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MRCP 2 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Markers of bone turnover in Paget’s

A

Raised alkaline phosphatase (ALP)

Serum C-telopeptide (CTx)

Urinary hydroxyproline

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2
Q

Management of Paget’s

A

Bisphosphonate

(either oral risedronate or IV zoledronate)

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3
Q

Denosumab

A

RANKL inhibitor (Human monoclonal antibody)

Prevents the development of osteoclasts

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4
Q

Bony metastases - bone protection

A

Bisphosphonates and denosumab can be used to prevent pathological fractures in bone metastases.

If the eGFR < 30, denosumab is preferred

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5
Q

There is an overlap between temporal arteritis and ?

A

Polymyalgia rheumatica (PMR)

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6
Q

GCA - visual complication?

A

Anterior ischemic optic neuropathy (AION)

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7
Q

CREST syndrome

A

Subtype of limited systemic sclerosis

Calcinosis

Raynaud’s phenomenon

oEsophageal dysmotility

Sclerodactyly

Telangiectasia

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8
Q

Anti-centromere AB

A

CREST

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9
Q

Anti scl-70 antibodies

A

Diffuse cutaneous systemic sclerosis

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10
Q

Renal complications of systemic sclerosis - treatment?

Scleroderma renal crisis (SRC)

A

ACE-inhibitors

(eg. captopril)

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11
Q

Discoid lupus erythematous - treatment?

A

Topical steroids → oral hydroxychloroquine

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12
Q

Which medications should never be co-prescribed with Methotrexate?

A

Co-trimoxazole

Trimethoprim

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12
Q

Methotrexate - MOA

A

Antimetabolite that inhibits dihydrofolate reductase

Which is an enzyme essential for the synthesis of purines and pyrimidines

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13
Q

Methotrexate toxicity

A

Folinic acid

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14
Q

Polyarteritis nodosa - define

A

Vasculitis affecting medium-sized arteries with necrotizing inflammation leading to aneurysm formation.

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15
Q

Still’s disease in adults - treatment

A
  1. NSAIDs
  2. Steroids
  3. Methotrexate / IL-1 inhibitor (Anakinra)
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16
Q

Most common cause of discitis

A

Staphylococcus aureus

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17
Q

Treatment of acute gout in patient with acute kidney disease

A

Steroids

NSAIDs/Colchicine (avoid in severe CKD)

18
Q

Familial Mediterranean Fever - treatment

A

Colchicine

19
Q

Reactive arthritis

A

HLA-B27 associated seronegative spondyloarthropathies

Urethritis
Conjunctivitis
Arthritis

20
Q

Osteomalacia - define

A

Softening of the bones secondary to low vitamin D

21
Q

Vit D levels 30-50 - treatment?

A

Maintenance Vitamin D

22
Q

Vit D levels <30 - treatment?

A

Loading Dose Vitamin D

23
Q

Polymyositis - investigations

A

High CK

LDH

EMG

Muscle biopsy

Anti-synthetase antibodies
Anti-Jo-1 antibodies

24
Q

Treatment for Polymyositis?

A

High dose steroids (Tapering)

Steroid sparing agent: Azathioprine

25
Q

McArdle’s disease

A

Autosomal recessive

Type V glycogen storage disease

Muscle pain and stiffness following exercise

26
Q

Felty’s syndrome

A

Rheumatoid Arthritis + Splenomegaly + Low white cell count

27
Q

Lateral epicondylitis

A

Worse on resisted wrist extension/supination whilst elbow extended

28
Q

Worse on resisted wrist extension/supination whilst elbow extended

A

Lateral epicondylitis (tennis elbow)

29
Q

Resisted wrist flexion and pronation - pain

A

Medial epicondylitis - Golfer’s elbow

30
Q

Letrozole

A

Aromatise inhibitor

Used to treat oestrogen receptor positive breast cancer

31
Q

Trastuzumab

A

Monoclonal antibody against the HER2 receptor

Part of therapy to treat HER2 positive breast cancer.

32
Q

Rheumatoid arthritis: management - initial therapy

A

DMARD monotherapy +/- a short-course of bridging prednisolone

DMARD of choice - Methotrexate

Sulfasalazine
Leflunomide
Hydroxychloroquine

33
Q

Most common causes of drug induced Lupus

A

Procainamide

Hydralazine

34
Q

Important and common side-effects of NSAIDs

A

Peptic ulceration

Exacerbation of asthma

35
Q

Treatment of choice for SLE

A

Hydroxychloroquine

36
Q

Oral ulcers, genital ulcers and anterior uveitis

A

Bechet’s syndrome

37
Q

Diagnosis of Bechet’s

A

Pathergy Test

Puncture site following needle prick becomes inflamed with small pustule forming

38
Q

Mycophenolate - safe in pregnancy?

39
Q

? antibodies are specific for drug-induced lupus.

A

Anti-Histone

40
Q

Pharmacological option for Raynaud’s phenomenon

A

Nifedipine

41
Q

Investigation of choice for Avascular necrosis of the hip

42
Q

Treatment for Fibromyalgia

A

Aerobic exercise: has the strongest evidence base

Cognitive behavioural therapy

Medication: pregabalin, duloxetine, amitriptyline

MRCP 2 (13 decks)

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