis

which antibody?

Answer 3

Anti-Jo1

ANA +

Question 4

anti-scl-70 antibodies?

Answer 4

diffuse systemic scleroderma

Question 5

SLE first line mx?

Answer 5

NSAIDS and sun block

hydroxychloroquine

if internal organs involved
> prednisalone

Question 6

Investigating Gout
uric acid levels?

Answer 6

> 360 in an acute setting

> 2 weeks

Synovial fluid analysis

Question 7

ankylosing spondylitis?

Answer 7

HLA-B27

20-30yrs old

ESR, CRP

Question 8

Xray findings of ankylosing spondylitis?

Answer 8

sacro ilitis > subchondral erossions, sclerosis

squaring of lumbar vertebrae
bamboo spine

syndesmophytes

cxr - apical fibrosis

Question 9

mx of ankylosing spondylitis?

Answer 9

NSAIDs
physiotherapy

DMARDs - sulphalasazine

anti-tnf ; etanercept

Question 10

which TB drugs can increase uric acid levels?

Answer 10

pyrazinamide and ethambutol

Question 11

Spondylolisthesis

Answer 11

displacement of one spinal vertebra

Question 12

when can anti-TNF alpha inhibitors be started in ankylosing spondylitis

Answer 12

2 different NSAIDs

Question 13

acute flares of RA?

Answer 13

oral / Im corticosteroids

Question 14

how to monitor response to treatment in RA?

Answer 14

CRP and disease activity - DAS28

Question 15

polymyalgia rheumatica?

Answer 15

muscle stiffness
raised inflammatory markers

ESR >40mm/hr

Question 16

dose of pred for polymyalgia rheumatica?

Answer 16

15mg/od

Question 17

initial management of RA?

Answer 17

conventional DMARD
monotherapy

> methotrexate

short term bridging corticosteroids

Question 18

treatment of choice for SLE?

Answer 18

hydroxychloroquine

Question 19

what is important to do before giving bisphosphonates?

Answer 19

correct hypocalcaemia / vitamin D deficiency

Question 20

poor prognostic markers in RA?

Answer 20

RF +
anti-CCP antibodies

hla dr4+

insidious onset

Question 21

how to take oral bisphosphonates?

Answer 21

take on an empty stomach

Question 22

in young adults with septic arthritis what is the most common organism found?

Answer 22

neisseria gonorrhoeae

Question 23

what are the features of osteomalacia?

Answer 23

bone pain
tenderness

proximal myopathy > waddling gait

= osteomalacia

Question 24

NICE recommends how long after starting oral bisphosphonate tx to reassess FRAX?

Answer 24

5 years

Question 25

Rheumatoid arthritis makrer

Answer 25

anti cyclic citrullinated peptide antibodies RF

Question 26

raised CK

Answer 26

polymyositis

Question 27

what abx interacts quite badly with methotrexate?

Answer 27

co trimoxazole > trimethoprim which also has anti folate activity = bone marrow aplasia and pancytopenia = sepsis and

Question 28

methotrexate monitoring?

Answer 28

FBC, U&E LFTs 3 monthly

Question 29

why is LFT monitoring important in methotrexate tx?

Answer 29

can cause hepatoxicity

Question 30

pseudogout

Answer 30

caclium pyrophosphate dihydrate crystals

Question 31

what is RF for pseudogout?

Answer 31

hyperparthyroidism

Question 32

what is pseudogout?

Answer 32

monarthropathy affecting large joint calcium pyrophosphate dihydrate crystals

Question 33

initial management of RA

Answer 33

weekly methotrexate and short course of prenisolone

Question 34

suspected septic arthritis ix?

Answer 34

synovial fluid sampling blood culture

Question 35

skull xray in an exam

Answer 35

think pagets marked thickening of calvarium

Question 36

TNFA-a example?

Answer 36

etanercept used in resistant RA