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MSK > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Anti-CCP

A

RA

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2
Q

ANA

A

SLE, Sjogrens, MCTD, SSc, AIH

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3
Q

anti-dsDNA

A

SLE

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4
Q

Anti-Sm

A

SLE

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5
Q

Anti-Ro

A

SLE, Sjogrens

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6
Q

Anti-La

A

Sjogrens

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7
Q

AMA

A

PBC

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8
Q

Anti-centromere

A

Limited SSc

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9
Q

Anti-Scl-70

A

Diffuse SSc

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10
Q

Anti-RNP

A

SLE, MCTD

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11
Q

Anti-Jo-1

A

Myositis

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12
Q

Anti-cardiolipin/anti-lupus anticoagulant

A

APS

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13
Q

ANCA

A

Small vessel vasculitis
pANCA - Churg Strauss (EGPA)
cANCA - Wegeners (GPA)
MPA

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14
Q

How to interpret an xray

A

Patient name and DOB
When xray was taken
ALIGNMENT: What type of xray it is, e.g bilateral PA hands
BONE: fractures, bone margins, mineralisation, osteopenia (radiolucency), osteophytes, erosions, subluxcation, dislocation, joint spaces, deformities
CARTILAGE: joint spaces, calcification
DISTRIBUTION: where are changes, pattern, symmetry
SOFT TISSUES: swelling, calcification

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15
Q

xray findings of RA

A

Periarticular osteopenia (thinning, lucency)
swan neck, boutonnieres, z shaped thumb, ulnar deviation
soft tissue swelling
periarticular erosions late on

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16
Q

xray findings of OA

A

LOSS
squaring of thumb
heberdens, bouchards nodes

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17
Q

Seronegative arthropathies are ___________ positive

A

HLA-B27

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18
Q

xray findings of AS

A

Sclerosis and fusion of SI joints

Bony spurs on vertebral bodys (syndesmophites) = bamboo spine

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19
Q

Arthritis mutilans

A

Severe form of arthritis in PA

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20
Q

Reactive arthritis

A

In response to infection - GU or GI
Large joints swell 3 weeks after infection
Reiter’s - uveitis, urethritis, arthritis

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21
Q

AS is more common in:

A

males

22
Q

Sjogrens

A

Autoimmune condition characterised by lymphocytic infiltrates in exocrine organs = sicca symptoms, arthralgia fatigue, parotid swelling, peripheral neuropathy, lymphoma

23
Q

Schirmer’s test

A

Sjogrens

24
Q

SSc features

A 
Vasomotor disturbance (Raynaud's), fibrosis, skin atrophy
Excess collagen deposition
Pulmonary HT, renal changes
25
Q

3 phases of cutaneous involvement in Sjogrens

A

Oedematous
Indurative
Atrophic
- skin thickens and tightens, sclerodactyly

26
Q

Limited SSc

A

Face, hands, forearms, feet

Organ involvement later

27
Q

Diffuse SSc

A

Trunk, rapid

Organ involvement early

28
Q

Investigations for SSc

A

Anti-centromere/anti-Scl-70
PFTs
Echo
Renal function

29
Q

Management of SSc

A 
Raynaud's = CCB
Renal = ACEI
GI = PPI
ILD = cyclophosphamide
30
Q

APS features

A 
Recurrent venous/arterial thrombosis
Late foetal loss
Stroke/MI/PE
Liebman-Sacks endocarditis (sterile)
MOF (catastrophic APS)
Migraine
Livdeo reticularis
31
Q

Investigations for APS

A

Thrombocytopenia (low platelets)
Prolonged APTT
Lupud anticoagulant/anti-cardiolipin

32
Q

Treatment of APS

A

Anticoagulate if episode of thrombosis

Recurrent pregnancy loss - LMWH

33
Q

How is uric acid formed?

A

Product of purine metabolism

34
Q

Podagra

A

1st MTP gout

35
Q

what causes gout?

A

Hyperuricaemia (diuretics, CKD)

Alcohol, red meat, sea food

36
Q

Pseudogout

A

Calcium pyrophosphate

37
Q

PMR

A

Elderly
Proximal myalgia of hip and shoulder girdle, lost lasting morning stiffness
Improves with movement

38
Q

GCA

A

linked with PMR

Transmural vessel inflammation, patchy infiltration, wall thickening, lumen narrowing = ischaemia

39
Q

Treatment of PMR

A

Lose dose steroids 15mg/day

Reduce over 18 months

40
Q

Symptoms of GCA

A

Visual disturbance, headache, scalp tenderness, jaw claudication, fatigue, fever
Swollen optic disc
Raised CRP/PV
Biopsy: monoculear infiltration, granulomas, multinucleate giant cells, patchy

41
Q

Treatment of GCA

A

40mg/day pred

60mg/day pred if visual symptoms

42
Q

Polymyositis

A

Idiopathic inflammatory myopathy = symmetrical proximal muscle weakness, dysphagia, ILD
Females over 20
CD8 T cells

43
Q

Investigations for polymyositis

A 
raised CRP/PV
raised CK
anti-Jo-1, ANA
EMG
Biopsy - inflammation, necrosis, regeneration
44
Q

Treatment of polymyositis

A

40mg pred

aza/mtx

45
Q

Dermatomyositis

A

Polymyositis with cutaneous papules/V shaped chest rash, heliotrope rash (spares nasolabial folds)
Risk of malignancy

46
Q

Fibromyalgia

A

Disorder of pain processing
Young women, widespread pain and fatigue
Persistent widespread pain, fatigue, cognitive difficulties, anxiety/depression/IBS/migraine

47
Q

Large vessel vasculitis

A

GCA - older

Takayasu - younger

48
Q

MPA

A

Small vessel vasculitis, necrotising, GN
ANCA
No granulomas

49
Q

EGPA

A

Churg-Strauss
Eosinophils, asthma
pANCA - MPO
Granulomas

50
Q

GPA

A

Wegeners
Epistaxis, sinusitis, nasal crusting, nasal collapse
cANCA - PR3
Granulomas

51
Q

Investigations for vasculitis

A 
ANCA
CRP, PV
FBC - anaemia
UandEs - renal
Urinalysis - GN
CXR
Biopsy

MSK (10 decks)

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