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Rheumatology SB > Others > Flashcards

Others Flashcards

1
Q

what is gout

A

inflammation of the joint trigger by uric acid crystals

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2
Q

what results in crystalisation

A

hyperuricemia

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3
Q

what are causes of hyperuricaemia

A

Increased urate production

Reduced urate excertion

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4
Q

what can cause increased urate production

A

psoriasis
haemolytic disorders
alcohol
high dietary purine intake (red meat/sea food)

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5
Q

what can cause reduced urate excretion

A

chronic renal impairment
heart failure
hypothyroidism
diuretics

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6
Q

presentation of acute gout

A 
usually affects 1 joint (1st MTP, ankle, knee)
abrupt onset, often over night
severe pain
joint stiffness 
joint swelling/effusion
tophi
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7
Q

treatment of acute gout

A

NSAIDS
Colchicine
Corticosteroids

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8
Q

what is a tophi

A

deposit of crystalline uric acid and other substances at the surface of joints or in skin or cartilage

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9
Q

what is treatment for recurrent gout i.e. prophylaxis

A

Allopurinol
Febuxostat
Start 2-4 weeks after acute attack

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10
Q

investigations of gout

A 
serum uric acid levels - will be raised
inflammatory markers - will be raised 
Polarising microscopy of synovial fluid
x-ray of affected joint
US - to look for tophi or erosions
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11
Q

what is Calcium pyrophosphate deposition disease

A

deposition of calcium pyrophosphate (CPP) crystal in the joints

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12
Q

What is CPDD also known as

A

pseudogout

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13
Q

what is CPDD associated with

A 
Hyperparathyroidism
Hypercalcemia
Hypothyroidism
Gout
Aging
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14
Q

treatment of CPPD

A

Intra-articular Corticosteroids (if possible)

1st line NSAIDs
2nd line Colchicine

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15
Q

what is the cause of a “Milwaukee shoulder” on an x-ray

A

Hydroxyapatite crystal deposition in or around the joint.

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16
Q

what happens in ‘Milwaukee shoulder’ and who gets it

A

Release of collagenases, serine proteinases and IL-1
Acute and rapid deterioration.
Females, 50-60 years

17
Q

Tx for Milwaukee shoulder

A

NSAIDs
Intra-articular steroid injection
Physiotherapy
Partial or total arthroplasty

18
Q

what is soft tissue rheumatism

A

General term to describe pain that is caused by inflammation/damage to ligaments, tendons, muscles or nerve near a joint rather than either the bone or cartilage

19
Q

what are features of soft tissue rheumatism

A

pain should be confided to a specific site e.g. shoulder, wrist

20
Q

who gets joint hyper mobility syndrome

A

females > males

genetic conditions - Marfan’s

21
Q

what is used to assess hyper mobility and how is it treated

A

Modified Beighton Score

Physiotherapy

22
Q

what does hyper mobility typically present with

A

arthralgia; joint pain

premature OA

23
Q

what is a score of hyper mobility in the Modified Beighton Score

A

more than 6 out of 9

Rheumatology SB (7 decks)

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