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Rheum Flashcards

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1
Q

what is HLA 27 associated with

A

ank spond
reactive arthritis
JIA
anterior uveitis
psoriatic arthritis

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2
Q

C-ANCA is associated with

A

Wegners granulomatosis

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3
Q

In a positive C-ANCA test you then need to test

A

PR3 (if negative then all insignificant)

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4
Q

In a positive P-ANCA test you also need to check

A

MPO (if negative then all insignificant)

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5
Q

What category of illness is ANCA associated with

A

vasculitis

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6
Q

What category of illness is ANA associated with

A

connective tissue disease such as SLE or sjogrens

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7
Q

Positive RF or anti CCP in RA suggests what

A

more severe disease/systemic complications more likely

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8
Q

Which arthritis has Hebden’s/Bouchards nodes

A

osteo

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9
Q

T score of -1.5-2.5 suggests

A

osteopenia

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10
Q

T score of -2.5 suggests

A

osteoporosis

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11
Q

Dactylitis is linked to what 3 conditions

A

spondyloarthritises
sarcoid
sickle cell

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12
Q

cardiac complications of ank spond

A

heart block
Aortic regurgitation

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13
Q

resp complication of ank spond

A

pulm fibrosis (apical)

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14
Q

what is the examination test for ank spond

A

schobers

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15
Q

What does MRI spine show in ank spond

A

BM oedema

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16
Q

XR findings of ank spond

A

bamboo spine
squaring of vertebral bodies
subchondral sclerosis and erosions
Syndesmphytes
ossification
joint fusion

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17
Q

what antibiotic must be avoided with MTX

A

trimethoprim (they will become pancytopenic)``

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18
Q

which medication require careful timing with the flu jab

A

rituximab

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19
Q

what other skin manifestation of lupus apart from malar rash

A

discoid rash in sun exposed areas

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20
Q

What are two quite specific lupus antibodies

A

anti smith
anti dsDNA

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21
Q

what other syndrome can SLE deveop

A

APL

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22
Q

diagnostic test for SLE other than bloods

A

skin biopsy

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23
Q

what medication should SLE avoid

A

oestrogen contraceptives

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24
Q

what is a potentially curative option in severe refractory SLE

A

stem cell transplant

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25
Does PMR get true muscular weakness?
No it is due to pain
26
How should PMR respond to steroid
dramatically and quickly
27
first line rx in ank spond
NSAIDs
28
when to use mtx in ank spond
peripheral disease
29
other treatments in ank spond
joint steroids biologics surgery
30
joints mostly affected in psoriatic arthritis
DIPs
31
Sjogren's antibodies
Ro La
32
Dermatomyositis ab
JO1
33
Diffuse sclerosis ab
Scl70
34
rash associated with APL syndrome
livedo reticularis
35
FBC result in APL
low plt
36
Abs in APL synd
lupus anticoag anticardiolipin anti-B2 glycoprotein
37
Sjogrens has a 5-9x risk of what cancer
lymphoma
38
Test for sjogrens with paper
Schirmers
39
Antibody in limited systemic sclerosis (CREST)
anti-centromere
40
what type of sclerosis has a better prognosis
limited
41
Limited sclerosis associated with what heart issue
pulm htn
42
Medication options for Reynauds
Nifedipine Iloprost for digital ulcers Sildenafil Fluoxetine
43
'punched out' erosions, tophi and joint effusions on XR
gout
44
Periarticular osteopenia on XR
RA
45
Acute gout mx
colchicine (continue allopurinol if taking)
46
When to offer allopurinol in gout
after first attack as urate lowering therapy
47
How do you decide allopurinol dose
Titrate until serum uric acid <300umol/L
48
weakly positive birefringemet rhombiod-shaped crystals on joint aspiration suggests what
pseudogout (calcium crystals)
49
Pseudogout rx
NSAIDs steroids
50
When do you start bisphosphonates following fracture
>75 with fragility frature- no need for DEXA first <75 --> DEXA --> FRAX --> maybe start
51
How can you manage a severe RA flare
PO/IM steroids
52
Starting biologics (-mab) can have what adverse affect that requires CXR beforehand
reactivation of TB
53
How long should sx be present for chronic fatigue dx
3 months
54
Bad GI side effects on aledronate for osteoporosis - alternative?
risedronate or etidronate
55
Linear calcification of the articular cartilage on XR
Pseudogout- Chondrocalcinosis
56
Pagets rx
bisphosphonate
57
hydroxychloroquine side effect
retinopathy
58
Rx for OA if paracetamol not working
Topical NSAIDs if knee/hand Oral if other
59
How to manage bone protection if a patient is taking the equivalent of prednisolone 7.5mg a day for 3 or more months
>65 OR previous fragility fracture- aledronate <65 --> DEXA --> Between 0 and -1.5- Repeat bone density scan in 1-3 years/Less than -1.5- offer bone protection. Ensure vit D and Ca replete
60
methotrexate SE
myelosuppression
61
sulfasalazine SE
sperm low
62
Leflunomide SE
liver, lung disease
63
What rheum drug causes proteinuria
Penicillamine and Gold
64
can you use azathioprine in pregnancy
yes
65
Rash on soles of feet is associated with what (keratoderma blenorrhagica)
Reactive arthritis
66
Osteoarthritis XR changes
LOSS (lossteoarthritis) Loss of joint space Osteophytes forming at joint margins Subchondral sclerosis Subchondral cysts
67
which rheum drug can exacerbate myaesthenia gravis
penicillamine
68
colchicine side effect
diarrhoea
69
Etanercept side effect
demyelination ('intercepts the nerves')
70
RA XR findings
LESS Loss of joint space Erosions Soft tissue swelling Soft bones (osteoporosis/ osteopenia)
71
oral ulcers, genital ulcers and anterior uveitis
behcets

MSRA (21 decks)

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