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Rheumatology Flashcards

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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?

24
Q

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

25
Lung problems associated with RA
bronchiectasis pulmonary fibrosis pleural effusions pulmonary nodules
26
Specific antibody for RA?
ANTI CCP
27
treatment of RA?
DMARD within 3 months of symptom onset and steroid to cover lag phase biologics e.g. anti tnf (infliximab, adalimumab) if unresponsive
28
Antibody associated with mixed connective tissue disease?
Anti RNP
29
Signs of dermatomyositis
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
antibodies associated with polymyositis?
anti jo | anti srp
31
how does polymyositis affect the muscles?
symmetrical proximal muscle weakness
32
treatment of polymyositis?
prednisolone | immunosuppression (MTX)
33
what is there risk of in poly and demo - myositis?
malignancy! (9% in poly; 15% in dermato)
34
Pattern of muscle weakness in inclusion body myositis?
distal muscle weakness
35
inclusion body myositis - more common in males or females?
males
36
Relationship between PMR and GCA?
50% of people with GCA have PMR | 15% of people with PMR develop GCA
37
Characteristics of PMR?
``` early morning stiffness + pain usually symmetrical shoulder girdle and hip muscle power NORMAL seen almost exclusively in over 50s ```
38
what does PRM respond dramatically to?
low dose steroids
39
what 2 inflammatory conditions is fibromyalgia associated with?
seen in 50% of SLE and 25% of RA
40
Enteropathic arthritis - what is it associated with - how is it treated?
``` associated with IBD DONT GIVE NSAIDS - may exacerbate IBD treat the IBD! paracetamol, cododamol steroids DMARDs Anti TNF ```
41
Reactive arthritis -- Reiter's what is the classic triad? what infections commonly predispose it? treatment
``` 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
what type of arthritis are psoriatic, enteropathic and reactive usually?
reactive = asymmetric MONOarthritis psoriatic and enteropathic = asymmetric OLIGOarthritis
43
X-ray signs of psoriatic arthritis
marginal erosions and whispering pencil in cup deformity osteolysis
44
what is the hallmark of ank spond?
sacroiliitis
45
ank spond more common in M or F?
Men
46
Ank spond = the 'A' disease, what are the 'A's?
``` Axial arthritis Aortic regurgitation Anterior uveitis Apical fibrosis Amyloidosis Achilles tendonitis plAntar fasciitis ```
47
Which HLA is and spond assoc with
HLA B27
48
1st line treatment for ank spond | whats the tx if there is peripheral joint involvement?
NSAIDs | DMARDs only if peripheral joint involvement
49
what neuro condition is GPA associated with?
mononeuritis multiplex
50
GPA - which type of ANCA?
cANCA
51
EGPA and MPA - which type of ANCA?
pANCA
52
What is seen in 90% of patients with microscopic polyangitis (MPA)?
glomerulonephritis
53
main treatment of large vessel vasculitis?
corticosteroids
54
What immunoglobulin mediates Henoch-Schonlein Purpura?
IgA
55
what do over 75% of kids with Henoch-Schonlein Purport have beforehand?
URTI, pharyngeal infection or GI infection | GAS is most common
56
What is it essential to check in HSP?
urinalysis because there's renal involvement in 50%

MSK (11 decks)

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