Rheum

Question 1

Who does SLE affect most?

Answer 1

Afro Caribbean women 20-40 years old

Question 2

List Sx of SLE

Answer 2

Polyarthritis, malar rash, mouth ulcers, serositis, nephrotic syndrome

Question 3

Pain and weakness in proximal muscles. Raised ESR and CRP. Dx?

Answer 3

Polymyalgia rheumatica

Question 4

What is polymyositis?

Answer 4

Inflammation of striated muscles leading to proximal muscle weakness

Question 5

What condition is temporal arteritis associated with?

Answer 5

Polymyalgia rheumatica

Question 6

What is Tx of temporal arteritis?

Answer 6

60mg prednisolone Temporal artery biopsy after 3 days

Question 7

Eye pain, blurred vision, slight photophobia. Dx?

Answer 7

Anterior uveitis

Question 8

What condition are anterior uveitis and conjunctivitis associated with?

Answer 8

Ankylosing spondylitis

Question 9

Red itchy eye. No blurring/photophobia. PMH: ank spon. Dx?

Answer 9

Conjunctivitis

Question 10

Eye pain, redness, reduced visual acuity. Nausea and vomitting. Dx?

Answer 10

Acute glaucoma

Question 11

Sudden onset back pain. Shooting pain down leg. Urinary retention. Absent ankle jerk reflex. Dx?

Answer 11

Cauda equina

Question 12

Ix of cauda equina?

Answer 12

URGENT MRI spine

Question 13

Young man w hip and back pain everyday. Worse in mornings. Has some tendititis. Dx?

Answer 13

Ank Spon

Question 14

Are ESR and CRP raised, normal or low in ank spon?

Answer 14

Raised

Question 15

What does XR spine show in ank spon?

Answer 15

Bamboo spine

Question 16

What is Tx for ank spon/

Answer 16

NSAIDs and exercises

Question 17

What do crystals look like in gout?

Answer 17

Negatively birefringant needles

Question 18

What do crystals look like in pseudogout?

Answer 18

Positively birefringant rhomboids

Question 19

Atypical mononuclear cells on aspiration. Dx?

Answer 19

EBV

Question 20

Reed Steenberg cells on aspiration. Dx?

Answer 20

Hodgkins lymphoma

Question 21

Tx for pseudogout?

Answer 21

NSAIDs and aspiration

Question 22

`List causes of pseudogout

Answer 22

Hypothyroidism, acormegaly, hyperPTH, Wilsons, haemochromatosis

Question 23

What is the most specific AB for SLE?

Answer 23

Anti double stranded DNA

Question 24

What AB is raised in limited systemic sclerosis?

Question 25

What condition has raised anti-mitochondrial ABs?

Answer 25

PBC

Question 26

SoB, dry cough, crackles on inspiration. Dx?

Answer 26

Pulmonary fibrosis

Question 27

List 2 causes of pulmonary fibrosis

Question 28

Sudden onset SoB, pleuritic chest pain, tachycardia, tachypnoea. Dx?

Question 29

What is the diagnostic Ix of PE?

Question 30

Multiple prev DVT and miscarriages. Dx?

Answer 30

Anti phospholipid

Question 31

What rheumatalogical condition is anti phosphilipid syndrome associated with?

Question 32

Which auto AB is raised in anti phospholipid syndrome?

Answer 32

Anti cardiolipin

Question 33

Decreased tear and saliva production. Parotid gland swelling. Dx?

Question 34

What is the pathophysiology of primary Sjorgens?

Question 35

What is the test for Primary Sjogren's?

Question 36

What is the difference between primary and secondary Sjorgens?

Answer 36

Secondary = primary on a background of other tissue disorders eg SLE

Question 37

Cold hands and feet for past 3 months. Worse in mornings and outside. Dx?

Answer 37

Raynaud's

Question 38

What is Tx of Raynaud's?

Question 39

What is microstomia?

Answer 39

Beak like nose and small mouth

Question 40

In what condition is microstomia seen?

Question 41

What areas of skin are affected in limited systemic sclerosis?

Question 42

Splenomegaly and neutropenia. PMH = RA. Dx?

Question 43

WHat is Mx of acute gout?

Answer 43

NSAIDs eg indomethacin

Question 44

What is discharge medication of gout?

Answer 44

Allopurinol and conservative Mx

Question 45

WHat is Behcet's?

Answer 45

Systemic vasculitis of unknown cause

Question 46

Oral ulcers, genital ulcers, occular problems, erythema nodosum. Dx?

Answer 46

Behcets

Question 47

What test is specific to Behcets?

Answer 47

Skin pathergy test - needle prick lead sto papule formation \<48hrs

Question 48

Head getting bigger with bowing of tibia. Sensorineural hearing loss. Dx?

Answer 48

Paget's disease

Question 49

What is Paget's disease of the bone?

Answer 49

Disorder of bone remodelling - constant resorption and formation of bone leading to deformity

Question 50

Serum Ca, serum PO43 and ALP of Pagets?

Answer 50

Normal Ca and PO43 Raised ALP