Rheumatology Flashcards
Causes of rabdo
Fall
Prolonged seizure
Statins (particularly with macrolides)
Symptoms of rabdo
Confusion
Vomiting
Tea-coloured urine (due to myoglobin released from muscle breakdown)
Pathology of rabdo
Muscle breakdown = myoglobin release Damages kidneys- AKI with disproportionally raised creatinine, hypocalcaemia as binds calcium Muscles release phosphate = raised Hyperkalaemia Develop metabolic acidosis
Features of rabdo
Raised CK AKI with v high creatinine Electrolytes: hypoca, hyperphosph, hyperk Metabolic acidosis Myoglobinuria
Mx of rabdo
IV fluids
RF for osteoperosis
Low BMI Premature menopause Smoking + excessive alcohol RA Meds: glucocorticoid use Endocrine: hyperthyroid, hyperparathyroid
Risk assessment tool for fractures
FRAX
Causes of dermatomyositis
Often idiopathic autoimmune (most ANA +ve)
CTD
Paraneoplastic syndromes (breast, lung, ovarian)
(Usually in older ladies)
Features of dermatomyositis
Symmetrical proximal weakness
Skin: photosensitive, macular rash on back and shoulders. Gottron’s papules on dorsum of hands. Heliotrope rash in orbital region.
RF for pseudogout + crystal type
CPPD crytals- anything that raises calcium
Hyperparathyroidism = RF due to raised Ca for crystal formation.
Most common joint affected by septic arthritis in adults
Knee
Features of septic arthritis
Acute pain, hot swollen joint, fever, often reduced mobility
Inv for septic arthritis
Synovial fluid sampling
Blood cultures (hematogenous spread)
Imaging
Mx of septic arthritis
Ortho review
IV AB (cover gram +ve) - fluclox.
Needle aspiration for decompression
What age group get polymyalgia rheumatica?
60+
