Brainscape's Knowledge GenomeTM

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


See full index

Year 3 Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What does a GALS assessment stand for?

A

Gait, Arms, Legs, Spine

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

What is a GALS assessment?

A

A quick screening assessment for MSK disorders

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

What is the purpose of a GALS assessment?

A

Can help to identify gross abnormalities that can be assessed in greater detail afterwards

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

What are some common Gait abnormalities?

A 
Antalgic
Trendelenburg
Sensory Ataxia
Cerebella Ataxia
Hemiplegic
Festinent/Projectile
Waddling
Psychogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is an Antalgic Gait?

A

Pain causes the patient to reduce the time spent putting weight through the affected side

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

What is Trendelenburg gait?

A

The pelvis drops to the opposite side when stood on the affected side

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

What is a Sensory Ataxic gait?

A

Wide based
Stamping to account for the lack of sensory input
Worsens if eyes are shut

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

What is a Cerebellar Ataxic gait?

A

Wide-based staggering gait.

Arms often flung out to improve balance

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

What is a Hemiplegic gait?

A

Narrow-based

Affected leg is swung forwards with the toes scraping the ground

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

What is a Festinant/Projectile gait?

A

Difficult initiating a walk, then becomes a shuffling run with reduced arm swing

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

What is a Waddling gait?

A

“Duck-like”, due to bilateral hip muscle weakness

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

What is a psychogenic gait?

A

Variable gait, worse when being observed

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

What is looked for during the arms inspection of a GALS assessment?

A

Inspection of hands looking for deformities - MCPJs are key sites for RA nodules
Precision grip
Active Elbow and Shoulder movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are the legs assessed in a GALS assessment?

A

Patient lies supine

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

What is assessed in the legs section of a GALS assessment?

A

Assess for muscle wastage and leg length discrepancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the earliest sign of hip disease?

A

Reduced hip internal rotation

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

What could a knee swelling represent?

A

Bony
Soft Tissue
Synovial fluid

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

Which joints in the legs are common sites of RA?

A

MTPJ

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

What abnormalities of the spinal curvature are suggestive of Ankylosing Spondylitis?

A

Exaggerated Thoracic Kyphosis

Loss of Lumbar Lordosis

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

How may osteoporotic spinal fractures present?

A

Exaggerated Thoracic Kyphosis

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

What is the first movement affected by cervical degeneration?

A

Lateral C-Spine flexion

22
Q

What are Dermatomyositis and Polymyositis?

A

Rare idiopathic muscle diseases that are characterised by inflammation of striated muscle

23
Q

How can Dermatomyositis/Polymyositis present?

A

Insidious onset of proximal muscle weakness that is often painless
SOB
Rash
Reynauds syndrome

24
Q

What are the diagnostic criteria for Polymyositis?

A

3 or more of:

Symmetrical Proximal Muscle Weakness
Raised serum muscle enzyme levels
Typical Electromyographic changes
Biopsy evidence of myositis

25
Q

What are the diagnostic criteria for Dermatomyositis?

A

A rash plust two or more of:

Symmetrical Proximal Muscle Weakness
Raised serum muscle enzyme levels
Typical Electromyographic changes
Biopsy evidence of myositis

26
Q

What abnormalities may be found upon investigation of Dermatomyositis/Polymyositis?

A

Raised ALT
80% are antinuclear antibody +ve
Muscle auto-antibody panel

27
Q

Which radiological investigation is the best for suspected myositis?

A

MRI

28
Q

What is the initial treatment for confirmed myositis?

A

High Dose Corticosteroids for the first few weeks

29
Q

What is the long-term management for myositis?

A

Methotrexate
Azathioprine
Rituximab
IVIG

30
Q

Other than pharmacological management, what else should patients be advised of with Dermatomyositis?

A

Sun Protection will help with symptoms/rash

31
Q

What is Fibromyalgia?

A

A common disorder of central pain processing characterised by chronic widespread pain in all 4 quadrants of the body

32
Q

What is Allodynia?

A

A heightened and painful response to innocuous stimuli

33
Q

What is thought to cause fibromyalgia?

A

Sleep deprivation

34
Q

How is sleep deprivation thought to trigger Fibromyalgia?

A

Leads to hyperactivation in response to noxious stimuli, and neural activation in brain regions associated with pain perception

35
Q

What are some common symptoms of Fibromyalgia?

A 
Joint/Muscle stiffness
Profound fatigue
Unrefreshed sleep
Numbness
Headaches
Irritable Bowel/Bladder
Depression and Anxiety
Poor concentration/memory
36
Q

What examination findings may there be with Fibromyalgia?

A

Tender points, where the patient experiences excessive pain with insignificant pressure

37
Q

What are some risk factors for Fibromyalgia?

A

Females
Aged 40-50
Onset may coincide with an obvious trigger

38
Q

What is the generalised management principles for coping with Fibromyalgia?

A

Education
CBT
Pharmacological
Physical Therapy

39
Q

What is the recommended pharmacological treatment for Fibromyalgia?

A

Low Dose Amitryptylline

Pregabalin

40
Q

Which medications should not be used to treat Fibromyalgia?

A

Opioids

41
Q

What is Giant Cell Arteritis otherwise known as?

A

Temporal Arteritis

42
Q

What is Giant Cell Arteritis?

A

Chronic vasculitis of large and medium sized vessels that occur in patients aged 50 or over

43
Q

Which vessels are most commonly inflamed in Giant Cell Arteritis?

A

Arteries originating from the arch of the aorta

44
Q

What can Occlusive Arteritis lead to in Giant Cell Arteritis?

A

Anterior Ischaemic Optic Neuropathy (AION) and acute visual loss

45
Q

What can inflammation of arteries supplying the muscles of mastication lead to in Giant Cell Arteritis?

A

Intermittent pain and claudication of the jaw and tongue, particularly when chewing

46
Q

Which other condition is Giant Cell Arteritis commonly associated with?

A

Polymyalgia Rheumatica

47
Q

What are some common symptoms of Giant Cell Arteritis?

A

Headache - Localised,unilateral, boring in quality over the temple
Tongue/Jaw claudication upon mastication
Visual Symptoms - Amaurosis Fugax, Blindness, Diplopia, Blurring
Scalp tenderness, particularly over the temporal artery

48
Q

What are the diagnostic criteria for Giant Cell Arteritis?

A

Aged >50 and any two of:

Raised ESR, CRP, PV
New onset localised headache
Tenderness/decreased pulsation of temporal artery
New visual symptoms
Biopsy result showing necrotising arteritis

49
Q

What is the acute treatment for confirmed Giant Cell Arteritis?

A

60-100mg Prednisolone PO for at least 2/52

50
Q

What is the recommended treatment if a Giant Cell Arteritis patient has visual symptoms?

A

1g Methylprednisolone IV Pulse therapy for 1-3 days

51
Q

Along with steroids, what other medication should a patient with Giant Cell Arteritis be started on?

A

Low-dose Aspirin Therapy to reduce thrombotic risk

Year 3 Medicine (8 decks)

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