Rheumatology Flashcards

Question

renal failure

Answer 1

low Ca, high Po, ALP raised

Answer 2

1. V/ A thrombosis, recurrent miscarriages, livedo reticularis, pre-eclamsia, PH, 2. Infections Hepatitis C, Human immunodeficiency virus (HIV), etc Autoimmune disorders Lupus, Sjogrens syndrome, Thyroid disease, Rheumatoid arthritis, and Celiac disease Raynaud's, Kidney failure, Stroke, Heart damage, Pregnancy complications, and Multiple organ damage cancers, PE 3. anticardiolipin, anti-beta2 GPI, lupus anticoagulant, thrombocytopenia, prolonged APTT

Answer 3

1. glycogen storage disease type 5 (GSD 5). autosomal ressesive 2. Muscle pain and fatigue, especially during exercise Muscle cramps Muscle weakness Brownish red urine 3.

Answer 4

1. Causes Repetitive grasping and lifting activities and Tightness and swelling in the radial tunnel.

Answer 5

1. lateral hip pain, typically aggravated by physical activity, and point tenderness adjacent to the greater trochante

Answer 6

1. autosomal dominent - collagen 3 2. Hypermobile joints that may dislocate Soft, fragile skin that bruises easily, flat feet, dentsl issues, muscle weakness

Answer 7

1. DHF reductase inhibiotor

Answer 8

1. Squaring, bamboo spine, Syndesmophytes (commonest), Shiny corner sign,

Answer 9

in order 1. non-pharmacological treatments & support therapeutic exercise 2. topical non-steroidal 3. oral NSAID + gastroprotective 4. intra-articular corticosteroid injections for short-term relief | no paracetamol, opioids, glucosamine

Answer 10

1. that weakens bones, making them fragile and prone to fractures, often developing silently until a fracture occurs, particularly in the hip, spine, or wrist. LRP5, WNT16, and others that are linked to bone health and fracture risk T Score = -1 to -2.5 indicating osteopenia, and -2.5 or lower indicating osteoporosis

Answer 11

1. FBN1 Cardiovascular: Aortic dilatation, aortic dissection, mitral valve prolapse. Skeletal: Long limbs, slender fingers and toes (arachnodactyly), scoliosis, pectus excavatum or pectus carinatum. Ocular: Ectopia lentis (lens dislocation), myopia. Fibrillin-1 and Microfibrils: Fibrillin-1 is a major component of microfibrils, which are thread-like structures that form part of the fibers providing strength and flexibility to connective tissue. Gene Mutation: Mutations in FBN1 lead to reduced or altered fibrillin-1, disrupting the structure of microfibrils and the overall function of connective tissue. TGF-beta Dysregulation: Fibrillin-1 also plays a role in regulating the activity of TGF-beta, a growth factor that influences cell growth and development. In Marfan syndrome, reduced fibrillin-1 leads to increased TGF-beta activity, contributing to tissue problems. Microfibril-Growth Factor Interactions: Microfibrils bind to growth factors and release them at specific times to control tissue growth and repair. In Marfan syndrome, the impaired microfibrils can't bind to these growth factors, leading to an excess of free growth factors and further contributing to tissue instability.

Answer 12

Reuced lateral flexion Reduced forward flexion - shobers test Reduced chest expansion

Answer 13

1. associated with Hep B

Answer 14

Labial salivary gland with focal lymphocytic sialadenitis and a focus score† of ≥ 1 Anti-SSA antibodies (anti-Ro) Ocular staining score‡ ≥ 5 (or van Bijsterveld score ≥ 4) in at least 1 eye Schirmer test ≤ 5 mm/5 min in at least 1 eye Unstimulated whole saliva flow rate ≤ 0.1 mL/min§ Patients who fulfill the following exclusion criteria do not have primary Sjögren syndrome: History of radiation treatment to the head and neck Active hepatitis C infection (confirmed by polymerase chain reaction) Advanced HIV infection Sarcoidosis Amyloidosis Graft-vs-host disease IgG4-related disease

Answer 15

1. Hydroxychloroquine, DMARD 2. Lymphoma

Answer 16

1. GCA 2. Taka

Answer 17

PAN Kawasaki

Answer 18

ANCA positive Veg Microscopic polyangitis

Answer 19

dorsal foot

Answer 20

IV bispohospehnate for cancer

Answer 21

headache, urine incon, leg pain

Answer 22

1. rash, arthralgia, myalgia, ANA +(100%), Anti Histone antibody (90%) 2. inh, PHY,Procan, HRDLZ

Answer 23

pain and stiffness, primarily in the shoulders, neck, and hips, develops quickly, Fatigue (extreme tiredness), Loss of appetite, Weight loss, Fever (sometimes), Depression or feeling unwell., no muscle weakness, anemia 50- 70 F>M recover with steroids (along with Vit D, Calcium, bisphosphonates) ESR, CRP positive a large vessel vasulitis Associate with GCA overlap syndrome

Answer 24

manifests as chronic back pain and stiffness, especially in the morning or after inactivity, often accompanied by fatigue and pain in other joints or where tendons attach to bones 18y - 40 y , HLA-B27 genetic risk factor, M>F Axial Spondylitis (Spine Involvement) - Back Pain and Stiffness, Sacroiliitis, Kyphosis, Peripheral Arthritis (Joint Involvement), - joint Pain and Swelling, Enthesitis, Dactylitis Extra-Articular Manifestations (Organ Involvement) - Uveitis, IBD, Cardiovascular(Aoritic Regurgitation, AV bock ), Pulmonary(Apical Pulmonary Fibrosis-), Skin rashes, especially psoriasis diagnosis - at least 3 months of lower back pain that gets better with exercise and doesn't improve with rest, X ray (MRI for pogression / early disease ) tramline" or "bamboo spine" appearance on X-rays refers to the fusion of vertebrae and the formation of new bone (syndesmophytes) along the spine Treatment - NSAIDS, TNF inhibitors, Interleukin-17 (IL-17) inhibitors, Exercises & physical training, Adelilumab, Etternest, Infliximab poor progonistic - ESR<30, Agee <16, Ealry Hip/lumbar, ductilitis

Answer 25

a common condition where blood vessels in the fingers and toes temporarily constrict in response to cold or stress, causing color changes and potential numbness or coldness Cause: Occurs on its own, without any underlying medical condition, first degree relative with Reynauds less severe ages of 15 and 25. resolve on their own. color change to the affected areas (white, then blue, then red

Answer 26

underlying medical condition, such as an autoimmune disease, medication, or injury. more serious lead to ulcers or tissue damage. appear later in life, around age 40. Progression:digital ischemia, tissue necrosis, and gangrene. Associated Conditions: Often associated with autoimmune conditions like scleroderma- 95%, lupus, rheumatoid arthritis, and Sjogren's syndrome. Treatment: underlying condition, and medications like calcium channel blockers color change to the affected areas (white, then blue, then red).

Answer 27

a chronic inflammatory condition affecting large and medium-sized arteries, particularly those in the head and neck, that can lead to serious complications like vision loss if left untreated Symptoms of Giant Cell Arteritis: Headaches: Often severe and located in the temple area. Scalp Tenderness: Pain or sensitivity when touching the scalp. Jaw Pain: Pain or stiffness when chewing or talking. Visual Disturbances: Sudden vision loss or double vision, which can be a serious complication. Flu-like Symptoms: Fatigue, fever, weight loss, and loss of appetite. Other Symptoms: Neck or shoulder pain, and in some cases, pain in the arms or legs. Systemic Features: Fever, fatigue, anorexia, weight loss, and depression. Diagnosis: Temporal Artery Biopsy: A biopsy of the temporal artery is the most definitive test for GCA. Blood Tests: Blood tests can help identify signs of inflammation. Imaging Studies: Imaging techniques like CT or MRI scans can help assess the extent of the inflammation.

Answer 28

Symptoms: AAION typically presents with sudden, often painless, vision loss, which can be severe and potentially lead to blindness if left untreated arteritic posterior ischemic optic neuropathy (A-PION - less common high-dose corticosteroids

Answer 29

bilateral apical fibrobullous lesions and can lead to symptoms like cough, dyspnea, and sputum production in advanced stages. lead to progressive fibrosis, nodular coalescency, cysts, cavities, and bronchiectasis

Answer 30

active infections, untreated latent tuberculosis, pre-existing demyelinating diseases, current malignancy, or severe congestive heart failure, Hepatitis B, Pregnancy,

Answer 31

dry eyes and mouth due to inflammation and destruction of the tear and saliva glands, but can also involve systemic symptoms like fatigue, joint pain, and dry skin antibodies - Anti-Ro/SSA and Anti-La/SSB gene - HLA-DR and HLA-DQ alleles. IRF5

Answer 32

where nerves or blood vessels in the area between your neck and shoulder (the thoracic outlet) are compressed, leading to symptoms like pain, numbness, and tingling in the neck, shoulder, arm, and hand. cold, swelling, blanching, dissapiarance of pulse when abduction

Answer 33

rare type of vasculitis that causes inflammation of the large arteries, primarily the aorta and its major branches, potentially leading to narrowing, blockage, or weakening of the artery walls. Japanese female 20-40

Answer 34

a painful condition characterized by pain and tenderness on the outside of the elbow, often caused by overuse or repetitive strain of the forearm extensor muscles

Answer 35

limited cutaneous systemic sclerosis, is a subtype of scleroderma characterized by the features: calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, - claw-like" appearance, and telangiectasia. scleroderma-associated interstitial lung disease (SSc-ILD), is a common complication of CREST syndrome. CREST syndrome is a form of limited scleroderma, a connective tissue disease characterized by skin thickening and changes to blood vessels. SSc-ILD involves scarring and thickening of the lung tissue, leading to breathing difficulties Pulmonary hypertension is a major complication of CREST syndrome, Scleroderma renal crisis is a severe and potentially life-threatening complication involving a sudden and significant increase in blood pressure, leading to rapid kidney failure anti-centromere antibodies are a hallmark of CREST syndrome, other autoantibodies, such as anti-Scl-70 (anti-topoisomerase I), are more commonly associated with diffuse scleroderma - trunk & proximal derma involved

Answer 36

chronic inflammatory disease characterized by vasculitis (inflammation of blood vessels) and granulomas (clusters of immune cells) that can damage organs, particularly the lungs, kidneys, and upper respiratory tract. sinusitis, nosebleeds, crusting, cough, shortness of breath, Kidney Problems, Skin Ulcer, rashes antineutrophil cytoplasmic antibodies (ANCAs), specifically those targeting proteinase 3 (PR3 common in 40 and 65 years HLA-DPB1 gene, PTPN22 and CTLA4 diagnosis - upper and lower respiratory tract involvement, renal involvement, and constitutional symptoms, along with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). Corticosteroids, Cyclophosphamide, Rituximab Long-term complications are common (86%), mainly chronic kidney failure, hearing loss, and deafness

Answer 37

ainful swelling around your thumb tendons caused by repetitive motion

Answer 38

enosynovitis involves tendon inflammation, while osteoarthritis affects the joints themselves.

Answer 39

Non-weight-bearing: The child is unable or unwilling to bear weight on the affected leg. Temperature > 38.5°C (101.3°F): The child has a fever. ESR > 40 mm/hr: The ESR is elevated. WBC > 12,000 cells/mm3: The WBC count is elevated

Answer 40

a perihepatitis linked to pelvic inflammatory disease (PID) often associated with chlamydial or gonococcal infections presents with right upper quadrant abdominal pain

Answer 41

- RA itself can lead to a weakened immune system - Immunosuppressive therapies, particularly anti-TNF drugs increase the risk of TB reactivation. Rituximab - Tofacitinib, a Janus kinase inhibitor, has also been associated with an elevated risk of TB reactivation

Answer 42

a rare, systemic necrotizing vasculitis that primarily affects medium-sized arteries, causing inflammation and damage that can lead to organ dysfunction Gene Mut - adenosine deaminase 2 (ADA2) Fever, Fatigue , Weight loss, Muscle and joint aches Abdominal pain, Skin abnormalities (e.g., purpura, livedo reticularis, ulcers, nodules, or gangrene) Nerve involvement (e.g., numbness, tingling, pain) Serious complications, such as aneurysms, strokes, or seizures

Answer 43

rare, chronic lung disease characterized by inflammation and scarring of the small airways (bronchioles), leading to airflow obstruction and difficulty breathing.

Answer 44

an autoimmune condition where the body's immune system mistakenly attacks its own muscle tissue, leading to inflammation and damage. This inflammation is primarily caused by the infiltration of cytotoxic T cells (CD8+), macrophages, and other immune cells into the skeletal muscle ro-inflammatory cytokines, like IL-21, TNF-alpha, and IL-17, which further contribute to muscle damage. between the ages of 30 and 60, with peak onset in the 50s. F>M progressive, symmetric proximal muscle weakness, elevated muscle enzymes (like creatine kinase), characteristic electrical activity on electromyography (EMG), and muscle biopsy showing inflammation, may include fatigue, joint pain, difficulty swallowing, and in some cases, skin rashes, fever, or breathing problems. ragged cuticles & bleeding at nail folds, Raynaud's Phenomenon Muscles may feel sore or achy, particularly in the morning. progressive proximal muscle weakness without sensory impairment, interstitial lung disease. CK elevated with a high ESR showing an inflammatory cause lung - resrictive pattern , CXR - diffused reticular infiltrate,