MSK and Gout

Question 1

What tissue type is associated with spondyloarthropathy?

Answer 1

HLA-B27

Question 2

What are the clinical features of spondyloarthopathy?

Answer 2

Sausage digits, psoriasis, inflammatory back pain, NSAID (good), Enthesitis, Arthritis, Chrons, HLA-B27 and Eye (uvitis)

Question 3

What is the clinical presentation of ankylosing spondylitis?

Answer 3

Gradual onset of lower back pain, worse at night, relieved by exercise, radiates to buttock, decreased spinal movement

Question 4

Give 2 causes of Reactive Arthritis?

Answer 4

GI Infection: Salmonella

STI: Chlamydia

Question 5

SOCRATES for RA?

Answer 5

Site: Hands and Feet (DIPJ Spared)
Onset: Gradual
Character: Aching, Stiff joint
Associated symptoms: See extra-articular features
Timing: Worse in morning
Exacerbating: rest, alleviating: movement

Question 6

Give 5 extra-articular features of RA?

Answer 6

Heart: Pericarditis 
Eyes: Scleritis 
Neuro: Peripheral neuropathy 
Kidney: Amyloidosis 
Haem: anaemia

Question 7

What antibodies/proteins would you find in the blood of a patient with RA?

Answer 7

Anti-CCp (cyclic citruilinated peptide), ANA and Rheumatoid Factor

Question 8

Give 3 X-ray findings of a patient with RA?

Answer 8

Peri-articular erosion, soft tissue swelling and joint space narrowing

Question 9

Name 4 symptoms of SLE?

Answer 9

Fatigue, arthralgia, rashes, photosensitive rash

Question 10

What are the SLE auto-antibodies?

Answer 10

Ds-DNA (double stranded DNA) and ANA

Question 11

Give 3 extra-articular features of SLE?

Answer 11

Glomerulonephritis, seizures and psychosis, mouth ulcers, venous and arterial thrombosis

Question 12

What inflammatory marker is raised in SLE?

Answer 12

Think SLE is ESR raised but CRP normal

Question 13

What two antibodies are found in systemic sclerosis?

Answer 13

Anti-centromere antibody and anti-RNA polymerase

Question 14

What two findings are common in sjogrens syndrome?

Answer 14

Dry eyes and dry mouth

Question 15

Name 3 predisposing factors for osteoarthritis?

Answer 15

Age, deformities, occupation, obesity, bone density

Question 16

SOCRATES for OA?

Answer 16

Site: DIPJ, CMPJ and weight bearing joints
Onset: Gradual
Character: Aching
Associated symptoms: Decrease ROM, crepitus, swelling
Timing: pain aggravated by activity and relieved by rest

Question 17

What would an X-Ray of OA show?

Answer 17

Loss of joint space, osteophytes, subarticular sclerosis, subchondral cysts

Question 18

What is the presentation for Septic arthritis?

Answer 18

Painful red, hot, swollen joint, fever

Question 19

Give 4 risk factors for osteoporosis?

Answer 19

Steroid use, alcohol and smoking , early menopause, RA or OA, low dietary calcium, hypothyroid, renal failure

Question 20

Give 3 red flag symptoms for MSK malignancy?

Answer 20

Weight loss, pathological fracture, pain at rest, loss of function