Brainscape's Knowledge GenomeTM

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


See full index

MRCP part 2 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Rheumatoid arthritis respiratory complications

A
  • pulmonary fibrosis
  • pleural effusion, pleurisy
  • pulmonary nodules
  • bronchiolitis obliterans
  • methotrexate pneumonitis
  • caplan syndrome (RA + massive lung fibrosis with pneumoconiosis e.g. coal worker’s lung, berylliosis, asbestosis, silicosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ocular features of rheumatoid arthritis

A
  • keratoconjunctivitis sicca (most common)
  • episcleritis/scleritis
  • corneal ulceration
  • keratitis
  • steroid-induced cataracts
  • chloroquine retinopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Neuromuscular complications of rheumatoid arthritis

A
  • vasculitis: nail fold infarcts, mild sensory neuropathy, (rarer: cutaneous ucleration, mononeuritis multiplex, mesenteric / cerebral / coronary artery involvment)
  • entrapment neuropathies (e.g. CTS)
  • osteoporosis
  • ligamentous laxity (atlantoaxial subluxation, subaxial subluxation i.e. lower cervical spine)
  • tenosynovitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Reactive arthritis features

A
  • asymmetrical oligoarthritis of lower limbs
  • dactylitis
  • urethritis
  • eye: conjunctivitis (seen in 50%), anterior uveitis
  • skin: circinate balanitis (painless vesicles on the coronal margin of the prepuce), keratoderma blenorrhagica (waxy yellow/brown papules on palms and soles)

Mx

  • treat precipitating infection
  • NSAIDs -> intra-articular steroid -> systemic steroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Relapsing polychondritis mx

A

1) Steroids to induce

2) Maintenance with azathioprine / methotrexate / ciclopsorin

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

Takayasu arteritis clinical features

A
  • large vessel vasculitis, varying pattern
  • systemic features of a vasculitis e.g. malaise, headache
  • unequal blood pressure in the upper limbs. May have subclavian steal syndrome
  • carotid bruit
  • intermittent claudication, especially arm
  • aortic regurgitation (around 20%)
  • assoc w/ RAS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Takayasu arteritis Ix

A
  • angiography

- ANCA not associated

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

Takayasu arteritis mx

A

1) steroids

2) immunosuppression

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

Polyarteritis nodosa features

A

Medium-sized artery vasculitis

  • general: fever, weight loss, malaise
  • mononeuritis multiplex
  • large joint arthralgia
  • GI: abdo pain, GI haemorrhage
  • renal: haematuria, renal failure, hypertension
  • livedo reticularis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Polyarteritis nodosa ix & mx

A
  • pANCA 20%
  • hep B 30%
  • angiography

Mx

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

Scleroderma renal crisis

A

Mx: ACEi

  • > ramipril if moderate
  • > captopril (fast acting) if severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of systemic sclerosis associated ILD

A

MMF or cyclophosphamide

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

Adult onset still’s disease features

A
  • arthralgia
  • pink maculopapular rash
  • pyrexia which is worse when pain / rash is worst
  • LNs
  • RF / ANA -ve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mx adult onset still’s disease

A

1) NSAIDs +/- steroids
2) Methotrexate
3) Biologics
- Etanercept (anti-TNF)
- anakinra, canakinumab (IL1 inhib),
- Tocilizumab (anti-IL6)
4) Rituximab

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

Psoriatic arthritis features

A
  • 10-20% psoriasis get arthropathy

Patterns

  • RA
  • sacroilitis
  • DIPJ
  • asymmetrical oligoarthritis

Ix

  • DIPJ pencil in cup
  • RF 10%
  • low ANA+ve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Psoriatic arthritis mx

A
  • as for RA including steroids for flares
    1) NSAIDs
    2) DMRARDs
  • MTX if co-existant psoriasis
  • sulfasalazine, leflunomide, ciclosporin
    3) Biologics e.g. anti-TNF - infliximab, etanercept
17
Q

Discoid lupus

A
  • erythematous rash
  • face, neck, ears, scalp
  • scarring alopecia and pigmentation
  • photosensitive
  • <5% progress to SLE

Mx:
topical steroids
hydroxychloroquine

18
Q

Lupus pernio

A
  • cutaneous sarcoidosis

- purplish lesions nose / cheeks

19
Q

Systemic sclerosis general features

A
  • raynaud’s
  • arthritis / arthralgia
  • ILD, pulmonary HTN
  • scleroderma renal crisis
  • scleroderma
  • reflux, SIBO, malabsorption
20
Q

Limited scleroderma

A
  • ANA+ve
  • anti-centromere abs
  • sleroderma limited to face, neck, limbs distal to knee, elbow
21
Q

Diffuse systemic sclerosis

A
  • ANA +ve
  • anti scl70
  • internal organ involvement more common
  • 50% 10 year survival
  • scleroderma also involves trunk and proximal limbs
22
Q

Polymyositis features

A
  • proximal muscle weakness +/- tenderness
  • raynaud’s
  • ILD
  • dysphagia
  • elevated CK
  • assoc with some cancers: cervix, lung, ovarian, bladder, stomach, pancreas
23
Q

Polymyositis abs

A

anti-Jo

24
Q

Polymyositis mx

A

1) steroids
2) azathioprine
3) MTX
4) infliximab / etanercept (anti-TNF)

25
Q

Relapsing polychondritis mx

A

1) Induce remission: steroids

2) Maintenance: azathioprine, methotrexate, cyclosporin, cyclophosphamide

26
Q

SLE Mx

A

ALL

  • NSAIDs
  • sun-block
  • hydroxychloroquine

Mild-mod
- short term pred

Mod
- short term pred + aza/mtx

Severe

  • IV steroids
  • cyclophosphamide / rituximab

Nephritis

  • MMF
  • > azathioprine in pregnancy

Pericarditis
- NSAIDs, colchicine, hydroxychloroquine

Myocarditis

  • steroids
  • cyclophosphamide
  • hydroxychloroquine
  • mx as HF
27
Q

Treatment and monitoring paget’s disease of the bone

A
  • bisphosphonate

- 6 monthly ALP to monitor

28
Q

Mx of gout in warfarinised patient with egfr <30

A
  • avoid NSAIDs
  • avoid colchicine as egfr <30 and it can increase inr
  • steroids orally or intra-articularly can help
29
Q

Causes of drug induced lupus

A
  • procainamide
  • hydralazine
  • penicillamine
  • isoniazid
  • phenytoin, cabemazapine
  • lamotrigine (cutaneous features only)
30
Q

Features of drug induced lups

A
  • as for SLE but renal / CNS involvement rare
  • ANA +ve
  • dsDNA -ve
  • anti-histone +ve
    (anti-Ro / Sm +ve 5%)
31
Q

Henoch-Schonlein purpura

A
  • IgA small vessel vasculitis
  • follows infection
  • usually children
  • rash over buttocks
  • abdo pain
  • polyarthritis
  • haematuria / renal failure may occur

Mx: analgesia, steroids for arthropathy

Course is usually self limiting. Good prognosis if no nephropathy. 1/3 relpase

32
Q

Takayasu’s arteritis

A
  • large vessel vasculitis affecting aorta and its branches
  • female predominance
  • fever, malaise, weight loss
  • TIAs
  • limb claudication
  • angina
  • AR
  • mesangial proliferative GN
  • Mx: steroids -> aza / MTX
33
Q

Dermatomyositis abs

A

anti Mi-2

34
Q

Indications for steroids in sarcoidosis

A
  • infiltrates on CXR with significant symptoms
  • significant hypercalcaemia
  • eye, heart, neuro involvement
  • erythema nodosum failing to respond to NSAIDs
  • lofgren’s (if unresponsive to NSAIDs) - EN + migratory polyarthritis

MRCP part 2 (11 decks)

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