Brainscape's Knowledge GenomeTM

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


See full index

Gastroenterology > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Azathioprine MOA :

A

Inhibits Purine Synthesis

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

Is Azathioprine safe in pregnancy ?

A

Yes

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

K/C/O Sarcoidosis—low TPMT—Started on Immunsupressant drug—pancytopenia + Fatigue + SOB.Dx?

A

Pancytopenia D/t Azathioprine and ow TPMT

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

Which of the following factors will predispose her to azathioprine toxicity

A

thiopurine methyltransferase deficiency

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

Muscles involved in Dequervian Tenosynovitis ?

A

Abductor Pollicis Longus (APL)
Extensor Pollicis Brevis (EPB)

Aah Eeeh, oh Pain !

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

Arterial/venous thrombosis, miscarriage, livedo reticulari

A

APLA

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

Diagnosis of APLA

A

Positive anti-cardiolipin antibodies on two occasions at least 12 weeks apart
Positive anti-β2GP1 antibodies on ≥2 occasions at least 12 weeks apart

Positive for Lupus Anticoagulant on ≥2 occasions at least 12 weeks apart

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

Mcardles is caused by which deficiency ?

A

myophosphorylase deficiency,

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

Severe Muscele cramp and dark coloured urine following exercise + Increse in creatine Kinase

A

Mcardle’s Syndrome

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

Mcardle’s Syndrome

A

Severe Muscele cramp and dark coloured urine following exercise + Increse in creatine Kinase + myophosphorylase deficiency.

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

Patient on Steroids + presents with progressive hip pain, particularly with weight-bearing activities + limited range of motion in the left hip. Dx and Ix of choice :

A

Avascular Necrosis of Hip.

Ix—MRI Hip

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

Primary Raynauds is seen in :

A

< 40 years of age and B/L symptoms

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

Cray findings of Ankylosing Spondylitis :

A

Subchondral Erosions, Sclerosis
Syndesmophytes—most commonly seen

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

Earliest clinical sign of Ankylosing spondylitis :

A

Reduced Lateral Flexion Lumbar spine—

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

Diagnostic test for Ankylosing spondylitis :

A

X ray Pelvis—Sacro ilitis

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

What is the most common cardiac defect seen in Marfan’s syndrome:

A

Dilation of Aortic sinuses

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

Osteoarthritis First lie :

A

PPI with NSAIDs

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

What organism is most likely to be present in the Aspirate Fluid of Reactive Arthritis ?

A

No Organism

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

Pseudoxanthoma elasticum is associated with Which cardiac abnormality ?

A

Mitral Valve Prolapse

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

Gymnast or tennis player + Pain on lateral forearm on extension + paraesthesia + tenderness distal to common extensor origin

A

Radial Tunnel Syndrome

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

tingling/numbness of the 4th and 5th finger( Medial fingers ) + Froment’s test positive

A

Cubital Tunnel Syndrome

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

Forment’s test?

A

Checks the addiction of thumb—Adductor policis brevis—which is weak in ulnar nerve problem

Pinch paper between thumb and fingers

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

which nerve is involved in cubital tunnel syndrome ?

A

Ulnar nerve

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

Cubital tunnel syndrome:

A

tingling/numbness of the 4th and 5th finger( Medial fingers ) + Froment’s test positive

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

Radial Tunnel Syndrome

A

Gymnast or tennis player + Pain on lateral forearm on extension + paraesthesia + tenderness distal to common extensor origin

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

Rickets can present as widening of the wrist joints due to an

A

excess of non-mineralized osteoid at the growth plate

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

Most commonly seen X ray finding of Ankylosing Spondylitis :

A

Syndesmophytes— Syndesmophytes (ossification of outer fibres of annulus fibrosus) are a feature of ankylosing spondylitis

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

The most commonly involved joints in the hand of patients with osteoarthritis are the:

A

carpometacarpal joints and the distal interphalangeal joints.

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

Osteopetrosis all the blood, calcium and PTH value s?

A

All are normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Joint pain + difficult in hearing + carpal tunnel + Family History

A

Osteopetrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

DEXA scans: the T score is based on:

A

bone mass of young reference population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which Collagen defect in Ehler Danlos ?

A

Type 3

Ehler Danlos—3hler Danlos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which Collagen defect in Osteogenis Imperfecta ?

A

Type 1
Osteogenesis 1mperfecta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Collagen defect in Good pasture ?

A

Type 4
Good 4sture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Collagen defect in Alport ?

A

4
Al4rt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

ears (auricular chondritis, vertigo, hearing loss)+the nose (saddle nose deformity)+ the respiratory tract (wheezing, inspiratory stridor, voice changes)+ the eyes (episcleritis, scleritis, iritis,) and the joints (arthralgia).

A

Relapsing Polychondritis

Main point—Involvement of ears and nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Is Rheumatoid factor present in Still’s Disease ?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Still’s Disease :

A

Salmon coloured Rash + Fever + Athralgia + O/e : HIgh temp,Lymphadenopathy, serum ferittin high
Lack of ANA and RA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Salmon coloured Rash + Fever + Athralgia + O/e : HIgh temp,Lymphadenopathy, serum ferittin high
Lack of ANA and RA.

A

Still’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is raised in still’s disease ?

A

Serum ferittin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

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

A

Lymphoid Malignancies such as Non Hodkin’s Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Discoid lupus erythematous —topical steroids not working , next step ?

A

Oral Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Risk factor for Pseudogout :

A

Haemochromatosis—Raised Transferrin Saturation

Hemp-gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is first raised in Haemochromatosis ?

A

Transferrin saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Reactive Arthritis Rx?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

H/O Diarrhoea + A 39-year-old man is referred to orthopaedics with a 24-hour history of knee pain. He undergoes aspiration — shows no organisms or .
chemosis +dysuria

A

Reactive Arthritis

Rx—NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Butterfly shaped Rash sparing Nasolabial fold+ Tenderness over small joints+ Recurrent Miscarriages with Previous VTE. Dx?

A

SLE with Secondary APLA Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Complement level in SLE :

A

Low or Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Z score > -2.5 + Loss of Libido + Absence of Morning Erection. Which test to be done next ?

A

Osteoporosis in Man + Loss of libido—Low Testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

mycophenolate mofetil.

A

Inhibits Inosine-5-Monophosphate dehydrogenase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Creatine Kinase in Polymyalgia Rheumatica ?

A

Normal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Anorexia in Polymyalgia Rheumatica ?

A

Present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

High or low phosphate level in PseudoGout ?

A

Low Phosphate level—predisposes to pseudogout

High PTH—recognised cause

High PTH—leads to —Low phosphate and low magnesium
And high calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pseudogout causes :

A

Haemochromatosis—Hemo Gout
Acromegaly
Hyperparathyroidism—leads to—
High calcium, Low Phosphate , Low Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Pseudogout common location:

A

Knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which crystals and substance is found in Pseudogout ?

A

Calcium Pyrophosphate Dihydrate in synovium

Positively Birifringement rhomboid shaped crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

X ray finding in pseudogout:

A

Chondrocalcinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Skin feature in Discoid Lupus

A

Characterised by follicular keratin plugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What kind of Alopecia occurs in Discoid Lupus ?

A

Scarring Alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

does Discoid Lupus lead to SLE ?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Age group affected in Discoid :

A

Young— 20-30 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the minimum steroid intake a patient should be taking before they are offered osteoporosis prophylaxis?

A

Equivalent of prednisolone 7.5 mg or more each day for 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Passive abduction of shoulder is painful between 60 and 120 degrees.

A

Supraspinatus Tendonitis

Adhesive Capsulitis:
Characterised by global reduction of all the movements.Escp external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Is Obesity a Risk factor for osteoporosis ?

A

No

Adipose tissue—androgens converts into oestrogen—helps in maintaining bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Is nephritis a feature of Drug induced Lupus ?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Drug Induced Lupus clinical Features and Mnemonic ?

A

SLAM

Skin—Malar Rash
Lungs—Pleurisy
Arthralgia
Myalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Most Common drug cause of Drug induced Lupus ?

A

Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Works on a construction site + history of painful hands. He advises you that when exposed to cold his fingers become white and numb,

A

Raynaud’s disease due to vibrating tools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Progressive SOB + Bibasal Crepts + thickening of proximal arm

A

ILD Fatures + proximal arm thickening— Diffuse cutaneous systemic scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Antibodies positive in Diffuse Scleroderma ?

A

Anti SCL Antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Lung complication in diffuse systemic Scleroderma ?

A

ILD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Lung complication in limited scleroderma ?

A

Pulmonary Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Antibodies in Limited Scleroderma?

A

Anti Centromere antibodies

CREST=C=Centromere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

A 32-year-old man presents to the endocrine clinic following a traumatic left-sided hip fracture.

A DEXA scan is performed: Osteoporosis confirmed
What scoring system would be most helpful to determine if the patient has a secondary cause of the underlying condition?

A

Z score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

When to offer allopurinol in gout patients?

A

Offer allopurinol after the first attack of gout ahas resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

External rotation (on both active and passive movement) is Impaired + Flexion + Abduction + Adduction is also impaired. Dx?

A

Adhesive Capsulitis

Characterised by global reduction of all the movements.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

K/C/O Breast Cancer + Violaceous papules on proximal and DIP + rash around eyelids + tired and lethargic :

A

Dermatomyositis

Myopathy-fatigue and weakness
rash —Helicotrope rash and grotton’s papules
It’s very commonly associated with Malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Most likely antibody to be positive in Dermatomyositis ?

A

ANA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Most specific in dermatomyositis :

A

Anti MI 2 antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Derma manifestations in dermatomyositis :

A

helicptrope rash around eyes
Macular rash around shoulder back and chest
Grottoes papules—in Pip and DIP
Mechanic hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Newly diagnosed of Dermatomyositis , next step ?

A

Urgent Malignancy screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Most common cause of death in systemic sclerosis ?

A

Respiratory involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

DIP joint + improves with rest, worsens by activity

A

Hand osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Golimumab MOA:

A

TNF inhibitor

GOLD(Golimumab ) painting of Dali (Dalimubab) caught fire—and its put down by TIN (TNF ) fire extinguisher (inhibitor )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Old woman rarely leaves home—c/o: Bone pain, tenderness and proximal myopathy . Dx?

A

Osteomalacia

Osteoporosis does not cause such symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Which clinical test in de quervian ?

A

Finkelstein test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

marker of poor prognosis in rheumatoid arthritis

A

Anti CCP antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

isolated lateral hip/thigh pain with tenderness over the greater trochanter+ pain is worse when she rolls onto that side during the night

A

Trochanteric Bursitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

PTT and Platelets in APLA :

A

Raised PTT and Low Platlets in APLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Most specific for SLE ?

A

Anti Sm

SMecific antibody in SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Bone pain + Low calcium + Low Phosphate + Raised ALP Dx?

A

Osteomalacia

It is Malacious and reduces calcium and phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Is Aclasia associated with Ankylosing ?

A

No
No GI stuff in Ankylosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Ankylosing Spondylitis association

A

Eye to Foot , except GI :

Amyloidosis
Anterior Uveitis
Heart :AV node Bock
Aortic Regurgitation
Lungs : Apical Fibrosis
Foot : Achilies Tendonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Bisphosphonates are associated with an increased risk:

A

Atypical stress fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Marfan’s + headaches, leg pain and intermittent episodes of urinary incontinence. What is the most likely diagnosis?

A

Dural Ectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Which drug to be avoided along with Methotrexate ?

A

Trimethoprim.

The concurrent use of methotrexate and trimethoprim containing antibiotics may cause bone marrow suppression and severe or fatal pancytopaenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

H/o Chemotherapy + Limited range of motion of hip in all directions

A

Avascular Necrosis of hip

Chemotherapy—A known Risk Factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Rheumatoid Factor is Ig__?

A

IgM antibody against IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Burning thigh pain. Dx and Nerve involved ?

A

meralgia paraesthetica - lateral cutaneous nerve of thigh compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Blood test to confirm Osteomalacia diagnosis ?

A

Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

he has developed a raised, erythematous rash in patches over her scalp. She describes worsening of the lesions if she forgets to wear a sunhat. On examination, there are patches of alopecia where some lesions have healed

A

Discoid Lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

history of recurrent joint dislocations and easy bruising.

On examination, her skin appears highly elastic and fragile, and you detect a mid-systolic click upon auscultation.

A

Ehler Danlos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Reoccurring episodes of abdominal pain, fever, arthralgia, and chest pain. Improved after colchicine

A

Familial Mediterranean Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Familial Mediterranean Fever

A

Reoccurring episodes of abdominal pain, fever, arthralgia, and chest pain. Improved after colchicine

105
Q

Familial Mediterranean Fever Rx?

A

Colchicine

106
Q

Rx of choice for SLE :

A

Hydroxychloroquine

107
Q

gradual onset leg and back pain, weakness and numbness which is brought on by walking + Relieved by bending forward

A

Spinal Stenosis

108
Q

Is sulfasalazine safe in pregnancy and breast feeding ?

109
Q

External rotation (on both active and passive movement) is classically impaired in

A

Adhesive capsulitis

110
Q

Difficulty in unhooking bra

A

Difficulty in external rotation—Adhesive capsulitis

111
Q

Worst prognosis in rheumatoid arthritis

A

Anti CCP Antibodies

112
Q

If patient is allergic to sulfasalazine , which drug should be avoided ?

A

Aspirin is avoided

113
Q

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

A

Lupus Anticoagulant

114
Q

pain and stiffness in her hands—DIP and PIP. Her symptoms are worse in the morning and seem to improve throughout the day.

A

Psoriatic Arthritis

115
Q

Familial Mediterranean Fever mode of inheritance ?

A

Autosomal Recessive

Mediterranean Sea is a smaller sea—hence its recessive

116
Q

GIT related side effect in limited Sclerosis ?

A

Dysphagia
Malabsorption—due to bacterial overgrowth in sclerosed intestine

117
Q

does malabsorption develop in Limited sclerosis ?

A

Yes due to bacterial overgrowth

118
Q

does constrictive pericarditis develop in limited sclerosis ?

A

No , Pulmonary hypertension develops

119
Q

Tamoxifen and Breast cancer :

A

It decreases the chance of breast cancer.

Villain has stomped over pink ribbon

120
Q

> 7.5 MG Steroids each day for 3 months. Next step ?

A

Calcium + vitamin D + Oral Bisphosphonates

121
Q

Anti Jo antibodies is positive in ?

A

Polymyositis

Jo-po
Jollymyositis

122
Q

which antibody is positive in Polymyositis ?

A

Anti Jo antibodies

123
Q

Marfan’s pathology :

A

A defect in glycoprotein structure that wraps around elastin

124
Q

Anti synthetase syndrome is related to :

A

Dermatomyositis

125
Q

Recurrent oral ulcers+genital ulcers+ painful red eyes. Dx and HLA ?

A

Behçet’s disease

HLA 51 ( Area 51)

Behcets= 6 letters—5+1=6

126
Q

Behçet’s disease HLA ?

127
Q

DVT + non-blanching reticulated rash throughout both lower limbs.

128
Q

celecoxib Is :

129
Q

Osteopenia T score ?

A

between -1 and -2.5

130
Q

X ray of Ankylosing spondylitis

A

Sacro ilitis

131
Q

Dx test of Ankylosing spondylitis

A

Sacro ilitis on X ray hip

132
Q

Which GIT condition is Polyarteritis nodosa associated with ?

A

Hepatitis b

133
Q

renal failure + Hematuria+ Mononeuritis multiplex + H/o Hepatitis B . Dx?

A

Polyarteritis Nodosa

Granulomatosis with polyangiitis classically involves renal impairment, as well as other disease features such as nasal congestion and epistaxis, rather than peripheral neuropathy.

Eosinophilic granulomatosis with polyangiitis is an ANCA-positive vasculitis which classically manifests with renal impairment and respiratory symptoms. For exam purposes, these patients often present with presumed asthma, which is difficult to control, with sensitivity to the prescription of leukotriene receptor antagonists. Blood eosinophilia is also observed.

134
Q

Collagen defect in osteogenesis imperfect:

A

Collagen type 1

135
Q

Which neurological symptoms positive in PAN ?

A

Mononeuritis Multiplex

136
Q

First line Rx for Osteoarthritis:

A

Topical NSAIDs

137
Q

SLE - antibodies associated with congenital heart block:

A

Anti Ro

Roadblock=heartblock

138
Q

X ray finding of rickets :

A

widening of the joint

139
Q

Bone within bone appearance is seen in :

A

Osteopetrosis

140
Q

Normal calcium, Normal phosphate, Normal ALP , Normal PTH + recurrent fracture. Bone within Bone appearance. Dx?

A

Osteopetrosis

Paget’s will have raised PTH levels

141
Q

K/C/O RA—Hot painful tender swollen Joint. Next appropriate step ?

A

Suspected septic arthritis—Most appropriate step—Joint aspiration

142
Q

In SLE which Complement level is low ?

143
Q

Which factor is involved in Rheumatoid arthritis ?

144
Q

Septic arthritis Rx:

A

IV Flucloxacillin

145
Q

First line Rx in Ankylosing spondylitis ?

A

Exercise + NSAIDs

146
Q

The major target for pANCA is:

A

myeloperoxidase

147
Q

Osteomyelitis Ix of choice:

148
Q

After nifedipine which Rx is used in Raynauds ?

A

IV prostacyclin

149
Q

Leflunomide Side effect :

A

Hypertension

150
Q

Dorsum of the foot—which nerve root ?

151
Q

Birbeck granules seen in :

A

Langerhans cell histiocytosis

152
Q

Tennis racket granules are seen in :

A

Langerhans cell histiocytosis

153
Q

Bone pain + cutaneous nodules + recurrent otitis media + Birbeck granules

A

Langerhans cell histiocytosis

154
Q

Langerhans cell histiocytosis

A

Bone pain + cutaneous nodules + recurrent otitis media + Birbeck granules

155
Q

Osteonecrosis of the jaw—caused by Oral or IV Bisphosphonates?

A

Caused by IV Bisphosphonates

156
Q

Temporal arteritis with eye involvement Rx:

A

IV methylprednisolone

157
Q

Photosensitive rash + small joint arthritis + Raynauds. Dx?

158
Q

which joint involvement in SLE ?

A

Small joints

159
Q

Which antibody is most likely to be positive in SLE ?

A

ANA
Anti-nuclear (ANA) antibody is the most likely antibody to be present. Approximately 95% of people with SLE have a positive ANA, however it is not very specific.

Anti-Sm are the most specific antibodies for SLE, but only around 35% of patients with SLE will be positive. Anti-dsDNA antibodies are positive in around 70% of SLE cases.

160
Q

Sjgorens patient—which meds for dry mouth ?

A

Pilocarpine

161
Q

Dry eyes + Dry Mouth + Arthralgia + Anti ro + anti LA + Schrimmer’s test positive. Dx:

162
Q

Sjogren

A

Dry eyes + Dry Mouth + Arthralgia + Anti ro + anti LA + Schrimmer’s test positive. Dx:

163
Q

Which eminence is involved in Median nerve ?

A

Thenar eminence

164
Q

Which muscles are supplied by Median nerve ?

A

LOAF

Lumbricles
Opponens policies
Abductor policies brevis
Flexor policies brevis

165
Q

Which thumb action is affected in carpal tunnel ?

A

Thumb abduction

166
Q

Which clinical signs are seen in Carpal Tunnel ?

A

Tinel’s sign—tingling sensation on tapping
Phalen’s test—Phlexion test—symptoms come up after flexion of wrist

167
Q

Which ocular complications is associated with Temporal Arteritis ?

A

AION

Anterior Ischaemic optic neuropathy

168
Q

Looser’s zone is associated with which ortho condition ?

A

Osteomalacia

169
Q

Which one of the following cells secretes the majority of tumour necrosis factor in humans?

A

Macrophages

170
Q

Age group of SLE patients ?

A

20-40 years

171
Q

Anti-dsDNA titres In SLE :

A

Useful marker to monitor the disease activity

172
Q

Physical or mental exertion usually makes the symptoms___ in chronic fatigue syndrome

173
Q

patients aged 75 and over with a history of fragility fractures should be

A

Start treatment with Oral Bisphosphonates before DEXA

174
Q

If alendronate is not tolerated,

A

Switch to risedronate

175
Q

Which foods precipitate attack of gout ?

A

Liver, kidneys, seafood, oily fish (mackerel, sardines) and yeast products

176
Q

Reactive arthritis + Yellow stuff on foot ?

A

keratoderma blennorrhagicum

177
Q

H/O travel—Weeks later C/o: Knee pain + yellow stuff on foot

A

Reactive arthritis

Gonococcal arthritis can present similarly but typically occurs during active infection rather than weeks later

178
Q

Does lithium precipitate Gout ?

179
Q

Which ANCA in PAN ?

180
Q

Which thyroid issue predisposes to Osteoporosis ?

A

Hyperthyroidism

181
Q

Does hypothyroidism cause osteoporosis ?

182
Q

what does not cause osteoporosis ?

A

Obesity and hypothyroidism

183
Q

Which congenital disorder predisposes maximum risk for osteoporosis ?

A

Osteogenesis Imperfecta

184
Q

Which gender is affected more in psoriatic arthropathy ?

A

male and Female are equally affected

185
Q

Neurological Manifest in Sjogren’s ?

A

Sensory Polyneurpathy

186
Q

Kindney manifestation in Sjogren ?

A

Renal tubular Acidosis

187
Q

Does dilated cardiomyopathy occur in Sjogren ?

188
Q

Methotrexate MOA :

A

Reversible Inhibition of dihydrofolate reductase

189
Q

Second wind Phenomenon is seen in :

A

Mcardle’s

190
Q

Double contour sign is seen in ?

191
Q

RANK L inhibitor :

192
Q

After Anti Mi 2 , which antibody is specific to dermatomyositis ?

193
Q

Which defect in Marfan’s ?

194
Q

Initial therapy for Rheumatoid Arthritis :

A

DMARD + Short Course of prednisolone

195
Q

Which nerve root in postero-lateral aspect of his right lower leg and foot?

196
Q

Bisphosphonates MOA :

A

Inhibits Osteoclasts

197
Q

Dactylitis + DIP joint involvement

A

Psoriatic arthropathy

197
Q

— helps to distinguish pseudogout from gout

A

Chondrocalcinosis

The correct answer is chondrocalcinosis. This can be seen as linear calcifications of the meniscus and articular cartilage on an x-ray of the knee. This is seen in pseudogout, but not particularly associated with gout, and so it can be used to distinguish between the two.

198
Q

lateral epicondylitis: worse on resisted _____/suppination whilst elbow extended

A

Wrist extension

199
Q

A diagnosis of mixed connective tissue disease (MCTD) is suspected

A

Anti RNP(Ribonuclaer protein)

200
Q

diagnosis of lateral epicondylitis is suspected. Which one of the following movements would characteristically worsen the pain?

A

: worse on resisted wrist extension/suppination whilst elbow extended

201
Q

Most common organism in septic arthritis :

A

Staph Aureus

202
Q

Most common side effects with alendronate :

A

Heart Burn

203
Q

Lens dislocation in Marfan’s :

A

Upward dislocation of lens

204
Q

Is “ Swelling immediately after the injury and now.“ indication for Ottawa X ray ?

205
Q

Ottawa rules for X ray ankle ?

A

bony tenderness at the lateral malleolar zone (from the tip of the lateral malleolus to include the lower 6 cm of posterior border of the fibular)
bony tenderness at the medial malleolar zone (from the tip of the medial malleolus to the lower 6 cm of the posterior border of the tibia)

206
Q

In Marfan’s , What is the most important investigation to monitor their condition?

A

Echocadiography—to monitor aortic dissection

207
Q

ulnar deviation reproducing the pain Is seen in :

A

Dequervian

Finkelstein test

208
Q

Eye symptoms in Behcets:

A

Anterior Uveitis

Not conjuctivitis

209
Q

Behcets triad :

A

Genital ulcers/Oral ulcers + Anterior uveitis

210
Q

apart from triad what other symptoms are seen in Behcets ?

A

Athralgia
DVT
Aseptic Meningitis
GI
Erythema Nodosum

211
Q

IV alendronate Side effects :

A

Osteopetrosis of jaw.

212
Q

Bull’s Eye Maculopathy is seen in :

A

Hydroxychhloroquine

213
Q

ON Hydroxychloroquine, which test to monitor ?

A

Eye and fundoscopy

214
Q

In Ankylosing Spondylitis , TNF-inhibitors will improve all of the following except:

A

Radiological progression

215
Q

Fever/back pain with pain on extension of the hip:

A

Iliopsoas abscess

216
Q

Which diuretics can precipitate gout ?

A

Thiazide diuretics—Indapamide

217
Q

Which antibiotic to avoid with Methotrexate ?

A

Co-trimoxazole

Methotrexate acts by inhibiting dihydrofolate reductase which thereby inhibits the synthesis of purines which, in turn, arrests cell division.

Co-trimoxazole contains sulfamethoxazole and trimethoprim. Both of these antibiotics exert their therapeutic effect through inhibition of folate metabolism. Therefore there is a greater risk of pancytopenia.

218
Q

apremilast MOA :

A

phosphodiesterase type-4 (PDE4) inhibitor

219
Q

Patient with Vitamin D deficiency :

A

load with vitamin D and then continue on maintenance.

220
Q

Worst prognosis in Polymyositis :

A

Interstitial Lung disease

221
Q

A 76-year-old female presents with a 1 month history of left sided temporal headaches and jaw claudication. Biopsy of left temporal artery is negative. Next step ?

A

Commence Prednisolone

222
Q

HLA associated with Reactive arthritis ?

223
Q

Birth Given—2 weeks later—Arhtralgia + Skin Rash + Fever.

224
Q

Raynauds is most commonly associated with which condition ?

A

Systemic Sclerosis

225
Q

A 59-year-old man with a history of gout presents with a swollen and painful first metatarsophalangeal joint. He currently takes allopurinol 400mg od as gout prophylaxis. What should happen to his allopurinol therapy?

A

Continue allopurinol in current dose.

Allopurinol is a xanthine oxidase inhibitor that reduces the production of uric acid, and it is used as a long-term management strategy for gout. According to the UK guidelines, during an acute attack of gout, existing urate-lowering therapy (like allopurinol) should not be discontinued or altered in dosage. This is because changes in serum urate levels can precipitate acute attacks. Therefore, continuing allopurinol at its current dose would be the most appropriate course of action.

226
Q

Elderly on Warfarin—C/o Gout Attack. Rx?

A

Colchicine

NSAIDs should be avoided in elderly patients taking warfarin due to the risk of a life-threatening gastrointestinal haemorrhage.

227
Q

CKD + Gout attack Rx?

A

Colchicine

Avoid NSAID in CKD patient

228
Q

Approximately what percentage of patients with psoriasis develop an associated arthropathy?

229
Q

CRP in SLE

230
Q

Relieving factors in carpal tunnel syndrome ?

A

Shaking of hands improve symptoms

231
Q

When does carpal tunnel syndrome pain get worse ?

A

It gets worse at night

232
Q

Mode of inheritance in Marfan’s ?

A

Autosomal Dominant

233
Q

Hydroxychloroquine in pregnancy ?

A

It’s considered safe in pregnancy

234
Q

Pain all over her body for the past 4 months + tender areas on her neck, elbow regions, and knees + feeling tired and not being able to sleep because of the pain +

A

Fibromyalgia

he pain did not appear to be originating from the joints and therefore this makes a diagnosis of rheumatoid arthritis unlikely. The two most likely diagnoses are fibromyalgia and polymyalgia rheumatica. However, polymyalgia rheumatica would have also presented with weight loss and fever. This patient most likely has fibromyalgia. She also feels tired and suffers from sleep disturbances, which are both common complaints in patients suffering from fibromyalgia.

235
Q

Osteoporosis is due to defect in :

A

Osteoclast Function

236
Q

Serum CK and Muscle Biopsy in Fibromyalgia ?

A

serum CK and muscle biopsy are normal.

237
Q

Eye symptoms in Behcets and Reactive arthritis :

A

Behcets—Anterior Uveitis
Reactive arthritis—Conjunctivitis

238
Q

Does aseptic Meningits occur in reactive ?

A

No

Occurs in Behcets

239
Q

Risk Factor for Carpal tunnel ?

240
Q

What is increased in Paget’s disease ?

A

Serum and urine Hydroxyproline

241
Q

Cardiac features of Pseudoxanthoma Elasticum :-

A

Mitral Valve Prolapse

Ischaemic Heart disease—D/t damage to Blood vessels

242
Q

GI Features of Pseudoxanthoma Elasticum:-

A

GI Haemorhage

243
Q

Mode of inheritance in Pseudoxanthoma Elasticum :

A

Autosomal recessive

244
Q

How to take alendronate ?

A

Take at least 30 minutes before breakfast with plenty of water + sit-upright for 30 minutes following.

245
Q

After NSAID and Steroids, what’s the treatment for Still’s disease ?

A

Methotrexate / IL 1 antagonist-Anakinra / Anti TNF therapy-Etanercept

246
Q

1st X-ray sign of Rheumatoid arthritis ?

A

Juxta Articular Osteopenia/Osteoporosis

247
Q

Temporal arteritis with No eye symptoms and eye symptoms :

A

No eye symptoms—High dose oral prednisolone

Eye symptoms—IV steroids

248
Q

Olecranon Bursitis :

A

Painful swelling on the posterior aspect of his elbow. There is no history of trauma. On examination an erythematous tender swelling is noted. What is the most likely diagnosis?

249
Q

Painful swelling on the posterior aspect of his elbow. There is no history of trauma. On examination an erythematous tender swelling is noted. What is the most likely diagnosis?

A

Olecranon Bursitis

250
Q

Mixed connective tissue disease Clinical features :

A

Raynauds + Dactylitis ( Both finger related symptoms ) + Arthritis/ Myalgai + Anti Ribonuclear protein Positive.

Dactylitis—Think MCTD or Psoriatic Arthritis

Psoriatic Arthritis—Dactylitis + DIP + Morning stiffness relieved by activity

MCTD—Raynauds + Dactylitis + Arhritis + Myalgia

251
Q

Raynauds + Dactylitis ( Both finger related symptoms ) + Arthritis/ Myalgai. Dx:

A

Mixed connective tissue disease

Anti ribonuclear protein positive

Dactylitis—Think MCTD or Psoriatic Arthritis

Psoriatic Arthritis—Dactylitis + DIP + Morning stiffness relieved by activity

MCTD—Raynauds + Dactylitis + Arhritis + Myalgia

252
Q

Patient has Rheumatoid arthritis + Which one of the following complications is most likely to occur as a result of her disease?

A

Ischaemic Heart disease

253
Q

A 72-year-old man presents with right knee pain, vomiting, and rigors that have persisted for one week and have not improved with oral co-amoxiclav. He has a past medical history including hypertension, type two diabetes and chronic kidney disease (CKD) stage 3.

His medication history includes ramipril, bendroflumethiazide, and dapagliflozin.

His temperature is 38.8ºC, and his blood pressure is 103/72 mmHg. Physical examination reveals a right knee effusion and reduced range of motion.

A joint aspirate shows purulent fluid and polymorphs but no identifiable organisms.

What treatment should be initiated?

A

Dx: Septic Arthritis—Onset is acute+fever+limited range of motions+ turbid synovial fluid —
Rx: IV Flucloxacillin

Not Gout—fever is not present in gout.

Reactive arthritis— Onset is subacute or insidious, typically occurring 1-4 weeks after a gastrointestinal or genitourinary infection.
Synovial fluid is typically non-purulent (clear or slightly cloudy).
Triad : Conjutivitis + Urhtritis + Arthritis

254
Q

What is the most likely underlying mechanism of Gout ?

A

Decreased renal excretion of uric acid

255
Q

Rx for Paget’s

A

Alendronate

256
Q

Mnemonic for X ray findings of Rheumatoid Arhritis :

A

LOSERS

Loss of joint space
Osteopenia—1st sign
Soft tissue swelling
Periarticular Erosions—Very Specific Sign
Sublaxation

257
Q

In the LOSERS mnemonic for Rheumatoid Arthritis, which is a very specific sign ??

A

Per articular erosions.

LOSERS

Loss of joint space
Osteopenia—1st sign
Soft tissue swelling
Periarticular Erosions—Very Specific Sign
Sublaxation

Gastroenterology (13 decks)

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