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
Retinitis pigmentosa syndromes
Ushers: - Associated with deafness Alport syndrome: - Associated with nephrotic syndrome
26
Clinical features of acromegaly (FIVE)
Large hands Prominent brow Headache Bitemporal hemianopia Macroglossia
27
Investigations for acromegaly (THREE)
Serum IGF-1 OGTT - no suppression of GH MRI pituitary
28
Complications of acromegaly (FIVE)
Hypertension T2DM IHD Visual field defect Obstructive sleep apnoea
29
Treatment of acromegaly (THREE)
Surgery: - Trans-sphenoidal resection Medical: - Octreotide - somatostatin analogue - Cabergoline - dopamine agonist
30
Cushing's features (FIVE)
Moon face Central obesity Bruising Thin skin Proximal muscle wasting
31
Cushing's causes (THREE)
Cushing's disease (ACTH producing pituitary tumour) Exogenous steroids for other condition Adrenal adenoma
32
Cushing's complications (FOUR)
Osteoporosis T2DM HTN Proximal myopathy
33
Cushing's investigations (FOUR)
24 hour urinary cortisol Low dose dexamethasone suppression test ACTH level MRI pituitary