Brainscape's Knowledge GenomeTM

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


See full index

Rheumatology and Orthopaedics > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What is Perthe’s disease?

A

Avascular necrosis of capital femoral epiphysis due to interuption of blood supply, followed by revascularisation and reossification over 18-36 months

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

What are the symptoms of Perthe’s disease?

A 
gradual onset
PAINLESS limp
Intermittent hip, knee, groin and thigh pain
Trendelenburg 
hip stiff, leg discrepency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would you treat Perthe’s disease?

A

NSAIDs, traction, crutches, physio
Muscle lengthening, osteotomy

Self-limiting

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

Who commonly presents with Perthe’s disease?

A

4-8 year olds, males>females

- 50% develop premature OA

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

What are risk factors for osteomyelitis?

A

behavioural - trauma, IVDU
vascular - DM, sickle cell
pre-existing bone problems
immune deficiency

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

What are the signs of osteomyelitis?

A

dull pain worse on movement
acue - tenderness, warmth, swelling
chronic - tenderness, warmth, swelling, ulcers, non-healing fractures

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

How would you treat osteomyelitis?

A

IV antibiotics for 6-10 weeks (e.g. flucloxicillin)
Surgical debridement
Immobilization

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

What are the signs and symptoms of septic arthritis?

A

red, hot, swollen joint

muscle spasms

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

How would you test for septic arthritis?

A

need surgeon to aspirate and culture
blood cultures
RBC
swabs

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

What are some red flag symptoms of bone pain and what would you suspect?

A

pain at rest and at night

- tumour, infection, fracture

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

What are some red flag symptoms of inflammatory joint pain and what would you suspect?

A

pain and stiffness in joint in morning, at rest and with use
- inflammatory, infective

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

How do inflammatory joint problems present?

A 
pain eases with use
significant stiffness (>60mins, early morning, at rest)
swelling 
hot and red
young patients, psoriasis, fam history
hand and feet 
responds to NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do degenerative joint problems present?

A 
pain increases with use 
stiffness is not prolonged (<30 mins, morning and evening)
not inflamed or swollen
1st CMCJ, DIPJ, knees 
not as responsive to NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some systemic symptoms of RA?

A 
fibrosis/interstial lung disease 
cardiomegaly/pericardial effusion 
plueral effusion 
pitting oedema e.g. kidney inflammation
digital vasculitis
gastric ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some red flag features of back pain?

A

if <16 or >50 and new back pain

  • history of cancer, weight loss or fever
  • recent serious illness or infection
  • bladder/bowel symptoms/saddle anaesthesia
  • neuro issues e.g. foot drop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you monitor people on methotrexate?

A

bloods every 3 months

- FBC, LFT, renal function

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

What are the complications to look out for with methotrexate?

A

get bone marrow failure, methotrexate toxicity if they have AKI, induces miscarriage

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

Which antibiotics do you not prescribe to patients on methotrexate?

A

trimethoprim and septrin

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

What drug do you need to give alongside methotrexate?

A

folic acid

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

What is the best test to exclude/confirm RA?

A

Anti-cyclic citrullinated ceptide - CCP

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

What is the first line disease modifying treatment for RA?

A

methotrexate 1 milligrams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a complication of methotrexate?

A

first 6 months - pneumonitis

dry cough, low grade fever, SOB

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

Which bone disease is giant cell arteritis linked to?

A

RA

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

How would you treat giant cell arteritis?

A

prednisilone - 60mg

ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is most common cause of bone and joint infection?

A

Staph aureus

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

Which test should everyone with inflammatory disease have?

A

Bone density scan

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

What are the mechanisms by which osteomyelitis occurs?

A

direct inoculation
continuous spread of infection to bone
haematogenous seeding

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

What are the symptoms in autoimmune connective tissue disease?

A

CREST
Calcinosis, Raynaud’s, Eosophageal dysmobility, Sclerodactyl (thickening of skin on digits), Telangiectasia (dilated veins on skin)

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

What is an example of large vessel vasculitis and how you would treat it?

A

giant cell artertitis

treat with corticosteroids, long term steroid treatment

30
Q

What is fibromyalgia and how would you diagnose it?

A

widespread MSK pain for at least 3 months - all other causes excluded
pain on at least 11/18 tender points, skinfold tenderness

31
Q

What are some symptoms of anti-phospholipid syndrome?

A

arterial and venous thrombosis
recurrent miscarriages
thrombocytopenia

32
Q

How do you treat anti-phospholipid syndrome?

A

low dose aspirin

warfarin if recurrent thrombosis

33
Q

Which rheumatology conditions is antiphospholipid syndrome associated with?

A

SLE

other rheumatic or autoimmune conditions

34
Q

What is ANCA?

A

anti-neutrophil cytoplasmic antibodies

a type of vasculitis

35
Q

What is polymyositis/dermatomyositis and how would you test for it?

A 
inflammation of striated muscle 
= proximal muscle weakness 
TEST
- autoimmune antibodies (JO-1, PM=Scl, Mi-2) 
EMG, MRI, needle biopsy
36
Q

How would you treat Raynaud’s?

A

keep warm
stop smoking
vasodilators
sympathectomy

37
Q

What is Raynaud’s syndrome/disease?

A

peripheral digital ischaemia due to spasm of digital arteries, percipitated by cold or emotion

38
Q

What are some symptoms of spondylitis?

A

SPINEACHE
sausage digits, psoriasis, inflammatory back pain, NSAIDs, enthesitis, arthritic, Crohn’s/colitis/CRP
HLA-B27
Eye -uveitis

39
Q

What is spondylitis?

A

inflammation of vertebrae

40
Q

What is the pathology of SLE?

A

apoptosis leads to release of nuclear antigen

genes react and form anti-nuclear antigens which deposit in tissues and cause tissue damage

41
Q

How would you treat systemic sclerosis?

A

Raynaud’s - vasodilators sympathectomy
Reflux - PPI
Ace-i to prevent renal crisis
skin oedema - cytotoxic drugs

42
Q

What are the symptoms of Sjogren’s sydrome?

A 
DRY 
sicca complex (dry eyes and mouth, enlarged salivary glands) 
inflammatory arthritis 
lymphadenopathy 
fatigue 
vasculitis 
dry cough, dysphagia
43
Q

What is scleroderma?

A

autoimmune connective tissue disorder esp. on hands, arms and face
life threatening when pulmonary involvement

44
Q

What is the difference between gout and pseudogout?

A

gout - monosodium urate crystals

pseudogout - calcium pyrophosphate crystals

45
Q

How would you treat SLE?

A 
UV protection 
assess organ damage and activity 
topical sunscreen, steroids, cytotoxic 
NSAIDs, antimalarials, anticoagulants 
rituximab
46
Q

How do you treat Sjorgren’s syndrome?

A

artifiical tears and saliva

immunosuppression e.g. ritiximab

47
Q

What is the diagnostic conditions for SLE?

A 
renal, neuro, haem disorders
antinuclear antibodies, antiphospholipid, anti-smith, anti-dyDNA 
butterfly/malar rash, photosensitivity 
discoid 
ulcers in mouth/nose 
scleritis (plueirits, pericarditis) 
arthritis
48
Q

What is the treatment of osteoarthritis?

A

non-medical e.g. physio
topical NSAIDs, analgesia
arthroscopy
arthroplasty

49
Q

What are the main extra-articular symptoms of rheumatoid arthritis?

A 
carpal tunnel syndrome 
tenosynovitis 
scleritis 
pulmonary fibrosis 
pericarditis 
vasculitis
50
Q

What are some symptoms of rheumatoid arthritis?

A 
early morning stiffness 
pain 
loss of function 
deformity, damage 
swelling 
symmetrical 
extra-articular
51
Q

What disease is enteropathic arthritis associated with?

A

IBD - 20% have IBD

52
Q

What are the differences between OA and RA?

A 
RA = autoimmune, joints and organs, symmetrical, any age, faster worsening 
OA = degenerative joints, old age
53
Q

How do you treat spondyloarthritis?

A

physio
anti-inflammatories
anti-TNF

54
Q

What is the antigen associated with spondyloarthritis?

A

HLA-B27

55
Q

What are some symptoms of psoriatic arthritis?

A

affects distal interpharyngeal joints
assymetricla oligarthritis
onycholysis

56
Q

How would you treat rheuamtoid arthritis?

A 
analgesia 
steroids 
DMARDs 
anti-TNF 
exercise, physio, manage rf
57
Q

What on XR indicates OA?

A 
joint space narrowing
osteophyte formation 
subcondral sclerosis 
subchondral cysts 
abnormalities of bone contour
58
Q

What causes reactive arthritis?

A

triggered 2days - 2 weeks after infection (especially UTI)

sterile inflammation of synovial membrane, tendons and fascia

59
Q

How do you test for gout?

A

polarized light microscopy of synovial fluid
XR - early shows soft tissue swelling, late shows periarticular erosion
Bloods - serum urate

60
Q

How do you treat crystal arthritis?

A

steroids
colchicine, allopurinol
NSAIDs

61
Q

What are some signs of Duchenne’s muscular dysrophy?

A

Proximal muscle weakness = pseudohypertrophy of calves

Gower’s sign

62
Q

What is the genetic disease that causes DMD and how can it vary?

A

X-linked dystrphin destruction

Becker’s

63
Q

What is the most common muscular dystrophy and it’s symptoms?

A

myotonic MD
facial, limb girdle and proximal limb wasting
GI disturbance, diabetes, myotonia

64
Q

What are some examples of large vessel vasculitis?

A

giant cell arteritis
polymyalgia rheumatica
Kawasaki’s
Tachyau’s arteritis

65
Q

How quickly do you need to do a biopsy in giant cell arteritis? Why could there be a false negative?

A

within 2 weeks of starting steroids

- can be false - as inflammation has skip lesions

66
Q

How do you treat giant cell arteritis?

A

IV methylprednisolone if visual disturbance

oral prednisilone if no visual disturbance

67
Q

What other condition is associated with giant cell arteritis that you need to include in a history?

A

polymyalgia rheumatica - ask about back pain

68
Q

What are some symptoms of Tachyau’s arteritis?

A

aneurysms, pulseless limbs, radio-radial delay, blood pressure differences

69
Q

What are some medium vessel vasculitis conditions?

A 
polyarteritis nodosa (Hep B, scrotal disease, peripheral neuropathy)
Behcet's (mouth and genital ulcers)
70
Q

What are some examples of small vessel vasculitis?

A 
granulomatosis with polyangiitis
microscopic polyangitis 
Churg strauss 
Good-pastures 
IgA vasculitis

Rheumatology and Orthopaedics (5 decks)

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