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MSK > Rheumatology > Flashcards

Rheumatology Flashcards

0
Q

What is the treatment for Raynaud’s phenomenon?

A

Calcium channel blockers (e.g. Nifedipine)

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1
Q

What is the most common site for pseudogout?

A

The knee

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2
Q

ANA is positive in 95-99% people with which condition?

A

SLE

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3
Q

What is the treatment for acute gout?

A

Intra-articular injection of corticosteroids, NSAIDs and/or colchicine

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4
Q

What is pseudogout?

A

Chondrocalcinosis (CPPD): accumulation of calcium pyrophosphate dihydrate in connective tissue

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5
Q

What blood tests best measure the disease activity of RA?

A

ESR, CRP, anaemia

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6
Q

What blood test is used to monitor the disease progression of SLE?

A

Anti-dsDNA

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7
Q

What is the most common cause of arthritis with enthesitis?

A

Spondyloarthopathies (Ankylosing spondylitis, then Psoriatic Arthritis)

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9
Q

When are DMARDs commenced in RA?

A

As soon as the diagnosis is confirmed

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10
Q

What is the difference between gout and pseudogout on analysis of synovial fluid?

A

Gout: urate crystals, needle-shaped, negatively birefringent
Psudocout: calcium crystals, rhoboidal, positively birefringent

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11
Q

What are the risk factors for gout?

A

ETOH, diuretics, lead exposure, obesity, low dose aspirin, dehydration

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12
Q

What is the most specific test for SLE?

A

Anti-ds DNA

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13
Q

Give 3 differentials for acute monoarthropathy.

A

Crystal arthritis (gout, pseudogout)
Trauma
Septic arthritis

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14
Q

What is rheumatoid factor?

A

Autoantibody: IgM against IgG

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15
Q

Which titre of ANA is strongly associated with autoimmune disease?

A

1: 160 lower cut off

1: 1280 strong

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16
Q

What are the x-ray findings of psoriatic arthritis?

A

Soft tissue swelling
Periosteal reaction (bone formation)
Erosions
Pencil-in-cup deformities

17
Q

What are the x-ray findings in RA?

A 
Soft tissue swelling
Periarticular osteopenia
Periarticular erosions
Joint space narrowing
Deformities: subluxation, ulnar deviation, swan neck, etc.
18
Q

What are the x-ray findings in OA?

A

Joint space narrowing
Subchondral sclerosis
Osteophytes
Subchondral cysts

19
Q

What are the extra-articular features of reactive arthritis?

A

Enthesitis, conjunctivitis/uveitis, urethritis, nail dystrophy, dactylitis, keratoderma blenorrhagicum

20
Q

Which arthropathies are associated with HLA-B27?

A

Ankylosing spondylitis
Reactive arthritis
Enteropathic spondylitis (IBD-associated)

21
Q

Which rheumatological conditions are associated with giant cell arteritis?

A

Polymyalgia rheumatica
SLE
RA

22
Q

Give one example of a small, medium and large vessel vasculitis.

A

Small (ateriole/capillary/venule): granulomatosis with polyangitis
Medium: polyarteritis nodosa
Large: giant cell arteritis

23
Q

Which patterns of ANA are associated with:

(a) SLE
(b) Systemic sclerosis

A

(a) Homogenous, speckled

(b) Centromere, nucleolar

24
Q

Which connective tissue disease are associated with the following?

(a) Anti-Ro
(b) Anti-Sm
(c) Anti-La

A

(a) Sjogren’s Syndrome
(b) SLE
(c) SLE and Sjogren’s Syndrome

25
Q

What serology findings can be present in SLE?

A 
ANA (homogenous or speckled)
RF
Anti-dsDNA (specific)
Anti-Sm > Anti-La
Antibodies against WBCs + RBCs
Antiphospholipid antibodies
26
Q

What are the adverse effects of NSAIDs?

A

PUD, exacerbation HF, bronchospasm, renal dysfunction, prothrombosis

27
Q

What are the adverse effects of steroids?

A

Weight gain, osteoporosis, cataracts/glaucoma, infection, bruising, acne, hypertension, hyperlipidaemia, hyperglycaemia, cushingoid, muscle weakness, hyperlipidaemia

28
Q

What medications can be coprescribed to reduce the adverse effects of NSAIDs?

A

Fish oil can have NSAID-sparing effect

PPI to reduce incidence of PUD

29
Q

What are the adverse effects of methotrexate?

A

Oral ulcers, GI symptoms, cirrhosis, pulmonary fibrosis, myelosuppression, deranged LFTs
Contraindicated in pregnancy

30
Q

What is the approach to the treatment of RA?

A
  1. Analgesia (NSAIDs, paracetamol)
  2. Stop inflammation + Prevent joint damage with DMARDs (or biologics if resistant)
  3. Maintain function
  4. Control systemic involvement
31
Q

What are the features of mixed connective tissue disease?

A

Anti-RNP

Serum markers present from >1 different type of connective tissue disease

32
Q

Which 3 investigations are required prior to commencing any DMARD?

A

CBE
LFTs
Urinalysis

33
Q

DMARDs are contraindicated in surgery. True or False?

A

True

34
Q

Is methotrexate appropriate for use in patients with a history of PUD?

A

Yes; however, it is contraindicated in active peptic ulcer disease.

35
Q

What is the most specific immunological marker for granulomatosis with polyangitis (GPA)?

A

C-ANCA

MSK (3 decks)

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