Rheumatology / Derm Flashcards
NICE guideline >65 long term steroid therapy
oral alendronate, calcium and vit D
<65 Bone density scan
T score
Greater than 0
Reassure
Between 0 and -1.5 Repeat bone density scan in 1-3 years
Less than -1.5
Offer bone protection
shingles
dermatomal pattern
painful vesicular rash
seborrhoeic keratosis
benign skin lesion
brown/black and light tan
ABCDE rule
asymmetry, border irregularity, colour variation, diamete >6mm
bowens disease
slow growing red scaly patch -itchy
SCC
rheumatoid arthritis
raised CRP
joint swelling /tenderness
symmetric
small joint involved
polymyalgia rheumatica
> 60
rapid onset <1 month
ache/morning stiffness proximal limb muscles
ESR >40mm/hr
Creatinine kinase and emg normal
still’s disease in adults
15-25 yrs
35-46 yrs
Features:
Arthralgia
Elevated serum ferritin
rash
salmon-pink
maculopapular
pyrexia
lymphadenopathy
RF and anti nuclear antibody
methotrexate moa
inhibits dihydrofolate reductase > stops purine and pyrimidines
DNA synthesis enzyme
lowers folate level and impairs blood cell production
> WBC, RBC, platelets
ankylosing spondylitis
HLA-B27
ESR / CRP raised
Xrya of sacroiliac joints
sacroiliitis : subchondral erosions
sclerosis
squaring fo lumbar vertebrae
bamboo spine
syndesmophytes
apical fibrosis
Mx of ankylosing spondylitis
regular exercise
NSAIDs
physio
DMARDS - sulphasalazine
anti-tnf ?
reactive arthritis
HLA-B27 seronegative spondyloarthropaties
reactive / reiters
triad
pee, see, bone pain
can’t see, can’t pee, can’t climb a tree
