Rheumatology Flashcards
Contraindication to infliximab (TNF alpha inhibitors)
Co-existing multiple sclerosis
Serious infection inc TB
Hypersensitivity
High dose in mod/severe heart failure
NOT C/I in preg/lactation
Which antibody in limited cutaneous systemic sclerosis (not all CREST symptoms present)
Anti-centromere
In limited systemic sclerosis, why dyspnoea?
Pulm artery HTN
If topi-isomerase positive(systemic sclerosis): ILD
Langerhan’s cell histiocytosis
(ILD + vertebral involvement + DI)
Confirmed on transbronchial lung biopsy
Positive CD1a and S100
Brubeck granules on electron microscopy
HRCT: apical cystic/cavitating lesions, later honeycombing
Raynaud’s worsened by which drugs
Atenolol
Methysergide (for migraine)
Swap with Ramipril for HTN control
Treat with Nifedipine (not Verapamil)
Biggest risk factor for developing RA?
Smoking
What are the features of alkaptonuria?
Deficiency of homogentisic acid oxidase
Dark urine, dark pigmentation of sclera, connective tissues
Ochronosis = cartilage pigmentation
Knee and spine involvement
Sjögren’s syndrome antibodies
Anti Ro
Anti La
TNF alpha antibodies
Infliximab
Adalimumab
Etanercept
Treatment of Charcot arthropathy?
Immobilisation in cast for 3-6 months
?Bisphosphonates
Treatment of APLA in pregnancy
low molecular weight heparin and Aspirin
Methotrexate toxicity
myelosuppression
raised ALT
Treatment of amyloid in familial Mediterranean fever
Colchicine
Systemic inflammatory amyloidosis
Hepatomegaly
Heavy proteinuria
Raised ALP
Associated with Rheumatoid
Pain pattern in PMR
Worse in the morning, improves throughout the day
Drug induced lupus
Hydralazine
Methyl dopa
Thiazides (anti Ro positive)
Procainamide
Isoniazid
Timolol
Phenytoin
Carbamazepine
Valproate
Simvastatin
Captopril
Penicillamine
Procainamide
Minocycline
Griseofulvin
Anti histone!!
Avascular necrosis confirmed by?
MRI hip
Treatment or halting of scleroderma renal crisis?
ACE inhibitors
Prostacyclin infusion
Dermatomyositis antibody
Anti Jo
Osteomalacia (Vit D deficiency) X-ray findings
Looser’s zones: low density bands extending from cortex inwards
Psoriatic arthritis can also present with what unique feature?
Flexor tendon synovitis
Lofgren syndrome
Acute sarcoidosis with polyarthralgia
Side effects of Tocilizumab
Neutropenia
HSP investigations?
Urine dip
Multicentric reticulo-histiocytosis
Nail fold nodules liek coral beads
Poor prognosis of systemic sclerosis
Anti RNA polymerase III
Scleroderma renal crisis
Prevention: avoid glucose-corticoids
Treatment: Use ACE inhibitors
Hereditary haemochromatosis
Liver disease
Impotence
Hypogonadism
DM
Skin hyperpigmentation
Chondrocalcinosis- calcium pyrophosphate crystal deposition causing arthropathy
Most common cause of infection/osteomyelitis in puncture wound/ear piercing in non-diabetic?
Pseudomonas
Otherwise S. aureus
Lupus pernio
Cutaneous sarcoidosis
Morphea
Form of scleroderma without visceral organ involvement
Discoid lupus
Cutaneous SLE
T score -4, risk of VTE, esophagitiss
Teriparatide (PTH analogue)
Arthritis mutilans
Psoriatic arthritis: distal
RA: proximal
(long standing)
Chronic deformity treated with MTX (as DMARD) and Prednisolone (for pain)
Sarcoid unique joint feature?
Ankle synovitis
Treatment of primary Raynaud’s
Nifedipine MR
Losartan
Erythema nodosum antibody association?
HLA B27
