MSK COPY Flashcards
State what the mnemonic SHATTERED stands for:
Steroids Hyper parathyroid/ thyroid Alcohol Thin <22 Testosterone deficiency Early menopause Renal or liver failure Erosive inflammatory disease i.e RA Dietary calcium decrease
What will be noticeable in the alkaline phosphate and calcium/phosphate levels of an osteoporotic patient ?
All will be normal
SLE:
What type of cell reaction is it?
What symptoms do they get?
Immune complex cell reaction (lg G)
Symptoms include: arthralgia, fever, fatigue, butterfly rash, discoid rash, arthritis of the small joints, Raynauds, Pleural effusions, episcleritis and mouth ulcers
What two specific blood tests would you do for sle?
Anti- dsDNA
ANA
What is the treatment for SLE?
Severe: Cyclophosphamide and Prednisolone
Symptomatic give ibuprofen and corticosteroids.
Using the mnemonic CLOT what does Anti-Phospholipid syndrome cause?
Coagulation Defect Lived reticularis Obsetric problems Thrombocytopenia (low platelets) ** It will also present with MI, TIA and DVT**
What two blood tests need to be done on a patient with anti-phospholipid syndrome?
Anticardiolipin
Anti-B2 glycoprotein I test
Need a positive test on more than one occasion
How do you treat anti-phospholipid syndrome?
Warfarin
and aspirin and clopidogrel as prophylaxis
How do we diagnose Sjogrens syndrome?
do Schirmers tear test wetting <10mm in 5 minutes means defective tear production
ANA
Anti- Ro antibodies
What is the treatment of Sjogrens?
Hydroxychlorquine
NSAIDs
What does CREST stand for?
Calcinosis Raynauds Eosphageal dysmotility or strictures Sclerodactyly: thickening of the skin Telenagiectasia: spider veins
Polymyositis/dermatomyositis: what is it?
What will people present with?
A condition that is when there is inflammation and necrosis of the skeletal muscle fibers
People will find it hard to squat, raise their arms above their head and rise up from a chair
Dermatomyositis: generally affects the skin more and can lead to muscle and oesphageal pain.
How do you diagnose Polymyositis or dermatomyositis?
What is the treatment?
You need to do a muscle biopsy (shows necrosis)
Muscle enzymes will also be raised
ANA positive
Give patient prednisolone
Give 4 features of RA in the hands
Z thumb Ulnar Deviation Boutinerres Swan neck deformity Rheumatoid nodules Thenar and hypothenar wasting
Give 5 extra articular manifestations of RA:
Carpal Tunnel Episceleritis Uveitis Felty's syndrome Caplan's in the lungs Anaemia of chronic disease
