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MSK > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Is gout more common in M of F

A

Men

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2
Q

Causes of hyperuricaemia?

A

psoriasis, haemolytic disorders, alcohol, purine intake

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3
Q

treatment of acute gout

A

NSAIDs/colchicine
corticosteroids
opiod analgesics

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4
Q

treatment of chronic gout

A

allopurinol (febuxostat if can’t tolerate allopurinol i.e. renal impairment)

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5
Q

What is calcium pyrophosphate deposition disease related to? who gets it? where does it affect? treatment?

A

related to OA
elderly get it
affects knee, wrist and ankle
treatment = NSAIDS, colchicine, steroids, rehydration

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6
Q

What is chondrocalcinosis?

A

calcium pyrophosphate deposition in cartilage/soft tissues without inflammation

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7
Q

What is scleroderma?

A

excessive fibrosis of organs and tissues

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8
Q

What is scleroderma associated with?

A

CREST

  • calcinosis
  • Raynauds
  • oEsophageal dysfunction
  • sclerodactyly
  • telangiectasia
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9
Q

Limited scleroderma

  • which antibody
  • where is skin involvement
  • organ involvement early or late
A

anti centromere antibody

skin: face, hands, forearms, feet

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10
Q

Diffuse scleroderma

  • which antibody
  • where is skin involvement
  • organ involvement early or late
A

anti scl 70 antibody
skin: trunk
early significant organ involvement

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11
Q

Environmental factors in SLE?

A

UV light
silica dust
viruses e.g. EBV

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12
Q

SLE - which type of hypersensitivity?

A

type 3

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13
Q

type of endocarditis assoc with SLE

A

Libman Sachs

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14
Q

Antibodies in SLE

A

anti ds DNA = specific
ANA - +ve but not specific
anti sm - specific but low sensitivity

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15
Q

high or low c3/c4 in active SLE?

A

low

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16
Q

SLE
treatment for skin disease & arthralgia
treatment in severe organ disease
treatment in unresponsive disease

A

skin disease & arthralgia: hydroxychloroquine, topical steroids, NSAIDs
severe organ disease: cyclophosphamide + IV steroids
unresponsive: Iv immunoglobulin + rituximab

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17
Q

Antibodies in anti phospholipid syndrome?

A

anti cardiolipin

anti beta 2 glycoprotein

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18
Q

features of anti phospholipid syndrome

i.e. skin appearance? condition of veins? etc

A 
foetal loss
recurrent thrombosis 
superficial thrombophlebitis
migranes
livedo reticular
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19
Q

mainstay treatment of APS?

A

anti coagulation

LMWH during pregnancy! warfarin = teratogenic

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20
Q 
Sjogrens
symptoms?
increased risk of what?
antibodies?
test?
treatment?
A

dry mouth, dry eyes
(also: arthralgia, vaginal dryness, fatigue, parotid gland swelling, ILD, neuropathy)
increased risk of lymphoma
anti RO and LA
schrimmers test
tx = eye drops, saliva replacement (pilocarpine), regular dental care because ^ risk of caries, hydroxychloroquine for arthralgia and fatigue

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21
Q

Side effect of pilocarpine?

A

flushing

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22
Q

Symptoms of IPEX syndrome

A 
v early onset DM 
severe malabsorption syndrome
severe infections
eczema
autoimmune thyroid disease, haemolytic anaemia
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23
Q

mutation that causes IPEX syndrome?

A

FOXP3

24
Q

is being male or being female a poor prognosic indicator for RA?

A

male

25
Q

Lung problems associated with RA

A

bronchiectasis
pulmonary fibrosis
pleural effusions
pulmonary nodules

26
Q

Specific antibody for RA?

A

ANTI CCP

27
Q

treatment of RA?

A

DMARD within 3 months of symptom onset and steroid to cover lag phase
biologics e.g. anti tnf (infliximab, adalimumab) if unresponsive

28
Q

Antibody associated with mixed connective tissue disease?

A

Anti RNP

29
Q

Signs of dermatomyositis

A

Gottrons sign - red + scaly over MCP and PIP
heliotrope rash - red over eyelids
shawl sign - red over back of neck and in v down front of chest

30
Q

antibodies associated with polymyositis?

A

anti jo

anti srp

31
Q

how does polymyositis affect the muscles?

A

symmetrical proximal muscle weakness

32
Q

treatment of polymyositis?

A

prednisolone

immunosuppression (MTX)

33
Q

what is there risk of in poly and demo - myositis?

A

malignancy! (9% in poly; 15% in dermato)

34
Q

Pattern of muscle weakness in inclusion body myositis?

A

distal muscle weakness

35
Q

inclusion body myositis - more common in males or females?

A

males

36
Q

Relationship between PMR and GCA?

A

50% of people with GCA have PMR

15% of people with PMR develop GCA

37
Q

Characteristics of PMR?

A 
early morning stiffness + pain
usually symmetrical 
shoulder girdle and hip 
muscle power NORMAL 
seen almost exclusively in over 50s
38
Q

what does PRM respond dramatically to?

A

low dose steroids

39
Q

what 2 inflammatory conditions is fibromyalgia associated with?

A

seen in 50% of SLE and 25% of RA

40
Q

Enteropathic arthritis

  • what is it associated with
  • how is it treated?
A 
associated with IBD
DONT GIVE NSAIDS - may exacerbate IBD
treat the IBD! 
paracetamol, cododamol
steroids
DMARDs
Anti TNF
41
Q

Reactive arthritis – Reiter’s
what is the classic triad?
what infections commonly predispose it?
treatment

A 
classic triad 
- urethritis, uveitis, arthritis 
"can't see, can't pee, can't climb a tree"
infections: chlamydia, neisseria, salmonella, campylobacter 
tx:
90% resolve spontaneously in 6 months 
NSAIDs
corticosteroids
AB for underlying infection 
DMARDs if resistant/chronic
42
Q

what type of arthritis are psoriatic, enteropathic and reactive usually?

A

reactive = asymmetric MONOarthritis

psoriatic and enteropathic = asymmetric OLIGOarthritis

43
Q

X-ray signs of psoriatic arthritis

A

marginal erosions and whispering
pencil in cup deformity
osteolysis

44
Q

what is the hallmark of ank spond?

A

sacroiliitis

45
Q

ank spond more common in M or F?

A

Men

46
Q

Ank spond = the ‘A’ disease, what are the ‘A’s?

A 
Axial arthritis
Aortic regurgitation
Anterior uveitis
Apical fibrosis
Amyloidosis
Achilles tendonitis
plAntar fasciitis
47
Q

Which HLA is and spond assoc with

A

HLA B27

48
Q

1st line treatment for ank spond

whats the tx if there is peripheral joint involvement?

A

NSAIDs

DMARDs only if peripheral joint involvement

49
Q

what neuro condition is GPA associated with?

A

mononeuritis multiplex

50
Q

GPA - which type of ANCA?

A

cANCA

51
Q

EGPA and MPA - which type of ANCA?

A

pANCA

52
Q

What is seen in 90% of patients with microscopic polyangitis (MPA)?

A

glomerulonephritis

53
Q

main treatment of large vessel vasculitis?

A

corticosteroids

54
Q

What immunoglobulin mediates Henoch-Schonlein Purpura?

A

IgA

55
Q

what do over 75% of kids with Henoch-Schonlein Purport have beforehand?

A

URTI, pharyngeal infection or GI infection

GAS is most common

56
Q

What is it essential to check in HSP?

A

urinalysis because there’s renal involvement in 50%

MSK (11 decks)

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