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Year 3 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What can cause a monoarthritis?

A

Septic arthritis
Gout/pseudogout
Oesteoarthritis
Trauma eg. haemarthrosis

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2
Q

What can cause an oligoarthritis?

A 
Psoriatic arthritis
Gout/pseudogout
Oesteoarthritis
Ankylosing spondylitis
Reactive arthritis
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3
Q

What can cause a symmetrical polyarthritis?

A

Rhematoid arthritis
Oesteoarthritis
Hep A/B/C
Systemic disease eg. SLE, sickle cell anaemia, sarcoidosis, leukaemia

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4
Q

What can cause an asymmetrical polyarthritis?

A

Psoriatic arthritis
Reactive arthritis
Systemic disease

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5
Q

What are the key sign/ symptoms of osteoarthritis?

A 
Pain on movement
Worse with prolonged activity
Pain relieved on resting
Nodes on fingers- Heberdens and Bouchards
Varus knees
Square hands
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6
Q

What are the key radiological features of osteoarthritis?

A

Loss of joint spaces
Osteophytes (Bony projections)
Subarticular sclerosis
Subchondral cysts (sacks of fluid)

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7
Q

What are the risk factors for septic arthritis?

A 
Diabetes
CKD
Joint disease
Recent joint surgery
Immunocompromised
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8
Q

What is the investigation for septic arthritis?

A

Joint aspiration-> Synovial fluid culture and microscopy.

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9
Q

What is the treatment for septic arthritis?

A

IV antibiotics eg Flucloxacillin

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10
Q

What are the risk factors for rhematoid arthritis?

A

Female
Smoking
HLA DR41
CCP Autoantibodies

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11
Q

What are the features indicative of RA on investigation?

A

CCP Autoantibodies
Raised CRP, C3, C4 and ESR
RF

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12
Q

What treatments are available for RA?

A

NSAIDS
Steroids
Anti TNFalpha eg. Infliximab
Surgery

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13
Q

What are the risk factors for gout?

A

Increased urate production eg. alcohol, red meat, sea food, psoriasis
Decreased urate excretion eg. CKD, diuretics, hypertension, metabolic syndrome

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14
Q

What are the features indicative of gout on investigation?

A

Negative bifringent urate crystals
Increased serum urate
Punched out erosions on bone

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15
Q

What plasma autoantibodies are found in RA?

A

RF, CCP autoantibodies

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16
Q

What plasma autoantibodies are found in coealiac?

A

Anti TTG

17
Q

What plasma autoantibodies are found in SLE?

A

ANA, Anti dsDNA

18
Q

What plasma autoantibodies are found in antiphospholipid syndrome?

A

Anti cardiolipin

19
Q

What plasma autoantibodies are found in PBC?

A

Antimitochondrial

20
Q

What plasma autoantibodies are found in vasculitis?

A

cANCA, pANCA

21
Q

What are osteophytes?

A

Bony projections associated with cartilage degeneration at joints

22
Q

What would be found on a blood culture in a patient with septic arthritis?

A

Usually strep, S. Aureus, N. Gonorrhoea or gram negative bacilli

23
Q

What are the features of rheumatoid arthritis on X ray?

A

Loss of joint space, soft tissue swelling and joint deformity

24
Q

How should synovial fluid normally appear?

A

Clear, colourless, no neutrophils

25
Q

How does synovial fluid appear in osteoarthritis?

A

Clear, straw coloured, viscous

WBC <1000mm

26
Q

How does synovial fluid appear in an acutely inflamed joint (crystal or Rheumatoid)?

A

Turbid, yellow, decreased viscosity, high number of neutrophils

27
Q

How does synovial fluid appear in septic arthritis?

A

Turbid, yellow, decreased viscosity, high number of neutrophils

28
Q

How does gout appear on Xray?

A

Soft tissue swelling
Bony erosion
Normal joint space

29
Q

What are the most likely causes of back pain in patients aged >50years?

A 
Degenerative changes
Vertebral collapse (due to osteoporosis)
Paget's disease 
Malignancy
Myeloma
Spinal stenosis
30
Q

What is the most likely cause of back pain in patients aged 15-30years?

A 
Prolapsed disc
Trauma
Fracture
Ankylosing spondylitis
Pregnancy
31
Q

What are the key signs that cauda equina is present?

A
  1. Leg pain (alternating/ bilateral)
  2. Saddle anaesthesia (perianal)
  3. Loss of anal tone
  4. Bladder and bowel incontinence
32
Q

What is ankylosing sponylitis?

A

Chronic inflammatory disease of spine

Unknown cause

33
Q

What is the typical patient that suffers anykylosing spondylitis and what are their symptoms?

A

Typical patient is male <30yrs with gradual onset lower back pain
Pain worse at night
Spinal morning stiffness
Relieved by exercise
Radiates from sacro-iliac joints to hips/buttocks

34
Q

Which diseases are associated with HLA B27?

A

Ankylosing spondylitis
Uveitis
Reactive arthritis
Psoriatic arthritis

35
Q

What are the key clinical features of SLE?

A 
Malar rash
Discoid rash
Synovitis
Serositis
Alopecia
Oral/nasal ulcers
Haemolytic anaemia, leucopenia, neutropenia
36
Q

Erythema nodosum is painful red/blue raised lesions on shins, caused by _______________

A

Sarcoidosis
Drugs
Strep infection

37
Q

Erythema marginatum is pink rings on the trunk which come and go, seen in _________________

A

Rheumatic fever

38
Q

Dermatitis herpetiformis is itchy blisters in groups on the knees, elbow and scalp, usually seen in ____________

A

Coeliac disease

Year 3 (22 decks)

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