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Final Year - Passmed > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

what s/e can methotrexate cause - respiratory?

A

pneumonitis

cough
dyspnoea
fever

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2
Q

Methotrexate S/E

A

mucositis
myelosuppression
pneumonitis

Pulmonary fibrosis
Liver fibrosis

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3
Q

how is pagets mx?

A

bisphosphonates

increased and uncontrolled bone turnover

osteoclast > too much resorption

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4
Q

Ix polymyalgia

A

ESR
CRP

EMG would be normal and so would creatinine kinase

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5
Q

bisphosphonate side effects

A

oesophageal problems common
> dyspepsisa/ heart burn

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6
Q

reactive arthritis si associate with a dermal skin thing on the dorsal / plantar aspect of the feet?

A

HLA B27

seronegative spondylarthropathies

can’t see
can’t pee
can’t climb a tree

Keratoderma blenorrhgia
> soles/ palsm

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7
Q

Keratoderma blenorrhagica

A

waxy brown / yellow papules on palms and soles

associated with reactive arthritis

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8
Q

psoriatic arthropathy

A

> uveitis
CRP/ESR

> erosive changes in XR;

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9
Q

nail changes in psoriatic arthritis

A

pitting

oncholysis ; lifting of nail pit from the nail bed

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10
Q

SLE

A

malar rash
arthralgia
lethargy

Hx of mental health

CRP usually normal

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11
Q

what is livedo reticularis?

A

net like pattern of discolouration

> lace / fishnet

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12
Q

methotrexate monitoring?

A

LFTs
> hepatotoxic

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13
Q

which drugs require TFT monitoring?

A

amiodarone
lithium

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14
Q

Temporal Arteritis Mx

A

high dose pred

but if eye loss

IV methylprednisolone

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15
Q

acute reactive arthritis management?

A

NSAIDs

intra articular steroids

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16
Q

reactive arthritis management?

A

oral prednisolone

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17
Q

suspected RA investigations?

A

Xrays hand and feet

Rf
anti cyclic citrullinated peptide antibody

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18
Q

how are bisphosphonates given?

A

taken weekly

IVzolendronate as first line - yearly

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19
Q

lateral epicondylitis

A

worse on wrist extension

while elbow is extended

20
Q

SLE is what type of hypersensitivity?

A

type 3
antigen - antibody complexes

21
Q

SLE associated with?

A

HLA B8
DR2
DR3

22
Q

felty syndrome?

A

splenomegaly
neutropenia
RA

23
Q

chronic fatigue syndrome

A

3 months

24
Q

bisphosphonates and renal impairment?

A

contraindicated if eGFR <35mL/minute

so use denosumab

25
Q

atlantoaxial subluxation is a rare complication of what?

A

Rheumatoid arthritis

anteropoesterior and lateral cervical spine radiographs

26
Q

mx of temporal arteritis

A

oral prednisolone

temporal artery biopsy

27
Q

in reactive arthritis can you culture the bacteria?

A

no
culture negative
no crystals
cloudy yellow colour
WCC 20000

28
Q

SLE what is useful in monitoring?

A

complement levels are usually low

29
Q

what is the most sensitive investigation for SLE?

A

ANA

30
Q

what is specific to SLE?

A

anti-dsDNA

31
Q

what is associated with RA on hand xray?

A

periarticular erosions
loss of joint space

soft tissue swelling
subluxation

32
Q

acute reactive arthritis should be managed how?

A

ibruprofen

33
Q

fibromyalgia management

A

explanation

aerobic exercise
CBT

meds: pregabalin, duloxetine, amitriptyline

34
Q

OA affects which hand joint most?

A

first carpometacarpal joint

35
Q

bisphosphonates can cause what side effect to jaw?

A

osteonecrosis of the jaw

36
Q

clinical findings of ankylosing spondylitis?

A

reduced chest expansion
reduced lateral flexion

reduced forward flexion

37
Q

what is schober’s test?

A

reduced chest expansion
reduced lateral flexion
reduced forward flexion

38
Q

ankylosing spondylitis other features?

A

apical fibrosis
anterior uveitis
aortic regurg
achilles tendonitis
av node block
amyloidosis

39
Q

what is important when starting gout prophylaxis?

A

colchicine or NSAID cover
6 months

to prevent precipitating gout attack

40
Q

xray changes associated with OA?

A

loss of join space
osteophytes
subchondral cysts
subchondral sclerosis

41
Q

Xray changes associated with RA?

A

peri articular erosions

42
Q

T score is what?

A

bone mineral density - compared to healthy young person

43
Q

threshold for osteoporosis?

A

t score <-2.5

44
Q

Z score is?

A

compared to other women your own age

bone mineral density

45
Q

acute gout flare mx?

A

continue allopurinol if already taking

+ colchicine

46
Q

most common joint to be affected in gout is?

A

first metatarsophalangeal joint

47
Q
A

Final Year - Passmed (47 decks)

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