rheumatology formative Flashcards
SLE antibody
Anti-dsDNA
What is the treatment for connective tissue disorders ie ehlers danlos
Treat symptomatically and monitor for major complications
SLE treatment
Hydroxychloroquine
What would NOT be a likely cause of chest pain in a patient with SLE
Pneumothorax
- could get MI, pleurisy, pericarditis, pul. Embolus
What sex does SLE affect more commonly
Female 9:1
Features of anti-phospholipid syndrome
Recurrent pregnancy loss
Venous thrombosis
Livedo reticularis
Migraine
1st line investigation for suspected SLE
Urinalysis > renal biopsy if blood / protein
A patient is diagnosed in the respiratory clinic as having pulmonary fibrosis. The chest physician notes that she has Raynaud’s phenomenon, dry eyes, facial telangiectasia and puffy hands. What is the most likely diagnosis
DIFFUSE systemic sclerosis
(Internal organ involvement !!!)
What are the nail changes associated with psoriatic arthritis ?
Onycholysis
Pitting
What are the spondyloarthropathies
AS
Psoriatic arthritis
Reactive arthritis
What medical conditions is sacroilitis associated with other than AS
Crohns (20%)
RF is positive at what percent for people with RA
85%
What are second line fro RA
Anti-TNF + anti-IL6
What is 3rd line for RA
Azathioprine
Is allopurinol a drug that can be used in the acute management of gout
No it is a prophylactic drug
Corticosteroids, colchicine is for acute gout attack
Initial investigator fro Polymyalgia rheumatica
ESR
antibody associate with polymyositis
Anti-Jo-1
Antibody associated with primary biliary cirrhosis
Anti-mitochondrial
Features of DMARDS
- reduce rate of progression of joint damage
- require regular BP monitoring
- slow acting
- should aim to be used within 12 weeks of symptoms presenting in patients
- patients will still need painkillers on top of DMARDS
What are the large vessel arteritides
GCA and Takayasu
What are the medium vessel vasculitides
Polyarteritis nodosa
Kawasakis
What are the small vessel vasculitides
GPA / wegeners
eGPA / churg Strauss
Microscopic polyangiits
What vasculitides are generally ANCA negative
Large adn medium
What vasculitis is positive for ANCA
Small vessel vasculitides
Associated disease of anti-PR3
GPA
Associated disease of anti-MPO ANCA
Eosinophilic GPA
Can you give live vaccinations when on DMARDS
NO - should be given prior
Which drugs for rheumatological treatments should be stopped in pregnancy
NSAIDs
Methotrexate
If a women with RA on methotrexate wants to start a family when should she stop taking her DMARD
3 months before conception
Polymyalgia rheumatica vs polymyositis
PR = pain and stiffness
Poly = WEAKNESS
