Station 5 Flashcards
Extra-articular features of rheumatoid arthritis
(SEVEN)
Episcleritis
Scleritis
Pleural effusions
Pulmonary fibrosis
Pericarditis
Splenomegaly (Felty’s)
Gomerulonephritis
Management of rheumatoid arthritis
(EIGHT)
MDT:
- Rheumatologists
- Physiotherapy
- Occupational therapy
Analgesia - NSAIDs with PPI
Steroids in acute flare and taper
DMARDS:
- Methotrexate
- Azothiaprine
- Sulphasalazine
What is methotrexate?
Inhibits purine synthesis
Patients must take folic acid
Once weekly medication
Regular monitoring of FBC and LFTs
Risk of myelosuppression
Exam findings in rheumatoid arthritis
(FOUR)
Swelling PIP and MCPJs
Ulnar deviation
Swan neck deformity
Bouttoniere’s deformity
Cardiovascular complications of Ehler-Danlos
(FOUR)
Aortic dilatation
Aortic regurgitation
Mitral valve prolapse
Conduction abnormalities
Types of Ehler-Danlos
(THREE)
Hypermobile type
Classical - more skin infected
Vascular type - increased risk internal haemorrhage
What is Ehler-Danlos
Connective tissue disorder
Absent or deficient collagen
Genetic
Sarcoidosis presentation
(FOUR)
SOBOE
Weight loss
Skin plaques and lupus pernio
Fatigue
Investigations for sarcoidosis
(NINE)
Urine dip for protein
Bloods:
- FBC
- U+E
- LFT
- Bone - looking for hypercalcaemia
- Serum ACE
Spirometry
CXR
Echo
Sarcoidosis CXR findings
(THREE)
Bilateral hilar lymphadenopathy
Pulmonary infiltrates
Fibrosis
Treatment of sarcoidosis
(THREE)
Supportive
Steroids
Methotrexate if steroids not working
Marfan’s syndrome vs Marfanoid habitus
Marfanoid habitus is skeletal only
Marfan’s syndrome involve eye and heart
Marfan’s syndrome inheritance
Autosomal dominant
Clinical features of Marfan’s
(SEVEN)
Hypermobility
Arachnodactyly
Mitral and aortic regurgitation
Aortic dilatation
Pneumothoraces
Upward lens dislocation
High arched palate
Diseases associated with Raynaud’s
(FIVE)
Systemic sclerosis
SLE
Rheumatoid arthritis
Polymyositis
Dermatomyositis
Treatment of Raynaud’s
(FOUR)
Gloves
Heated things
Nifedipine
PDE5 inhibitors - sildenafil
Investigations for Raynauds
(TWELVE)
Bloods:
- FBC, U+E, LFT, CRP
- ANA
- ENA
- Anti dsDNA
- ESR
- Anti Scl70
- Anti centromere
- Complement
Urine dip
CXR
ECG
Spirometry
Systemic sclerosis features
(NINE)
Calcinosis
Raynaud’s
Oesophageal dysmotility
Sclerodactyly
Telangiectasia
Pulmonary hypertension
Pericarditis
GORD
Renal impairment
Pre-eclampsia presentation
(SEVEN)
Headache
Visual disturbance
Epigastric/RUQ pain - HELLP
Nausea or vomiting
Oedema
Hypertension
Proteinuria
Investigations for pre-eclampsia
(FIVE)
Blood pressure
Urine dip
Urine P/CR
FBC - plts
LFTs
Causes of reactive arthritis
(FOUR)
Salmonella - diarrhoea
Campylobacter
Streptococcus
Chlamydia - STI
Ankylosing spondylitis extra articular features
(SIX)
Anterior uveitis
Apical fibrosis
Aortic regurgitation
AV block
Achilles tendonitis
IBD
Retinitis pigmentosa features
(FIVE)
Progressive reduction in visual acuity
Difficulty seeing at night
Family history of visual loss
Bone spicule retinal pigmentation
Waxy pale optic disc
Retinitis pigmentosa inheritance
Varied
Autosomal dominant
Autosomal recessive
X-linked
