Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Musculoskeletal > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What does Arthropathy mean?

A

Disease of a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does Arthritis mean?

A

Inflammation of a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does Arthralgia mean?

A

Pain in a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Arthritis can be either…

Give two examples?

A

Arthritis can be either inflammatory (Eg: Rheumatoid) or non-inflammatory (Osteoarthritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inflammatory arthritis is classified into 4 categories. Name them?

Give an example for each?

A

Seropositive (Eg: Rheumatoid)

Seronegative (Eg: Ank Spond, Psoriatic Arthritis)

Infectious (Eg: Septic Arthritis)

Crystal Induced (Eg: Gout)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a seropositive arthropathy?

A

Seropositive conditions have auto-antibody production

They are auto-immune conditions (harm against self)

These auto-antibodys attack organs and tissue causing damage and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anti-CPP antibody is seen in..?

A

Rheumatoid Arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ANA (Anti-Nuclear Antibody) is seen in?

A

SLE

Sjorgen’s

Systemic Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anti dsDNA is seen in..?

A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anti-Sm is seen in?

A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anti-Ro is seen in?

A

SLE

Sjorgen’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anti-La is seen in?

A

Sjorgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anti-centromere antibody is seen in?

A

Limited Systemic Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anti-Scl-70 antibody is seen in?

A

Diffuse Systemic Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anti-RNP antibody is seen in?

A

SLE

Mixed Connective Tissue Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anti-Jo-1 antibody is seen in?

A

Myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anti-cardiolipin and lupus antiocoaguluant antibodies are seen in?

A

Anti-Phospholipid Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ANCA (Anti-Neutrophil Cytoplasmic Antibody) is seen in?

A

Small Vessel Vasculitis (Churg Strauss, Wegener’s, Microscopic Polyangiitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe osteoarthritis?

A

This is degenerative arthritis

Often seen in elderly

There is wear and tear (deterioation) of the normal structure of the joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Who is osteoarthritis seen in?

A

Elderly (Nearly all cases over 45 yrs)

Family History

Obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the cause of osteoarthritis?

A

Multifactorla

  • Genes
  • Joint Injury
  • Environmental (Work, Hobbies)
  • Abnormal Joints
  • Secondary to other conditions (Perthes, SUFE, Gout)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the signs and symptoms of Osteoarthritis?

A

Joint Tenderness

Joint Pain

Morning stiffness <1hr

Assymetrical

Affects DIPJs and weight bearing joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Osteoarthritis:

  • Is there swelling?
  • Hands affected? If so which joints?
  • Morning stiffness?
  • Asymetrical or symmetrical?
  • How is it at the end of the day?
A

No swelling

DIPJs affected

Morning stiffness for less than an hour

Asymmetrical

Worse at the end of the day (use)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Radiological findings of Osteoarthritis?

A

LOSS
- Loss of joint space

  • Osteophytes
  • Subchondral Sclerosis
  • Subchondral Cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

True or False:

  • Osteoarthritic joints are hot and swollen?
  • Osteoarthritic joints are stiff in the morning
  • Osteoarthritic joints show peri-articular osteoporosis and erosions?
A

FALSE: Osteoarthritic joints are not hot and swollen

TRUE: Osteoarthritic joints are stiff in the morning, this lasts for about half an hour

FALSE: Osteoarthritic joints do not show peri-articular osteoporosis and erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

With increasing joint usage, the pain from osteoarthritis gets BETTER/WORSE?

A

With increasing joint usage, the pain from osteoarthritis gets WORSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment of Osteoarthritis?

A

Weight Bearing Exercise

Weight Loss

Analgesia

Surgical Joint Replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is Rheumatoid Arthritis?

A

Most common seropositive inflammatory arthropathy

Autoimmune condition

Causes painful, swollen joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pick either osteoarhritis or Rheumatoid:

  • DIPJs affected?
  • Swelling?
  • Symmetrical?
  • Worse on exercise?
A

DIPJs = Osteoarthritis

Swelling = Rheumatoid

Symmetrical = Rheumatoid

Worse on exercise = Osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Who does Rheumatoid Arthritis commonly affected?

A

Women

Any age affected (peak around 35-50yrs)

Those with a first degree relative affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the cause of Rheumatoid Arthritis?

A

Genetics

Hormones (Oestrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the pathogenesis of Rheumatoid Arthritis?

A

Auto-immune antibodies against synovium

Inflammation occurs and a pannus forms (hypertrophied synovium)

This causes even more inflammation - infiltrate, macrophages etc.

This causes joint destruction by attacking articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe the symptoms of Rheumatoid Arthritis?

A

Doughy Symmetrical Swelling

Pain

Morning stiffness (>1hr)

PIPJs, MCPJs affected - DIPJs spared

Can cause deformities of the hand (Swan Necking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Rheumatoid Arthritis:

  • Is there swelling?
  • Hands affected? If so which joints?
  • Morning stiffness?
  • Asymetrical or symmetrical?
  • How is it at the end of the day?
A

RA:
- Swelling is present

  • MCPJs and PIPJs affected, DIPJs spared
  • Morning stiffness for >1 hr
  • Symmetrical
  • Better at the end of the day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe some extra-articular manifestations of rheumatoid arthirits?

A

Rheumatoid Nodules on extensor surface

Lung - Pleural effusion, interstitial fibrosis, pulmonary nodes

Increased cardio morbidity/mortality

Ocular Involvement - Keratoconjunctivitis Sicca, Uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe blood tests seen in Rheumatoid Arthritis?

A

Anti-CPP antibody high

Rheumatoid Factor (RF) high

15-20% will be seronegative

Raised CRP

Raised ESR

Raised Plasma Viscosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When is ESR raised?

When is CRP raised?

A

In inflammation (non specific)

In inflammation (non specific)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the radiological findings of rheumatoid?

A
  • Osteopenia
  • Soft tissue swelling
  • Bone erosions
  • Bone displacenebt
  • Periarticular Erosions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment for rheumatoid arthritis?

A

Analgesia

NSAIDS

Steroid Injection

DMARDS (Methotrexate, Sulfasalazine)

Anti-TNF Alpha (Infliximab)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When should DMARDs ideally be started in rheumatoid arthritis?

A

Within 3 months of symptom onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Name a TNF-Alpha drug?

What is the requirements for starting these?

A

Infliximab

Must show disease activity - use DAS 28 score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What DAS 28 score indicates anti-TNF use?

A

Score of greater than 5

This suggests disease activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Describe the surgerys that can be used in Rheumatoid Arthritis?

A

Synovectomy

Joint Replacement

Spine Stabilisation

Fusion (Arthrodesis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe seronegative inflammatory arthropathies?

A

Inflammatory arthropathies that do not have auto-immune antibody involvement

Includes:

  • Ankylosing Spondylitis
  • Reactive Arthritis
  • Psoriatic Athritis
  • Enteropathic Arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is Ankylosing Spondylitis?

A

Inflammatory condition of the spine and iliosacral joints

Common in young males

Causes back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Patients who have seronegative inflammatory arthropathies are commonly …. positive?

A

HLA-B27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Who is commonly affected by ank.spond?

A

Young men

(20-40s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the signs and symptoms of ank.spond?

A

Spinal Pain

Stiffness

Spinal pain worse in morning

Pain improves on exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is seen on examination of ank.spond?

A

Loss of range of spinal movement

  • Schober’s Test is less than 20cm

May be increased thoracic kyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What does X-Ray of ank spond show?

What does MRI show?

A

X-Ray = Can be normal or can show joint fusion

MRI can show bone marrow oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Describe treatment of ankylosing spondylitis?

A
  • Physiotherapy
  • Exercise
  • NSAIDs
  • Anti-TNF

DMARDs can be given for peripheral joint involvement

NO SPINE SURGERY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Describe surgical treatment of Ank Spond?

A

NO SPINE SURGERY

There can be hip and knee surgery if there is peripheral joint invovlement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is SL?

A

Systemic Lupus Erythematous

This is a chronic autoimmune condition that involves many body systems - blood, skin, joints, kidney, nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Who is SLE common in?

A

Women

Young (20-30s)

Genetic predisposition (family history)

High in blacks (UK/USA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the general signs and symptoms of SLE?

What are the muskuloskeletal symptoms?

Skin symptoms?

A

General signs = Weight loss, fever, fatigue

MSK = Arthralgia, myalgia, inflammatory arthritis, avascular necrosis (of femoral head)

Skin = Malar rash, photosensitivity, discoid lupuds, Raynauds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are the renal symptoms of SLE?

  • Respiratory?
  • Haem?
  • Cardiac?
  • Neuro?
A

Renal = Nephritis

Respiratory = Pleural effusion, PE, pulmonary hypertension, interstitial lung disease

Haem = Anaemia

Cardiac = Pericarditis, Pericardial Effusion, Ischaemic Heart Disease

Neuro = Seizures, Headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Name some of the clinical criteria for diagnosing SLE? (11)

A
  • Acute cutaneous lupus
  • Chronic cutaneous lupus
  • Oral or nasal ulcers
  • Non scarring alopecia
  • Arthritis
  • Serositis
  • Renal Involvement
  • Neurological Involvement
  • Haemolytic Anaemia
  • Leukopenia
  • Thrombocytopenia
58
Q

Describe the immunology seen in SLE?

A

ANA

Anti-dsDNA

Anti-Sm

C3/C4 low when disease is active

59
Q

Describe treatment of SLE if patient had Skin disease + Arthralgia?

A

Hydroxychloroquine (DMARD)

Topical Steroids

NSAIDs

60
Q

What kind of drug is Hydroxychloroquine?

A

DMARD

61
Q

How do you treat SLE if there is inflammatory arthritis/mild organ involvement?

A

Immunosuppression Eg: Azathioprine

Corticosteroids

62
Q

How do you treat SLE if there is severe organ disease/non responsive?

A

IV Steroids

Cyclophosphamide

IV Immunoglobulin

63
Q

How do you monitor SLE?

A

Use anti-dsDNA levels

Use c3/c4 (low when disease is active)

Urinalysis (for glomerulonephritis)

Manage CV risk

64
Q

What is Sjorgens’ syndrome?

A

Chronic autoimmune condition

Characterised by lymphocyte infiltrate in exocrine organs

65
Q

Who is Sjogren’s syndrom seen in?

A

Females

Often Elderly

Very rare to be seen before 40/50yrs

66
Q

Signs and symptoms of Sjorgen’s syndrome?

A

Dry Eyes

Dry Mouth

Arthralgia

Fatigue

Vaginal Dryness

Parotid Gland Swelling

Peripheral Neuropathy

Interstitial Lung Disease

67
Q

What are the causes of Sjorgen’s?

A

Primary = No underlying condition, seen in people with HLA-DR (HLA II)

Secondary to Rheumatoid Arthritis or SLE

68
Q

Describe the diagnosis of Sjorgen’s?

A

Ocular Dryness (Schirmers Test)

Antibodies - Anti-Ro, Anti-La

Biopsy of lip gland

Saliva Scintography

69
Q

Treatment for Sjorgen’s?

A

Ocular Lubricants

Saliva Replacement

Hydroxchyloroquine (DMARD) for arthralgia and fatigue

Immunosuppression (Eg: Azathioprine) if organ involvement

70
Q

What is systemic sclerosis?

A

Systemic connective tissue disease

Causes fibrosis and subsquent atrophy of the skin, subcutaneous tissue and muscle

There is often internal organ changes too

71
Q

Who gets systemic sclerosis?

A

Women

Aged 30-40

Slightly higher age in men

It is a rare condition

72
Q

Describe the skin signs and symptoms of systemic sclerosis?

A

Raynauds

Skin becomes atrophied and tight

Skin scerosis seen on the face, arm and neck

Sclerodactyl

Fingertip atrophy

73
Q

Describe non cutaneous signs and syptoms of systemic sclerosis?

A

Pulmonary hypertension, fibrosis

Renal Hypertension

Dysphagia, malabsorption

Inflammatory Arthritis

74
Q

Describe the two types of systemic sclerosis?

A

Limited - skin confied to hands, feet, face and forearms

Organs aren’t involved till later

Diffuse: Skin changes everywhere including trunk

Early significant organ involvement

75
Q

Name the antibodies seen in diffuse and limited systemic sclerosis?

A

Anti-centromere antibody = Limited

Anti-Scl-70 = Diffuse

76
Q

Anti-centromere antibody is seen in..?

A

Limited Systemic Sclerosis

77
Q

Anti-Scl-70 antibody is seen in?

A

Diffuse Systemic Sclerosis

78
Q

Treatemnt for Raynaud’s in systemic sclerosis?

Treatment for renal disease in systemic sclerosis?

Treatment for reflux in systemic sclerosis?

A

Calcium Channel Blockers

ACE Inhibitors

PPI

79
Q

What is mixed connective tissue disease?

A

This is a disease that has symptoms seen in many other connective tissue diseases

80
Q

Who is mixted connective tissue disease seen in?

A

Young Females

(15-25yrs)

81
Q

Describe the symptoms of mixed connective tissue disease?

A

Raynauds

Arthralgia/Arthritis

Myositis

Sclerodactyl

Pulmonary Hypertension

Interstitial Lung Disease

82
Q

What antibodies are seen in mixed connective tissue disease?

A

Anti-RNP Antibodies

83
Q

Management of Raynaud’s in mixed connective tissue disease?

Management of muscle or long conditions?

A

Raynauds = Calcium Channel Blockers

Lung/Muscle = Immunosuppression (Eg: Methotrexate, Aziathioprine, Cyclophosphamide)

84
Q

What kind of drug is cyclophosphamide?

A

Immunosuppressive

85
Q

What is anti-phospholipid syndrome?

A

A disorder that manifests clinically as recurrent venous or arterial thrombous +/- recurrent fetal loss

86
Q

Who gets anti-phospholipid synrome?

A

Some may have SLE/other rheumatic/autoimmune diseases

Some may have no associated disease

Females

Young to middle aged

87
Q

Symptoms and signs of anti-phospholipid syndrome?

A

Increased frequency of stroke or MI

Sterile endocarditis

PE

Migraines

Livedo Rectiularis (skin mottling)

Spontaneous Foetal Loss

88
Q

What antibodies are seen in anti-phospholipid syndrome?

A

Anti-phospholipid antibodies

Lupus Anticoaguluant

Antiocardiolipin Antibodies

Anti-beta 2 glycoprotein antibodies

89
Q

Treatment for anti-phospholipid syndrome?

A

Warfarin (Teratogenic)

Heparin (If trying for a baby)

Only give medication to those with thrombus history, not if they just have raised antibodies

90
Q

Anti-phospholipid treatment for:

  • A patient trying for a baby with history of thrombus
  • A patient not trying for a baby with a history of thrombus
  • A patient with no history of thrombus
A

Trying for a baby = Heparin

Not trying for a baby = Warfarin

No history of thrombus = No treatment needed

91
Q

What is gout?

A

Crystal arthropathy

Characterized by deposition of urate crystals within a joint

92
Q

Who is Gout seen in?

A
  • Obese
  • High BP
  • Family history
  • Alcohol intake
  • Poor Diet
93
Q

Describe the pathophysiology of gout?

A

High serum uric acid (due to diet, alcohol or poor excretion from renal disease)

This causes urate crystal deposition in joints

94
Q

Signs and symptoms of gout?

A

Pain over first metatarsal-phalangeal joint

Swelling

Redness

Hot Joint

Gouty Tophi

95
Q

How long does gout last for?

A

Symptoms last for about 7-10 days then resolve

96
Q

How is gout diagnosed?

A

From clinical examination

Presence of needle shaped uric acid crystals that display negative bifrigence under light microscopy (go from yellow to blue)

97
Q

Treatment of gout?

A

NSAIDs (Or Colchicine if unable to take NSAIDs)

Corticosteroids

Opiod Analgesia

AFTER ACUTE ATTACK START ON ALLOPURINOL FOR PROPHYLAXIS

98
Q

Describe prevention of gout?

What do you use if the main treatment is not suitable?

A

Lifestyle changes

Allopurinol

If allopurinol is unsuitable then Febuxostat

99
Q

What is pseudogout?

A

Crystal arthropathy causing arthritis

Caused by calcium pyrophosphate crystals

100
Q

Who gets pseudogout?

A

Hyperparathyroidism

Hypothyroidism

OA

101
Q

Describe the symptoms of pseudogout?

A

Mimics symptoms of rheumatoid/osteoarthritis

  • Red, hot swollen joint
  • Stiff joint
  • Severe tenderness
  • Mainly affects knee or wrist
102
Q

How is pseudogout diagnosed?

A

Clinical Examination

Positively bifringement crystals of calcium pyrophosphate dihydrate

103
Q

Treatment of pseudogout?

A

NSAIDs (or colcichine if NSAIDs not tolerated)

Corticosteroids

No prophylaxis medications

104
Q

What is polymalgia rheumatica?

A

Common inflammatory condition

Causes proximal myalgia of hip and shoulder

Morning stiffness

105
Q

Who gets polymyalgia rheumatica?

A

Elderly

Women

Northern European

106
Q

What is the difference between polymyalgia rheumatica and polmyositis?

A

Polymyalgia Rheumatica = Proximal Muscle Pain, Stiffness

Polymyositis = Proximal Weakness

107
Q

What are the symptoms of polymyalgia rheumatica?

A

Proximal Myalgia (Pain) in hip and shoulder)

Morning stiffness (>1hr)

Symptoms improve throughout day

Also fatigue and malaise

108
Q

About 15% of patients with polymyalgia rheumatica will go on to develop…?

A

Giant Cell Arteritis (Temporal Arteritis)

109
Q

Describe the treatment of polymyalgia rheumatica?

A

Low Dose Steroids (15mg Prednisolone)

Patients respond very well

Step down dose over 2 years - by this time, condition will have resolved in the majority of cases

110
Q

What is giant cell arteritis?

A

Most common form of systemic vasculitis in adults

111
Q

Who is giant cell arteritis seen in?

A

Elderly

White

Females

  • Those who smoke
  • Diabetics
  • Those with polymyalgia rheumatica
112
Q

Describe the presentation of giant cell arteritis?

A

Visual Disturbance

Jaw claudication (cramping pain when chewing)

Headache

Shoulder/neck pain

Fatigue and malaise

Fever

113
Q

Patients over the age of 50 with new onset headache, temporal pain, raised ESR and CRP will most probably have?

A

Giant cell arteritis

114
Q

How is giant cell arteritis diagnosed?

A

Blood Tests - Raised CRP, ESR, Plama Viscosity

Temporal Biopsy - Specific but not that sensitive. Shows multinucleated giant cells

115
Q

Describe the treatment of giant cell arteritis?

A

Prednisolone

60mg if visual disturbance present

40mg if no visual disturbance present

Dose lowered over 2 years - condition normally resolves within this time

116
Q

What is polymyositis?

A

Idiopathic inflammatory arthropathy

Caused symmetrical proximal muscle weakness

117
Q

Who is normally affected by polymyositis?

A

Women

Adults aged 45-60

118
Q

Describe the pathophysiology of Polymyositis?

A

T cell mediated cytotoxic process - CD8 T cells and macrophages surrond and destroy normal muscle fibres

119
Q

What antibodies are seen in polymyositis?

A

Anti-RNP

ANA

Anti-jo

Anti-SRP

120
Q

Symptoms and signs of polymyositis?

A

Symmetrical proximal weakness

Affects uppper and lower limbs (Eg: Shoulder and hip)

Insidious onset

Causes difficulty with daily activities (Eg: Stair climbing)

May also be dysphagia and interstitial lung disease

121
Q

Diagnosis of polymyositis?

A

Raised CRP and ESR

Antibodies: ANA, Anti-SRP, Anti-Jo

Biopsy shows inflammation and necrosis of muscle fibres

122
Q

Treatment of polymyositis?

A

Prednisolone 40mg

Immunosuppression (Eg: Methotrexate and Aziathioprine)

Around 30% will have residual weakness - normally elderly

123
Q

Describe dermatomyositis?

A

Similar to polymyositis but there is dermatological features

  • V shaped rash
  • Gottron’s Papules
  • Helitrope Rash
124
Q

Dermatomyositis increases the risk of what by 25%?

A

Malignancy

125
Q

What is Fibromyalgia?

A

Unexplained condition causing muscle pain and fatigue

There may also be a lowered pain threshold and sensitivity

126
Q

Who gets fibromyalgia?

A

Women

Young/middle aged

25% of Rheumatoid Arthritis patients

50% of SLE patients

127
Q

What are the symptoms and signs of fibromyalgia?

A

Widespread muscle pain

Fatigue and disturbed sleep

Low pain threshold

Increased sensitivity (light, noises, odours)

Can be associated with depression, anxiety and impairment of functional living

128
Q

Diagnosis of Fibromyalgia?

A

There is no specific test

Based on clinical history

Tests to rule out other conditions (Eg: Rheumatoid, Hypothyroid, SLE etc.)

129
Q

Treatment of Fibromyalgia?

A

Self Managed condition

Education

Graded exercise

Atypical Analgesia (Eg: Gabapentin)

Psychology input

130
Q

What is vasculitis?

A

Inflammation of blood vessels - can affect large blood vessels, medium or small

Causes vessel thickening, stenosis and ischaemia

131
Q

Who gets vasculitis?

A

Depends on the type

  • Henoch Schloein Purpura seen in young (10-20)

Kawasaki Disease seen in young males (under 4yrs)

Giant cell arteritis seen in elderly females

TA seen in young asian females

132
Q

Describe large vessel vasculitis?

A

Inflammation of aorta and branches

Causes giant cell arteritis in elderly and Takaysu in young asian females

There is fever, malaise, night sweats, weight loss, arthralgia and fatigue

Can be vascular stenosis causing bruitis

133
Q

Treatment of large vessel vasculitis?

A

Corticosteroids - Prednisolone 40/60mg

Methotrexate + Aziathioprine

134
Q

Describe small and medium vessel vasculitis?

A

Fever, weight loss

Raised, non blanching purpuric rash

Arthralgia and arthritis

Glomerulonephritis

  • ANCA Associated (EGPA, GPA, MPA)
135
Q

Describe the symptoms of EGPA/Churgg Strauss?

Antibody?

A

Late onset asthma

Rhinitis

Eosinophilia

Neuro Symptoms

pANCA

136
Q

Describe the symptoms of Wegener’s/GPA?

Antibodies?

A

ENT Symptoms

Nasal Collapse

Cavitating Chest Lesions

cANCA

137
Q

What does this photo show?

A

Saddle nose deformity

Caused by GPA (Wegener’s)

138
Q

Describe vasculitis diagnosis?

A

Raised CRP

Raised ESR

Raised Plasma Volume

Anaemia

ANCA (cANCA, pANCA)

CXR
Urinalysis

Biopsy

139
Q

Treatment of vasculitis?

A

IV Steroids

Cylclophosphamide (DMARD)

140
Q

Treatment of Henoch-Schloein purpura?

A

No treatment - self limiting

141
Q

What is the cause of this rash?

A

Henoch-Scholein-Purpura

Vasculitic Rash

142
Q

Diagnosis?

4 Year old child comes in with a purpuric rash over the buttocks and lower limbs

There is vomiting and joint pain

Upper Respiratory tract infection 3 weeks ago

Treatment

A

Henoch-Schloein-Purpura

Self-limiting, settles over weeks to months

Musculoskeletal (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions