Rheumatology 1

Question 1

Main cytokine driver in RA?

Answer 1

TNF-a

Question 2

Best treatment for RA?

Best treatment for seropositive RA?

Answer 2

Methotrexate

Rituximab

Question 3

NSAIDS cause what in fetus?

Answer 3

Premature PDA closure

Question 4

Ankylosing spondylitis has what clinical feautres?

Answer 4

Anterior Uveitis
Aortitis/Aortic dilatation
Aortic regurgitation
Achilles Enthesitis
IBD

Question 5

Criteria to use TNF-a inhibitors in ankylosing spondylitis?

Answer 5

Uveitis
Enthesitis
Axial involvement - early phase

Question 6

Clinical features specific for Psoriatic arthritis?

Answer 6

Nail oncholysis

Question 7

Best treatment for psoriatic arthritis?

Best treatment for extra-articular Psoriatic arthritis?

Answer 7

Methotrexate
-UV light if has skin lesions

Ustekinumab/Secukinumab

Question 8

Pathognomic for Reactive arthritis?

Answer 8

Keratoderma blenorrhagicum

Question 9

How does sweet soft drinks increases gout?

Answer 9

Increases purine - and then purine to uric acid

Question 10

When gout manifest?

Answer 10

Urate > 0.40

Question 11

Xray of gout shows?

Answer 11

Tophi

Punched out lesions/sclerotic

Question 12

Colchicine mechanism in gout?

Answer 12

Inhibit neutrophil chemotaxis towards uric crystals

Question 13

Colchicine and clarithromycin?

Answer 13

NO - FATAL

Question 14

pseudogout - which joint?

Answer 14

Knee (medial calcinosis > lateral) - chondrocalcinosis ( Calcium pyrophosphate deposition)

Question 15

Contraindication for using pegloticase/rasburicase?

Answer 15

G6PD

Question 16

how alcohol causes gout?

Answer 16

Increase lactic acid therefore increase uric acid

weak Xanthine dehydrogenase inhibitor - so more uric acid produced

Question 17

Fibromyalgia specific clinical signs?

Answer 17

Tenderness at B/L trapezius and gluteal upper quadrant

Question 18

Specific sign for GCA?

Specific sign in imaging for GCA?

Answer 18

Jaw claudication
(diplopia- most common)

‘Halo sign’ in ultrasound

Question 19

Takayasu a/w what HLA?

What bloods specific for takayasu?

Answer 19

HLA B52

Pentraxin-3 plasma - more accurate than CRP/ESR

Question 20

PAN histology?

Answer 20

Internal elastic lamina disruption - intimal fibroplasia and necrosis

Question 21

pANCA a/w what GN?

Answer 21

Rapidly progressive GN

Question 22

MTX in SLE when?

MMF in SLE when?

Answer 22

SLE + inflammatory arthritis

SLE + Lupus nephritis

Question 23

Scleroderma causes increase in what?

Answer 23

TGFB - more collagen

Endothelin - pHTN

Question 24

GI disease in Diffuse scleroderma?

Answer 24

GAVE - Gastric antral vascular Ectasia - Watermelon stomach

high risk of bleeding

Question 25

Most specific site for OA? Most common site for OA?

Answer 25

1st- Carpo-metacarpal joint Knee joint

Question 26

OA early stage pathophysiology?

Answer 26

Proteoglycans + collagen loss

Question 27

OA later stage pathophysiology?

Answer 27

Bony spurs/osteophytes subchondral bone demineralization [compensatory mechanism]

Question 28

Cheiroatropathy common in what disorder?

Answer 28

Type 1/2 DM - deposition of collagen

Question 29

After steroids in GCA - on histology what hallmark feature will remain?

Answer 29

Disruption of elastic lamina

Question 30

TNFa inhibitors a/w what?

Answer 30

Demyelination, MS