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MRCP PACES > Station 5 > Flashcards

Station 5 Flashcards

1
Q

Extra-articular features of rheumatoid arthritis
(SEVEN)

A

Episcleritis
Scleritis
Pleural effusions
Pulmonary fibrosis
Pericarditis
Splenomegaly (Felty’s)
Gomerulonephritis

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2
Q

Management of rheumatoid arthritis
(EIGHT)

A

MDT:
- Rheumatologists
- Physiotherapy
- Occupational therapy
Analgesia - NSAIDs with PPI
Steroids in acute flare and taper
DMARDS:
- Methotrexate
- Azothiaprine
- Sulphasalazine

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3
Q

What is methotrexate?

A

Inhibits purine synthesis
Patients must take folic acid
Once weekly medication
Regular monitoring of FBC and LFTs
Risk of myelosuppression

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4
Q

Exam findings in rheumatoid arthritis
(FOUR)

A

Swelling PIP and MCPJs
Ulnar deviation
Swan neck deformity
Bouttoniere’s deformity

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5
Q

Cardiovascular complications of Ehler-Danlos
(FOUR)

A

Aortic dilatation
Aortic regurgitation
Mitral valve prolapse
Conduction abnormalities

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6
Q

Types of Ehler-Danlos
(THREE)

A

Hypermobile type
Classical - more skin infected
Vascular type - increased risk internal haemorrhage

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7
Q

What is Ehler-Danlos

A

Connective tissue disorder
Absent or deficient collagen
Genetic

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8
Q

Sarcoidosis presentation
(FOUR)

A

SOBOE
Weight loss
Skin plaques and lupus pernio
Fatigue

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9
Q

Investigations for sarcoidosis
(NINE)

A

Urine dip for protein
Bloods:
- FBC
- U+E
- LFT
- Bone - looking for hypercalcaemia
- Serum ACE
Spirometry
CXR
Echo

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10
Q

Sarcoidosis CXR findings
(THREE)

A

Bilateral hilar lymphadenopathy
Pulmonary infiltrates
Fibrosis

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11
Q

Treatment of sarcoidosis
(THREE)

A

Supportive
Steroids
Methotrexate if steroids not working

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12
Q

Marfan’s syndrome vs Marfanoid habitus

A

Marfanoid habitus is skeletal only
Marfan’s syndrome involve eye and heart

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13
Q

Marfan’s syndrome inheritance

A

Autosomal dominant

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14
Q

Clinical features of Marfan’s
(SEVEN)

A

Hypermobility
Arachnodactyly
Mitral and aortic regurgitation
Aortic dilatation
Pneumothoraces
Upward lens dislocation
High arched palate

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15
Q

Diseases associated with Raynaud’s
(FIVE)

A

Systemic sclerosis
SLE
Rheumatoid arthritis
Polymyositis
Dermatomyositis

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16
Q

Treatment of Raynaud’s
(FOUR)

A

Gloves
Heated things
Nifedipine
PDE5 inhibitors - sildenafil

17
Q

Investigations for Raynauds
(TWELVE)

A

Bloods:
- FBC, U+E, LFT, CRP
- ANA
- ENA
- Anti dsDNA
- ESR
- Anti Scl70
- Anti centromere
- Complement
Urine dip
CXR
ECG
Spirometry

18
Q

Systemic sclerosis features
(NINE)

A

Calcinosis
Raynaud’s
Oesophageal dysmotility
Sclerodactyly
Telangiectasia
Pulmonary hypertension
Pericarditis
GORD
Renal impairment

19
Q

Pre-eclampsia presentation
(SEVEN)

A

Headache
Visual disturbance
Epigastric/RUQ pain - HELLP
Nausea or vomiting
Oedema
Hypertension
Proteinuria

20
Q

Investigations for pre-eclampsia
(FIVE)

A

Blood pressure
Urine dip
Urine P/CR
FBC - plts
LFTs

21
Q

Causes of reactive arthritis
(FOUR)

A

Salmonella - diarrhoea
Campylobacter
Streptococcus
Chlamydia - STI

22
Q

Ankylosing spondylitis extra articular features
(SIX)

A

Anterior uveitis
Apical fibrosis
Aortic regurgitation
AV block
Achilles tendonitis
IBD

23
Q

Retinitis pigmentosa features
(FIVE)

A

Progressive reduction in visual acuity
Difficulty seeing at night
Family history of visual loss
Bone spicule retinal pigmentation
Waxy pale optic disc

24
Q

Retinitis pigmentosa inheritance

A

Varied
Autosomal dominant
Autosomal recessive
X-linked

25
Q

Retinitis pigmentosa syndromes

A

Ushers:
- Associated with deafness
Alport syndrome:
- Associated with nephrotic syndrome

26
Q

Clinical features of acromegaly
(FIVE)

A

Large hands
Prominent brow
Headache
Bitemporal hemianopia
Macroglossia

27
Q

Investigations for acromegaly
(THREE)

A

Serum IGF-1
OGTT - no suppression of GH
MRI pituitary

28
Q

Complications of acromegaly
(FIVE)

A

Hypertension
T2DM
IHD
Visual field defect
Obstructive sleep apnoea

29
Q

Treatment of acromegaly
(THREE)

A

Surgery:
- Trans-sphenoidal resection
Medical:
- Octreotide - somatostatin analogue
- Cabergoline - dopamine agonist

30
Q

Cushing’s features
(FIVE)

A

Moon face
Central obesity
Bruising
Thin skin
Proximal muscle wasting

31
Q

Cushing’s causes
(THREE)

A

Cushing’s disease (ACTH producing pituitary tumour)
Exogenous steroids for other condition
Adrenal adenoma

32
Q

Cushing’s complications
(FOUR)

A

Osteoporosis
T2DM
HTN
Proximal myopathy

33
Q

Cushing’s investigations
(FOUR)

A

24 hour urinary cortisol
Low dose dexamethasone suppression test
ACTH level
MRI pituitary

MRCP PACES (5 decks)

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