Station 5

Question 1

Causes of CTS

Answer 1

Occupational trauma
Rheumatoid arthritis
Acromegaly
Hypothyroidism
Pregnancy

Question 2

Causes of Gynaecomastia

Answer 2

Imbalance between testosterone and oestrogen

Systemic
- CLD
- CKD
- Obesity

Endocrine
- hyperprolactinaemia
- hypogonadism (Klinefelter syndrome)
- Acromegaly

Drugs
- spironolactone
- 5 alpha reductase inhibitors
- ACE inhibitors
- anabolic steroids

Question 3

Gluten-containing foods

Answer 3

Wheat
Rye
Barley
Oats

Question 4

Extra-articular manifestations of RA

Answer 4

Eyes: Scleritis & episcleritis
Lungs: pulmonary fibrosis (lower lobes), lung nodules, effusions, BO
Heart: increased CV risk, pericarditis, myocarditis, valvular disease, conduction defects
Renal: amyloidosis
Neurological: compression neuropathies (CTS, ulnar neuropathy, cervical myelopathy), mononeuritis multiplex
Haematological: anaemia, Felty’s syndrome

Question 5

Connective tissue disease antibodies

Answer 5

Limited SS: anti-centromere Ab
CREST syndrome: anti-centromere Ab
Diffuse SS: anti-Scl 70
MCTD: anti-U1-RNP

Question 6

Triggers of DKA

Answer 6

Infection
Insulin non-compliance
Infarction
Injury

Question 7

Risk factors for osteoporosis

Answer 7

Old age
Female gender
Post-menopause
Low BMI
Smoking
Alcohol
Low vitamin D & calcium
Steroids

Question 8

X-ray features: OA vs RA

Answer 8

Both: bone cysts, joint-space narrowing
OA: sclerosis, osteophytes
RA: osteopenia, erosions, deformities

Question 9

Treatment for methotrexate toxicity

Answer 9

Folinic acid

Question 10

Sero-negative spondyloarthopaties (HLA-B27 positive)

Answer 10

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis
IBD-associated arthropathy

Question 11

Secondary causes of hypertension

Answer 11

Intrinsic renal causes: chronic glomeronephritis, ADPKD

Renovacular causes: Renal artery stenosis, renal artery atherosclerosis

Endocrine: Hyperthyroidism, Cushing’s syndrome, acromegaly, hyperparathyroidism, pheochromocytoma, Conn’s syndrome

Question 12

RA vs PsA

Answer 12

PsA more likely if
- asymmetrical
- nail changes
- dactylitis
- negative RF and anti-CCP
- family history

Question 13

SLE
- Questions
- Tests
- Diagnosis
- Treatment

Answer 13

Questions: Joint pain? Photosensitive rash? Hair loss? Mouth ulcers?

Tests: ANA, anti-dsDNA, anti-Smith, C3 & C4

Diagnosis: Positive ANA, then score 10 points

Treatment: hydroxychloroquine, steroids