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Adult health 1 > Rheumatology Essentials: BW 2 > Flashcards

Rheumatology Essentials: BW 2 Flashcards

1
Q

Todays lecture:

When can rheumatologist help?

List inflammatory arthritis -

Define them: A traumatic joint swelling “soft mushy swelling”.

OA: Hard bony swelling, more for GPs, physio, orthopaedic surgeons

A
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2
Q

1) reactive arthritis - Chylamdia postive, or Camplybacter
2) Tenosynovitis- Psoriatric arthritis, DIP, sausage, boggy joints
3) Gouty Tophus - Maori pacific islanders- more common
4) Early Rheumatoid: Early, you dont see deformities - Present 2 months pain, morning predominant in hands

A

Classically: Aspiration of knees or other joints

>WCC>2000 x 106 = infammatory arthritis

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3
Q

What are major connective tissue disorders?

  • Scleroderma
  • SLE
  • Sjorens
  • Polymosistis

Vasculitis:

  • GCA
  • PMR
  • ANCA positive-

Key questions is to ask in vasculitis or CT disorder, is there any organ threatening disease (kidneys, eyes, lungs)

ALWAYS check Urine for blood etc, when seeing any of these conditions

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4
Q

How are Vasculitis(s) catergorized? - By vessel size effected

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5
Q

Different types of Vasculitis?

Know basics: EMQ?

  • Henoch Schlonein Purpura
  • Polymyositis
  • GCA
  • Raynauds
  • Scleroderma - Fibrosis, thickening of hands (sclerodactyl)
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6
Q

What is ANCA vasculitis? (small vessel Vasculitis)

(rarer)

3 Major types

All have ability to cause severe glomerularnephritis,

A
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7
Q

3 major types of small vessel Vasculitis (ANCA positive)

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8
Q

Case

A
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9
Q

ANCA vasculitis

What is most common causes of GN over >50 - Haematuria

A
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10
Q

What are Basic Prinicples of Rheumatology

What are the common conditions

What are the common medications used? DMARDS, Pred (try limit steroids, use DMARDS)

A
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11
Q

Gout:

Clinical features

Signs: XRAY: erosive deformites

Investigations: Gold standard (fluid aspirate) -

Management

A
  • Also increases kidney stones, uric acid stones
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12
Q

What are the biggest risk factor for GOUT?

A

High Urate, Uric acid. (hyper-uricaemia)

  • Increases with age, diet, genetics
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13
Q

Prevalence of gout throughout the ages?

A
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14
Q

Gout management

Acute:

Chronic:

(NEED to know for exams)

What is a Gout action plan? (what to do in flares)

A

TREAT to target Urate - potentially curable with a pill - Urate lowering therapy (allopurinol) (lifelong medications)

What drug interactions are important in Allopurinol?

Allopurinol - But in first 6 months may make condition worse - thus need to explain it to the patient, that the next 6 months may have attacks, but after will reduce dramatically.

Increase monthly 100mg

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15
Q

What are the key to RA?

A
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16
Q

What joints are commonly affected in RA?

X ray features?

A
17
Q

UNtreated or poorly treated RA results in what?

A
18
Q

Treatment for RA:

What are conventional DMARDS?

What are biological DMARDS?

What role do corticosteroids have in RA?

A
19
Q

Management of RA - Specific factors (MEthotrexate)

Methotrexate: MOA, once per week+ folic acid

A
20
Q

Common myths about methotrexate

A
21
Q

Biological DMARD

MOA

A
22
Q

What is treatment for RA

Know Psoriatic artritis: Same treatment as RA almost

A
23
Q

What is Ankylosing Spondylitis?

Male more common then female

Key features:

RULE OUT RED FLAGS - e.g waking at night? weight loss? IVDU?

Morning stiffness, improves with excercise, nocturnal waking

HLAB 27 positve!

What is associated with AS?

A

—> Psoriasis, crohns, IBD, Uveitis. (painful red eye ddx)

24
Q

X ray features of ankylosing spondylitis?

What joints are involved?

A
25
Q

Spectrum of illness

A
26
Q

What is the criteria for diagnosis of Axial spondylitis?

A
27
Q

What is the management of AS?

A
28
Q

Medications for AS

What are their MOA?

A
29
Q

What are major consideration when giving Biological Disease modifying agents?

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30
Q

What do you need to consider with ALL patient on Biological agents?

What do you need to consider for their management?

A
31
Q

What are the 4 cardinal signs on X ray of OA?

Need to know

A
32
Q

Management of OA?

Non-pharmacological major?

Symptomatic treatment

A
33
Q

Key points about CT tissue disease:

SLE, Scleroderma, polymyositis, Sjogrens.

A
  • DS DNA tests are specific, Anti Smith, Anti RNP, very
34
Q

LUPUS! need to know Blood tests which are most

Whats in the urine? Kidney biopsy?

A
35
Q

What are the various rashes associated with SLE? Lupus

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36
Q

What are clincial and labs associated with Scleroderma

What are the long term risks with Scleroderma (PAH)

What can

A
37
Q

What are the key things to know about Scleroderma?

What are the key bloods

A
38
Q

Clinical features of GCA?

Bloods?

Associated conditions? Morning stiffness

Diagnosis?

Treatment?

A
39
Q

Summary:

A

Adult health 1 (24 decks)

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