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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

24
Q

bisphosphonates and renal impairment?

A

contraindicated if eGFR <35mL/minute

so use denosumab

25
atlantoaxial subluxation is a rare complication of what?
Rheumatoid arthritis anteropoesterior and lateral cervical spine radiographs
26
mx of temporal arteritis
oral prednisolone temporal artery biopsy
27
in reactive arthritis can you culture the bacteria?
no culture negative no crystals cloudy yellow colour WCC 20000
28
SLE what is useful in monitoring?
complement levels are usually low
29
what is the most sensitive investigation for SLE?
ANA
30
what is specific to SLE?
anti-dsDNA
31
what is associated with RA on hand xray?
periarticular erosions loss of joint space soft tissue swelling subluxation
32
acute reactive arthritis should be managed how?
ibruprofen
33
fibromyalgia management
explanation aerobic exercise CBT meds: pregabalin, duloxetine, amitriptyline
34
OA affects which hand joint most?
first carpometacarpal joint
35
bisphosphonates can cause what side effect to jaw?
osteonecrosis of the jaw
36
clinical findings of ankylosing spondylitis?
reduced chest expansion reduced lateral flexion reduced forward flexion
37
what is schober's test?
reduced chest expansion reduced lateral flexion reduced forward flexion
38
ankylosing spondylitis other features?
apical fibrosis anterior uveitis aortic regurg achilles tendonitis av node block amyloidosis
39
what is important when starting gout prophylaxis?
colchicine or NSAID cover 6 months to prevent precipitating gout attack
40
xray changes associated with OA?
loss of join space osteophytes subchondral cysts subchondral sclerosis
41
Xray changes associated with RA?
peri articular erosions
42
T score is what?
bone mineral density - compared to healthy young person
43
threshold for osteoporosis?
t score <-2.5
44
Z score is?
compared to other women your own age bone mineral density
45
acute gout flare mx?
continue allopurinol if already taking + colchicine
46
most common joint to be affected in gout is?
first metatarsophalangeal joint
47

Final Year - Passmed (47 decks)

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