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Internal Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Type 1 immune reaction

A

Anaphylatic
IgE, basophils, mast cells
Asthma, allergic rhinitis, anaphylaxis

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2
Q

Type 2 immune reaction

A

Cytotoxic
Antibody formation, phagocytosis of oponised cells
autoimmune haemolytic anaemia, Goodpasture’s syndrome, Grave’s disease, pernicious anaemia

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3
Q

Type 3 immune reaction

A

Immune complex
Antibody-complement formation, attract inflammatory cells
SLE, PAN, PSGN

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4
Q

Type 4 immune reaction

A

Cell-mediated/delayed hypersensitivity
T-cell mediated
Contact dermatitis

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5
Q

HLA-B27

A

Ankylosing spondylitis
Reactive arthritis
Enteropathic arthritis

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6
Q

HLA-DR4, DR1

A

Rheumatoid arthritis

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7
Q

HLA-DR3

A

Sjogren’s syndrome
SLE
Non-rheumatic diseases (celiacs, DM1, graves)

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8
Q

Joint Pain causes (SOFTER TISSUE)

A 
Sepsis
OA
Fracture
Tendon/muscle
Epiphyseal
Referred
Tumour
Ischaemia
Seropositive arthritis
Seronegative arthritis
Urate
Extra-articular rheumatism
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9
Q

Seropositive disease

A 
Rheumatoid arthritis
SLE/antiphospholipid syndrome
Scleroderma
Dermatomyositis/polymyositis
Sjogren's syndrome
Mixed connective tissue disease
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10
Q

Seronegative disease

A

Ankylosing spondylitis
Enteropathic arthritis
Reactive arthritis
Psoriatic arthritis

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11
Q

Seropositive features

A

Female predominance
Symmetrical affecting small and large joints
Does not affect spine or enthesis.
Others: rheumatoid nodules, vasculitis (SLE), dryness (Sjogren’s), Raynaud’s (scleroderma)

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12
Q

Seronegative

A

Predominantly males
Usually assymetrical affecting larger joints. Affects axial and enthesis.
Others: iritis (reactive), dactylitis, DIP (psoartic), oral ulcers, GI (enteropathic), skin conditions

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13
Q

SLE antibodies

A 
ANA
RhF
anti-dsDNA
Anti-SM
Lupus anticoagulant
Anti-cardiolipin
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14
Q

Sjogern’s antibodies

A

ANA
RhF
Anti-La
Anti-Ro

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15
Q

CREST antibodies

A

Anti-centromere

ANA

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16
Q

Dermatomyositis, polymyositis antibodies

A

Anti-Jo

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17
Q

Rheumatoid arthritis antibodies

A

RhF

Anti-CCP

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18
Q

Negatively birefringent

A

Monosodium urate

19
Q

Positively birefringent, rhomboid shape

A

Calcium pyrophosphate dihydrate

20
Q

OA radiographic signs

A

Joint space narrowing
Subchondral sclerosis
Subchondral cysts
Osteophytes

21
Q

Vasculitides (seropositive)

A

Small: non-ANCA associated, Sjogern’s (Wegener’s granulomatosis)
Medium: polyarteritis nodosa, Kawasaki’s
Large: giant cell arteritis, Takayasu’s

22
Q

Anti-neutrophil cytoplasmic antibodies (ANCAs)

A

Wegener’s granulomatosis
Microscopic polyangiitis
Primary pauci-immune necrotizing crescentic glomerulonephritis Churg-Strauss syndrome
Drug induced vasculitides

23
Q

Antiphospholipid syndrome antibodies

A

Lupus anticoagulant

Anti-cardiolipin

24
Q

Wegener’s granulomatosis antibodies

A

c-ANCA

25
Q

SLE (MD SOAP BRAIN)

A 
Malar rash
Discoid rash
Serositis
Oral ulcers
ANA
Photosensitivity
Blood
Renal
Arthritis
Immune
Neurological
26
Q

Antiphospholipid syndrome

A

Thromboembolic events
Spontaneous abortions
Thrombocytopenia

27
Q

Raynauds phenomen causes (COLD HAND)

A 
Cryoglobulins
Obstruction/Occupation
Lupus erythematous
Diabetes/Drugs
Haematologic
Arterial
Neurologic
Disease of unknown origin
28
Q

CREST syndrome

A 
Calcinosis
Raynauds
Esophageal dysfunction
Sclerodactyl
Telangiectasia
29
Q

PM/DM

A

Symmetric proximal muscle weakness (shoulders, hips)
Elevated muscle enzymes (CK, LDH, AST, ALT)
EMG changes
Muscle biopsy (necrosis, regeneration, perivascular inflammation)
Rash (Gottron’s papules, helitrope rash, shawl sign)

Associated malignancies: breast, lung, colon, ovaries

30
Q

Sjogern’s triad

A

Dry eyes
Dry mouth/dysphagia
Arthritis

31
Q

Wegener’s granulomatosis

A

Nasal/oral involvement (inflammation, ulcers, epistaxis)
Abnormal CXR (nodules, cavitations)
Urinary sediment (protein RBC casts)
Biopsy (granulomas in lung, necrotising segmantal GN)

c-ANCA positive, small vessel vasculitis

32
Q

Polyarteritis Nodosa

A 
Weight loss
Mylagias/weakness
Livedo reticularis
Neuropathy
Testicular pain
Diastolic BP >90
Elevated Cr
Hep B positive
Arteriography abnormal
Biopsy of artery

ANCA negative, medium vessel vasculitis

33
Q

Giant cell arteritis

A 
Age >50
New headache/loss of vision/jaw claudication
Temporal artery abnormality
Elevated CRP
Abnormal biopsy

Large vessel vasculitis

34
Q

Ankylosing spondylitis

A 
Age onset 20's
Axial, LE distribution
Sacroilitis
Enthesitis
Aorticic regurge
HLA-B27
35
Q

Psoriatic arthritis

A 
Age onset 35-45
Peripheral arthritis
Any distribution
Dactylitis, enthesitis
Psoriasis
Uveitis, urethritis
36
Q

Reactive arthritis

A 
Age onset 20's
Peripheral arthritis, LE
Sacroilitis
Dactylitis, enthesitis
Urethritis, aortic regurge
HLA-B27

Onset: post Shigella, Salmonella, Campylobacter, Yersinia, Chlamydia, Mycoplasma

37
Q

Enteropathic arthritis

A

Peripheral arthritis, LE
Pyoderma, erythema nodosum
IBD

38
Q

AS extra-articular manifestations (6 A’s)

A 
Atlanto-axial subluxation
Anterior uveitis
Apical lung fibrosis
Aortic incompetence
Amyloidosis (kidneys)
Autoimmune BD (UC)
39
Q

Gout

A

First MTP
Erosion of bone
Tophi, gout nephropathy

40
Q

Pseudogout

A

Knee, wrist, polyarticular

Chondrocalcinosis, OA

41
Q

Gout precipitants (drugs are FACT, foods are SALT)

A

Furosemide
Aspirin/alcohol
Cytotoxic drugs
Thiazide diuretics

Shellfish
Anchovies
Liver and Kidney
Turkey
Sardines
42
Q

Polymyalgia Rheumatica

A 
Pain and stiffness of the proximal extremities, fever, weight loss mylagia
Age >50
Bilateral aching/morning stiffness
Increased ESR
Rapid response to corticosteroids
43
Q

Fibromylagia

A

Chronic, widespread pain with tender points (occiput, trapezius, low cervical, lateral epicondyle, gluteal, greater trochanter)

Internal Medicine (12 decks)

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