AMK rheum

Question 1

rheumatoid arthtrits more specific antibody

Answer 1

CCP

specific mean not seen in many other condtions

sensitive most likely to be positive as most senstive to be detected

more sensitive is rheumatoi facotr

if rf negative then look for anti-ccp

Question 2

do you take methotraxate and folic acid together

Answer 2

no 24hr apart

Question 3

MX of rheum

Answer 3

1st present
refer to rhuem and NSAID
dont give steriods as can mask sx

confrimed dx
then give steriods for flares and DMARS

DAS28 score

Question 4

chlamydia synovial joint fluid sample would show what - leads to reactive arthritis

Answer 4

sterile fluid with high WCC

cnat see cant pee cant climb tree

Question 5

most common cause of septic arthritis

Answer 5

staph a

Question 6

symmetrical polyarthriits, asymetricla oligoarthritis, dip joitn disease adn nail changes such as pitting adn onycholysis what is seen on xray fro this conditon and what is tx

Answer 6

dmard

Question 7

when do oyu measure urate post gout

Answer 7

2w

Question 8

abx for septic arthritis how long

Answer 8

4-6weeks - local guidlines and theatre for joint washout

Question 9

kochers criteria in children for septic arthrtisi vs transietn synovitis what is the criteria

Answer 9

non-weight bearing
esr over 40
fever over 38.5
wcc over 12000

Question 10

what ix supports ank spondy

Answer 10

pelvic x ray sacroiltiis

Question 11

ank spond

Answer 11

mronig stiff
improve with activity
extraarticular features

Question 12

muscular abck pain presnet slike

Answer 12

pain worse when moving
localised pain

Question 13

neurological pain

Answer 13

radiates along dermatome
parasethesia

Question 14

bony pain

Answer 14

worse with movement
neurolgoical sx

Question 15

most senstiive sle

Answer 15

ANA

Question 16

most specific autoanitbodu for sle

Answer 16

anti-dsDNA
anti-smith

Question 17

tx for SLE

Answer 17

hydroxycholorquine and NSAID

Question 18

derm features of sle

Answer 18

malar rash
discoid rash

Question 19

cardiac features of sle

Answer 19

pericarditis
myocarditis
raynauds

Question 20

polymyalgia rheumatica

Answer 20

pain stiffnes in prox muscles
morning stiffness
no weakness
systemic features - fever, fatigue, weight loss

over 60 females

Question 21

1st line polymyalgia

Answer 21

steriods such as pred

Question 22

fibromyalgia

Answer 22

pain and fatigue
widespread tender spots
30-50yr female

cbt lifestyle

Question 23

poly dermatomysositis sx

Answer 23

bilateral proximal muscle pain
weakness
systemic sx and raynauds

females
BLOOC malig

Question 24

polymyositis autoanitbody

Answer 24

anti-Jo1

gold standard ix is muscl ebiopsy

Question 25

tx for myositis

Answer 25

steriods

Question 26

lambert eaton synrome

Answer 26

autoimune agaisnt ca channels - ascending - improves with use Antibodies to presynaptic voltage gated calcium channels of the P/Q–type

Question 27

guillian barre syndrome

Answer 27

ascending paraetheisa peripherla nerve demyeliantion

Question 28

most appropraite dose for steriods for giant cell arthritis

Answer 28

40-60mg - pred bone protection? ppi? aspirin visual sx and refer to opahtlomology

Question 29

bloods in temproal arthritis show

Answer 29

nromocytic mornochormic anaemai and high esr USS shows hypoechocic halo sign need biopsy gold

Question 30

methotraxate how much do you give dose wise weekly

Answer 30

7.5mg

Question 31

how much folic acid do you co-prescrib ewith methotrexate

Answer 31

5mg avoid preg for 6m as well as men too monitor FBC, UandE and LFT ( risk of liver fibrosis)

Question 32

hydroxychloroquine what major risk

Answer 32

cause bull eys retinopathy - yearly screening

Question 33

sulfasalazinen se

Answer 33

reduced sperm count cautions - aspirin allergy and GPD6 def berfore starting safe in preg and breastfeeeding - one of the onyl

Question 34

only DMARD safe in preg and breastfeeding

Answer 34

sulfasalazine