Rheumatology Extra

Question 1

What are the most common underlying malignancies associated with dermatomyositis?

Answer 1

ovarian, breast and lung

Question 2

How long before development of RA do anti-ccp antibodies develop?

Answer 2

10 years

Question 3

What is the sensitivity and specificity of anti-ccp?

Answer 3

• sensitivity similar to RF (70-80%)

- specificity higher (90-95%)

Question 4

What drug should be given for renal complications of systemic sclerosis (HTN and AKI):

Answer 4

lisinopril (ACEi)

Question 5

What should you do when starting allopurinol?

Answer 5

• use colchicine cover (or NSAID)

- co-prescribe up to 6 months from initiation

Question 6

What should you use to prevent pathological fractures in someone with an eGFR <30?

Answer 6

• Denosumab
• monoclonal antibody that prevents development of osteoclasts by inhibiting RANKL
• subcut injection

Question 7

What should be done for any patient presenting with a new synovitis?

Answer 7

urgent referral to rheumatology

Question 8

What is Ewing’s sarcoma?

Answer 8

• a malignant tumour that occurs most frequently in the diaphysis of the pelvis and long bones
• mainly affects children and adolescents
• onion skin appearance on X-ray
• fine needle aspiration
• presence of EWS-FLI1 protein