Rheumatology

Question 1

Most likely complication for CREST

Answer 1

Malabsorption - secondary to bacterial overgrowth of sclerosed small intestines

Question 2

Minimum steroid intake to be offered osteoporosis prophylaxis

Answer 2

prednisolone 7.5mg/d for 3M

Question 3

Antiphospholipid syndrome - FBC and clotting screen

Answer 3

(paradoxically) prolonged APTT + low platelets

Question 4

Chilblains(pernio)

Answer 4

itchy,painful purple swellings - occur on fingers and toes after exposure to cold

Question 5

Raynaud’s + Hx of recurrent miscarriages

Answer 5

SLE / antiphospholipid syndrome

Question 6

> 75Y +fragility fracture

Answer 6

start bisphophonates

Question 7

Antiphospholipid syndrome in pregnancy

Answer 7

aspirin + LMWH
Aspirin - once pregnancy confirmed on urine testing
LMWH - once fetal heart seen on USS (stop at 34wk)

Question 8

Mononeuritis multiplex

Answer 8

Involvement of >1 peripheral and/or cranial nerve

Question 9

AS Bamboo spine characteristics

Answer 9

Fusion of ant.spinal ligament
Fusion of sacroilitis
Syndesmophytes

Question 10

RA presentation

Answer 10

MCP joint involvement

x lumbar
x thoracic
x DIP
x base of thumb (OA)

USS - hypervascularized synovitis

Question 11

Which arthritis doesn’t affect MCP

Answer 11

OA

Question 12

Rheumatoid nodules confirms?

Answer 12

Sero+ve RF

Not necessarily for anti-ccp