Yearclub Revision Flashcards
What antibodies are raised in anti-phospholipid syndrome?
ANA (unspecific)
Anti-cardiolipin
Lupus anticoagulant
What antibody is diagnostic in SLE?
Anti-dsDNA
What disease is associated with gritty eyes and dry mouth?
Sjogrens syndrome
What are the symptoms of limited vs diffuse systemic sclerosis?
Both: Raynauds phenomenon,
Limited: tight/thickened skin below elbows and knees + face
Diffuse: tight/thickened skin all over including torso
What antibody is positive in limited and diffuse systemic sclerosis (CREST)?
Limited: anti-centromere
Diffuse: anti scl-70
What effect does anti-phospholipid syndrome have on pregnancy?
Repeat miscarriages
How is anti-phospholipid syndrome treated?
Lifelong LMWH (warfarin teratogenic)
How is polymyalgia rheumatic managed?
Steroids
What is the difference between polymyositis and polymyalgia rheumatic presentation?
Both: Pain and stiffness
Polymyositis = weakness
What is the risk with bilateral leg symptoms and indication of bladder or bowel disturbance?
Cauda Equina syndrome
How is Cauda Equina syndrome investigated?
Urgent MRI + PR
MRI = determine level of disc prolapse
How is cauda equina syndrome managed?
Urgent discectomy (to relieve pressure)
What injury is associated with lifting something heavy and is worse on coughing? How is it managed?
Acute disc prolapse
Conservative management
Who does spinal stenosis present in?
Older people
Long history
How is an osteochondroma treated?
Radio + chemotherapy
What increases the risk of avascular necrosis?
Long term steroids
Excess of alcohol,
Chemotherapy,
Trauma
What is the most common infecting organism in septic arthritis and how does it present compared to osteomyelitis?
Sudden onset pain (much worse than osteomyelitis)
Staph, aureus
How is a subtrochanteric fracture managed?
IM nail
How is a femoral shaft fracture managed initially then definitively?
Initial: Thomas splint
Definitive: Closed reduction with IM nail
What nerve is injured in foot drop?
Common fibular nerve (knee dislocation)
What nerve is injured in wrist drop?
Radial nerve (posterior arm muscles)
What antibodies are indicated in GPA, EGPA and MPA and against what?
GPA: cANCA against PR3
EGPA: pANCA against MPO
MPA: pANCA against MPO
What is Behçets disease and how does it present?
Systemic vasculitis of unknown cause
Presents with oral and genital ulcers, ocular/GI involvement
How is Behçets disease investigated?
Skin pathergy test
On needle prick, papule forms within 48 hours
What is Bergers disease and how does it present?
IgA nephropathy (glomerulonephritis) Presents with haematuria
What is Henoch-Schönlein purpura and how does it present?
Small vessel vasculitis
Presents in children following an URTI with lower limb purpuric rash (+/- arthritis of knees, ankles and elbows)
What is Ehler-Danlos syndrome and what causes it?
Hypermobility syndrome
Due to defect in collagen
What is the difference between epimysium, perimysium and endomysium?
Epimysium: surrounds whole muscle
Perimysium: surrounds single fascicle
Endomysium: surrounds single muscle fibre
What is the progression in units of a muscle?
Sarcomere < myofibril < muscle fibre < fascicles
Sarcomere = smallest functional unit
What lines in a muscle fibre divide individual sarcomeres?
Z lines
What is the difference between isotonic and isometric muscle contractions?
IsoTonic: Tension remains constant (movement)
IsoMetric: length (in Metres) remains constant (postural)
Who does SUFE vs Perthes present in?
SUFE: overweight boys
Perthes: hyperactive young boys
What are Ortolani and Barlow gets used for?
DDH (dislocation/relocation)
What type of arthritis involves the DIP joints?
Osteoarthritis
What is the difference between a Galeazzi and Monteggia injury?
GRUesome MURder
GRU: galeazzi, radial fracture, ulnar dislocation
MUR: monteggia, ulnar fracture, radial dislocation
what antibody is used for diagnosis of RA?
Anti-CCP
What is the first line treatment of RA and what is used if risk of pregnancy?
Methotrexate (teratogenic)
Sulfasalazine (if risk of pregnancy)
