Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Rheumatology History taking and Pharmacology > Flashcards

Rheumatology History taking and Pharmacology Flashcards

1
Q

name three inflammatory arthrides that start acutely

A

crystal arthropathies
infectious athritis
reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the additive pattern

A

one which more and more joints are affected over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what arthritis involves the MCPs, wrists, elbows, shoulder, ankles or second to fifth MTPs

A

secondary arthritis (previous trauma or infection) or inflammatory arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what type of arthritis begins as monoarthritis

A

oestoarthritis- one weight bearing joint

can also be inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is oligoarthritis

A

involving 1-4 joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is polyarthritis usually associated with

A

inflammatory arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

is psoriatic arthritis symmetrical or asymmetrical

A

asymmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does anklylosing spondylitis affects the joint

A

affects axial skeleton and large peripheral joints in an asymmetrical fashion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what joints does osteoarhritis affect

A

DIP, base of thumb, knees, hips, lumbar and cervical spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what type of arthritis commonly doesn’t affect other joints- just the one affected

A

degenerative- primary osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what type of arthritis spreads to other joints (additive)

A

inflammatory- rheumatoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is palindromic pattern of joint involvement

A

The begins with a joint becoming involved and reaching peak intensity over 24 hours and then resolving just as quickly as it came on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of arthritis has an intermittent pattern (on and off)

A

inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the inflammatory features of arthritis

A

joint swelling
redness (septic, gout, reactive arthritis, psoriatic)
morning stiffness (longer than 30mins)
gets better with movement (no inactivity gelling like in osteo)
disturbed sleep
fever (septic arthritis, gout, vasculitis, SLE)
weight loss (vasculitis, inflam arthritis, CTD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does smoking affect arthitis

A

less likely to respond to medications
more progressive disease in RA
increased risk of cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does alcohol affect arthritis

A

reacts badly with drugs e.g. methotrexate

can cause gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what suggests a bacterial infectious arthritis

A

monoarticular- very red and warm
associated with fevers and chills
portal of entry
prior underlying joint abnormality (prosthetic, arthritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what suggests a viral infectious arthritis

A 
acute polyarticular onset 
may have associated  rash (parovirus)
duration less than 6 weeks 
other people sick at home 
hepatitis and HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what associated symptoms would suggest rheumatoid arthritis

A 
rheumatoid nodules 
sicca features (dry eyes and mouth)
raynauds phenomenon 
occular inflammation 
pulmonary involvement (dry cough, SOB)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what associated mucocutaneous symptoms would suggest a CTD

A 
alopecia, 
oral/ nasal ulceration, 
nosebleeds, 
chronic sinusitis, 
malar rash, 
photosensitivity, 
subcutaneous lupus, 
urticaria, 
dry mouth, sclerodactyly (systemic sclerosis)
21
Q

what associated occular symptoms would suggest a CTD

A 
sicca symptoms (sjogrens)
red, inflamed eye
22
Q

what associated pulmonary symptoms would suggest a CTD

A

pleuritic chest pain
SOB
cough

23
Q

what associated cardio symptoms would suggest a CTD

A

pericardial chest pain

raynauds syndrome

24
Q

what associated CNS symptoms would suggest a CTD

A 
headaches and migrarines
psychiatric illness
peripheral neuropathy 
mononeuritis mulitplex 
seizures
25
Q

what associated lymph symptoms would suggest a CTD

A

lymphadenopathy

26
Q

what associated renal symptoms would suggest a CTD

A

new onset hypertension
haematuria
proteinuria

27
Q

what would suggest ant-phospholipid syndrome

A 
recurrent miscarriages 
blood clots (arterial or venous)
28
Q

what symptoms would suggest a vasculitis

A

ENT problems (nasal stuffiness/sinusitis, crusting, nose bleeds, acute hearing loss)

non blanching rash

CNS problems (acute nerve palsy, acute temporal headache with scalp tenderness (GCA))

occular problems- red inflamed eye, sudden vision loss (GCA)

pulmonary problems (asthma (EGPA), polyangitis (churg strauss), cough, SOB, haemoptysis

renal problems- new onset hypertension, haematuria, proteinuria

29
Q

what symptoms would suggest seronegative spondyloarthritides

A 
psorias symptoms/ FH of psoriasis
FH of spin problems (AS)
recent STI/ urethral discharge 
recent gastroenteitis 
IBD symptoms 
enthesitis 
dactylitis 
eye inflammation
30
Q

what drug can cause gout

A

diuretic use

31
Q

what medical conditions is gout associated with

A

hypertension, obesity, insulin resistance, hypercholesterolemia

32
Q

why might peptic ulcer disease be a problem

A

risk is higher in RA, concurrent use of anticoagulants (GI bleed)

33
Q

why might liver or kidney disease be a problem

A

many rheumatological medications hepatoxic (methotrexate) or nephrotoxic or metabolised in the liver

34
Q

why might pulmonary disease be a problem

A

Some rheumatological medications may cause pneumonitis (eg methotrexate and anti-TNF drugs) and pre-existing lung disease might affect choice of treatment. NSAIDs are contraindicated in patients with NSAID / aspirin sensitive asthma

35
Q

what rheumatological drugs do you not give in pregnancy

A

methotrexate and leflunomide

36
Q

what are bouchards nodes

A

swelling of PIPs- seen in osteoarthritis

37
Q

what is the most specific inflammatory marker

A

CRP

38
Q

what can be seen in x rays of rheumatoid arthritis

A

loss of joint space, erosions, osteopenia

39
Q

what happens to the pannus during inflammation

A

become hypervascular and/ or hypertrophic

40
Q

what can show a hypertrophic or hypervascular pannus

A

MRI

41
Q

what joints does psoriatic arthritis affect in hand

A

DIPs and PIPs

42
Q

what is the dosage of methotrexate

A

starts 15 mg then increased to 20mg weekly

43
Q

what must methotrexate be prescribed in combination with and why

A

folic acid (taken everyday)- as methotrexate is a folate antagonist, if not will get: nausea, alopecia, mouth ulcers

44
Q

what condition is monitored by the DAS28 score

A

RA only

45
Q

what is the lowest titre of serum ANA

A

1:80

46
Q

why is creatine raised in renal conditions

A

as is excreted through the kidneys

47
Q

what does protein in the urine show

A

kidneys not working

48
Q

in systemic sclerosis what organs can be affected and how

A

lung and kidneys

pulmonary artery hypertension
interstitial lung disease

49
Q

what imaging for pulmonary artery hypertension

A

transthoracic echocardiogram- shows tricuspid valve to see if back pressure causing regurgitation and how strong ejection is

MSK (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions