Rheumatology

Question 1

Ankylosing spondylitis - x-ray findings?

Answer 1

subchondral erosions, sclerosis
and squaring of lumbar vertebrae

Question 2

Anti phospholipid syndrome antibodies?

Answer 2

anticardiolipin antibodies
anti-beta2 glycoprotein I (anti-beta2GPI) antibodies
lupus anticoagulant

Question 3

De Quervain’s tenosynovitis affects the muscles?

Answer 3

Abductor pollicis longus and extensor pollicis brevis tendons

Question 4

McArdle’s disease

Answer 4

myophosphorylase deficiency.
rhabdomyolysis & myoglobinuria after short bout if exercise

Question 5

Behcet syndrome

Answer 5

oral ulcers, genital ulcers and anterior uveitis, HLA B 51

Question 6

Scleroderma antibodies

Answer 6

Anti scl 70 - systemic scleorsis
Anti centromere - limited cutaneous

Question 7

Osteomalacia lab values

Answer 7

low ca, phosphorous, raised alp and pth

Question 8

mixed connective tissue disorder antibody

Answer 8

anti U1RNP

Question 9

Gout X Ray findings

Answer 9

Gout
â- Soft tissue swelling, punched-out bone lesions and overhanging sclerotic margins.

Question 9

OA X Ray findings

Answer 9

Osteoarthritis
â- Joint space narrowing, osteophytes, subchondral sclerosis, and subchondral cysts.

Question 10

RA X Ray findings

Answer 10

Rheumatoid arthritis
â- Early x-ray findings: loss of joint space, juxta-articular osteoporosis, soft-tissue swelling
â- Late x-ray findings: periarticular erosions, subluxation

Question 10

Psoriatic arthritis X Ray findings

Answer 10

Psoriatic arthritis
â- Often have the unusual combination of coexistence of erosive changes and new bone formation
â- Periostitis
â- ‘Pencil-in-cup’ appearance

Question 11

Proximal muscle weakness + mechanic hands

Answer 11

Anti synthetase syndrome associated with myositis

Question 12

Langerhans cell histiocytosis

Answer 12

Birbeck granules on electron microscopy, recurrent otitis media, skin rash and the lytic bone lesions

Question 13

Rotator cuff muscles

Answer 13

SITS
Supraspinatus - abduction of shoulder upto 15 degrees, further by deltoid
Infraspinatus - external rotation
Teres minor - external rotation
Subscapularis - internal rotation

Question 14

ANCA target cells

Answer 14

C anca - serine proteinase 3 pr3
P anca - myeloperoxidase mpo

Question 15

What levels to check before starting Azathioprine

Answer 15

thiopurine methyltransferase TPMT
Azathioprine is metabolised to the active compound mercaptopurine by TPMT, if tpmt def can cause pancytopenia
safe in pregnancy

Question 16

Dermatomyositis/ polymyositis criteria for diagnosis

Answer 16

Proximal muscle weakness
Skin changes - periorbital swelling, heliotrope rash, gattrons papules
Raised CK
Biopsy of muscle showing increased wbcs between muscles
Electron microscopy
Anti Mi 2 positive

for polymyositis - skin changes not prominent, Anti Jo-1 positive

Question 17

Osteogenesis imperfecta occurs due to an abnormality in which type of collagen

Answer 17

Osteogenesis imperfecta occurs due to an abnormality in type 1 collagen

Question 18

Pseudogout caused due to

Answer 18

deposition of calcium pyrophosphate dihydrate crystals in the synovium.
underlying risk factor -
haemochromatosis
hyperparathyroidism
low magnesium, low phosphate
acromegaly, Wilson’s disease

Question 19

DOC for SLE

Answer 19

HCQ

Question 20

Features of Lateral epicondylitis and Medial epicondylitis

Answer 20

Lateral - pain on wrist extension, supination - tennis elbow
Medial - pain on wrist flexion, pronation - golfer’s elbow

Question 21

Antibodies for diseases

Answer 21

anti-Ro: Sjogren’s syndrome, SLE, congenital heart block
anti-La: Sjogren’s syndrome
anti-Jo 1: polymyositis
anti-scl-70: diffuse cutaneous systemic sclerosis
anti-centromere: limited cutaneous systemic sclerosis