Exam Flashcards Preview

Rheumatology > Exam > Flashcards

Flashcards in Exam Deck (40)
Loading flashcards...
1
Q

What is the main investigation in an acute attack of gout?

A

Aspiration and microscopy of synovial fluid- negatively birefringent needle-shaped crystals

2
Q

How is gout treated a) acutely and b) prophylactically?

A

a) NSAIDs, colchicine, intra-articular steroids

b) allopurinol (2-4 weeks after acute attack), feubuxostat

3
Q

What causes pseudogout?

A

Deposition of calcium pyrophosphate crystals

4
Q

Symptoms of osteoarthritis (3)

A

Pain on activity relieved by rest
Morning stiffness
Inactivity “gelling”

5
Q

Radiological signs of osteoarthritis (LOSS)

A

Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis

6
Q

Conservative management of osteoarthritis

A

Analgesia, physio, OT, tricyclics

7
Q

Surgical management of osteo

A

Joint replacement, washout, osteophyte removal

8
Q

Symptoms of polymyalgia rheumatica (2)

A

Severe symmetrical pain across the neck and shoulder girdle and pelvis
morning stiffness

9
Q

Investigations in PMR (3)

A

Raised inflammatory markers
CK normal
Skip lesions on temporal artery biopsy

10
Q

Management of PMR (2)

A

Corticosteroids

High dose prednisolone if temporal arteritis

11
Q

Immunopathology of lupus

A

Immune complex deposition in small vessels

12
Q

Most sensitive lupus antibody

A

ANA

13
Q

Most specific lupus antibody

A

Anti-Sm

14
Q

Most clinically useful lupus antibody

A

Anti-dsDNA

15
Q

Monitoring of lupus (3)

A

C3/C4
ESR
dsDNA

16
Q

Management of lupus (3)

A

Steroids
Hydroxychloroquine
Immunosuppressants e.g. MTX, AZT

17
Q

Cause of Sjogren’s syndrome

A

Lymphocytic infiltration of exocrine glands

18
Q

Symptoms of Sjogren’s (6)

A
Dry eyes
Dry mouth
Dry cough
Dry vagina
Dysphagia
Raynaud's
19
Q

Tests for Sjogren’s (3)

A

Schirmer’s test
Gland biopsy
Autoantibodies- rheumatoid factor, ANA, Ro/lA

20
Q

Limited cutaneous scleroderma symptoms (CREST)

A
Calcinosis
Raynauds
Esophageal dysmotility
Sclerodoctyly
Telangiectasia
21
Q

Distinguishing features of diffuse cutaneous scleroderma

A

Rapid onset of skin symptoms following Raynaud’s;

early organ involvement

22
Q

Anti-centromere antibody

A

Limited scleroderma

23
Q

Treatment for Raynauds

A

Nifedipine

24
Q

Treatment of pulmonary hypertension (2)

A

Sildenafil, Bosentan

25
Q

Presentation of rheumatoid arthritis

A

Symmetrical stiff, swollen joints (MCP, PIP, wrist, feet) and non-specific symptoms

26
Q

Best antibodies for rheumatoid arthritis

A

Anti-ccp and rheumatoid factor

27
Q

Radiological signs in RA (5)

A
Osteopenia
Erosions
Loss of joint space
Periarticular swelling
Deformity
28
Q

Management of RA

A

Steroids for lag phase and flare-ups
MTX + other DMARD
Analgesia for symptomatic relief

29
Q

Main feature of polymyositis/dermatomyositis

A

Symmetrical proximal progressive muscle weakness

30
Q

Skin signs in dermatomyositis

A

Gottron’s papules
Shawl sign
Heliotrope rash

31
Q

CK in polymyositis/dermatomyositis

A

Elevated

32
Q

Jo-1

A

Polymyositis

33
Q

Mi-2

A

Dermatomyositis

34
Q

Treatment of poly/dermatomyositis (3)

A

High dose prednisolone
DMARDs
Skin therapeutics

35
Q

Inclusion body myositis

A

More distal, more progressive, more often in men

36
Q

The four main seronegative arthritides

A

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis

37
Q

HLA in the sernonegative arthritides

A

HLA-B27

38
Q

1-4 weeks after dysentery/urethritis

A

Reactive arthritis

39
Q

Reiter’s syndrome

A

Conjunctivitis, urethritis, arthritis

40
Q

Skin lesions in reactive arthritis (3)

A

Keratoderma blenorrhagica
Oral ulcers
Hyperkeratotic nails