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Final Year - Rheum > Finals > Flashcards

Finals Flashcards

1
Q

Gout ivx

A

CRP
URate

Mx

NSAIDS
Colchicine

Prevention - avoid purine in alcohol, beer, red meat, shellfish, pulses, spinach, asparagus
Weight loss to reduce

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2
Q

Rheumatoid investigations

A

CRP and ESR
CCP antibody and RF positive

US - synovitis
XR - for erosive damage

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3
Q

Generic ladder of support in rheum

A

analgesics
NSAIDS

Steroids to damp down inflammation

Conventional DMARD - methotrexate

DMARDS - synthetics - Jakinib

Biological DMARDs - TNF

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4
Q

When do you move onto biological DMARDS?

A

If two conventional DMARDS haven’t worked e.g. methotrexate and sulfasalazine

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5
Q
A

Refer to physio, support groups

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6
Q

Symptoms in axial spondyloarthritis

A

Pain worse in the morning

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7
Q

Movement findings in axial spond

A

Occiput to wall disatance
Thoracic expansion an drotation
Lumbar spine forward flexion and lateral flexion

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8
Q

Axial spond investigations

A

CRP, HLA B27

MRI to detect pre-radiographic changes

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9
Q

MRI and X ray findings for ax spond

A

Shiny corners - oedema
Sacroilitiitis

X ray

Widening of joints
Fusion of joints

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10
Q

Mx of ax spond

A

Analgesics
NSAIDS
Steroids
Biologics

DMARDS DO NOT WORK GO STRAIGHT TO BIOLOGICS

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11
Q

Joint distribution of psoriatic arthritis

A

PIP, DIP, dactylitis

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12
Q

Psoriatic nail changes

A

Oncholysis
Pitting
Subungal hyperkeratosis
Discolouration

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13
Q

Psoriatic investigations short and long term

A

Short term - soft tissue changes - US, MRI for synovitis

X ray in longer term

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14
Q

Invs for reactive arthritis

A

CRP, HLA-B27
ASOT for strep
Lyme serology - chronic lyme disease
GUM - Chlamydia

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15
Q

Reaactive

A
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16
Q

Osteopenia vs osteoporosis

A

T score -1 to -2.5 = osteopenia
T score -2.5 or below = osteoporosis

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17
Q

After a fracture how do you manage

A

T score
Input data into FRAX score
NOGG guidelines

18
Q

Low risk osteoporosis mx

A

Oral alendronic acid

19
Q

High risk osteoporosis mx

A

IV zolendronic acid annually
SC denosumab 6 monthly
PTH analogue - SC teriparatide
Anti sclerostin antibody - romosozumab monthly for 1 year then bisphosphonate

20
Q

Connective tissue disease/small vessel vasculitis investigation

A

Urine dip for nephritis
ANA for connective tissue
ANCA for subset of small vessel vasculitis

21
Q

SLE investigations

A

dsDNA = SLE
ENA - Ro, La, Sm, RNP

Full blood tests incl. LFT

22
Q
A
23
Q

Management of SLE

A

Pred
Hydroxychloroquine

Steroid sparing - methotrexate, mycophenolate, tacrolimus

Severe disease - cyclophosphamide

24
Q

Anti centromere abx is for

A

Limited scleorderma

25
Q

anti scl70

A

specific for diffuse cutaneous scleroderma

26
Q

Idiopathic inflammatory myositis

A

Dermatomyositis + polymyositis

27
Q

Invs for Idiopathic inflammatory myositis

A

Creatinine kinase
ANA and myositis antibody panel
MRI scan involving muscles
EMG
Muscle biopsy
PET scan to investigate for underlying malignancy

28
Q

Mx of dermatomyositis/polymyositis

A

Prednisolone
Steroid sparing agents

29
Q

cANCA

A

GPA

30
Q

p-ANCA

A

eGPA

31
Q

Another name for HSP

A

IgA Vasculitis

32
Q

When does IgA vasscsulitis present

A

After an infection, with purpuric rash, glomerulonephritis, abdo pain, joint pain

33
Q

Investigation for IgA vasculitis

A

Urinalysis
IgA
CRP
Renal function
Skin/kidney

34
Q

Mx of IgA vasculitis

A

Conservative in adults
monitor urinalysis, consider nephrology follow up

35
Q

When do you do a PET scan for GCA?

A

if it’s large vessel

36
Q

when do you refer to opthal for GCA

A

SAME DAY opthal review

37
Q

How much prednisolone for GCA

A

40mgs OD or 60mgs if visual symptoms)

38
Q
A

Biopsy

39
Q

pseudogout

A

knees and wrists
Calcium pyrophosphate crystals
positive birefringent
Rhomboid crystals

40
Q

gout

A

first MTP
Negative birefringent

41
Q
A

Final Year - Rheum (7 decks)

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