Rheumatology 3

Question 1

Dermatomyositis

Answer 1

autoimmune condition
50-70 years old

> Paraneoplastic !!
screen

Question 2

what malignancy associated with dermatomyositis ?

Answer 2

ovarina
breast
lung

Question 3

Ix findings for Dermatomyositis?

Answer 3

ANA +

anti-Jo 1

Question 4

Rotator cuff muscle

internal rotation

Answer 4

subscapularis > anteriorly on you chest

Question 5

Supraspinatus

Answer 5

top of shoulder

needed for first 20 degrees of abduction

Question 6

Infraspinatus ?

Answer 6

posteriorly on superiro aspect of back

external rotation of shoulder

Question 7

Teres minor

Answer 7

posterior on superior aspect of back

EXTERNAL ROTATION

Question 8

what muscles help with external rotation of shoulders?

Answer 8

Teres minor
Infraspinatus

Question 9

Osteoarthritis?

Answer 9

pain exacerbated by exercise

relieved by rest

reduction in internal rotation

age, obesity,RF

Question 10

Azathiopurine

be careful of?

Answer 10

Myelosuppression - FBC

TPMT test needed : if abnormal can lead to azathiopurine toxicity

Question 11

TPMT

Answer 11

thiopurine methyltransferase

some people genetically low

> myelosuppression

Question 12

dermatomyositis is associated with which autoantibodies?

Answer 12

antinuclear

Question 13

discoid lupus erythematosus

Answer 13

follicular keratin plugs

Mx:
Topical steroids
Oral hydroxychloroquine

Question 14

Behcet’s syndrome

dermatological associations?

Answer 14

aphthous ulcers
genital ulcers
acne-lesions

erythema nodosum

Question 15

what is erythema nodosum?

Answer 15

painful red lesions

inflammed subcut fat

shins

Question 16

behcets HLA?

Answer 16

HLA b51

Question 17

features of behcets?

Answer 17

oral ulcers
genital ulcers
anterior uveitis

thrombophlebitis
DVT
arthritis

neuro

GI

erythema nodosum

Question 18

osetogenesis imperfecta

Answer 18

djusted calcium, PTH, ALP and PO4 results are usually NORMAL

Question 19

why do allopurinol and azathiopurine interact?

Answer 19

bone marrow suppresion

xanthine oxidase inhibitor

active-6 mercaptopurine levels increases = increase bone marrow suppression

Question 20

what is polymyositis?

Answer 20

raised CK proximal muscle weakness

no rash

caused by anti-jo 1 AB

Question 21

polymyositis

Answer 21

t cell mediated cytotoxic

Question 22

Ix polymyositis?

Answer 22

CK levels
muscle enzymes

EMG
muscle biopsy

autoantibodies

Question 23

referred lumbar spine pain?

Answer 23

do the femoral nerve stretch test

> femoral nerve compression causes referred pain
lie the patient prone

Question 24

who should be advised to take vitamin D supplementation?

Answer 24

all pregnant and breastfeeding women 10ug

all children 6m-5 yrs

> 65

housebound pts

Question 25

granulomatosis with polyangiitis

Answer 25

cytoplasmic antineutrophil cytoplasmic antibody cANCA small vessel vasculitis targets the serine proteinase 3

Question 26

GPA -features

Answer 26

based on granulomas in kidneys and lung >renal findings renal impairment Respiratory ENT symptoms CXR

Question 27

Eosinophilic granulomatosis with polyangiitis

Answer 27

presents with allergic picture asthma associated with UC, PSC, anti-GBM pANCA perinuclear antinutrophil cytoplasmic antibodies

Question 28

systemic sclerosis?

Answer 28

hardened sclerotic skin 3 types Limited Diffuse Scleroderma

Question 29

Diffuse cutaneous systemic sclerosis

Answer 29

respiratory involvement : ILD, pulomanry hypertension ACEi given for renal disease: captopril anti-SCl 70 ab

Question 30

Limited cutaneous systemic sclerosis

Answer 30

raynaud first feature anti centromere CREST

Question 31

CREST?

Answer 31

calcinosis raynauds oEsophageal dysmotility sclerodactyly telangiectasia

Question 32

greater trochanteric pain syndrome?

Answer 32

sudden onset? outside of hip bad at night

Question 33

marfan deficiency in?

Answer 33

fibrillin