Rheumatology

Question 1

Methotrexate s/e

Answer 1

Hepatotoxicity

Question 2

What is systemic sclerosis ?

Answer 2

Autoimmune connective tissue disorder

Question 3

Treatment for systemic sclerosis

Answer 3

CCBs, avoid changes in temperature

Question 4

Sx systemic sclerosis

Answer 4

C = calcinosis 
R = Raynaud's
E = oesophageal dysmotility 
S = sclerodactyly 
T = telangieostasia

Question 5

What is Marfan’s syndrome ?

Answer 5

Mutation in fibrillin-1 gene

Question 6

Dx Marfan’s

Answer 6

Ct

Question 7

treatment for Marfan’s

Answer 7

B blockers

ECG

Question 8

Sx Marfan’s

Answer 8

Long thumbs and arm
Aortic dissections
Hypermobility

Question 9

Sx gout

Answer 9

Swelling and flare ups
Erythema
1st MTP affected first

Question 10

Treatment for gout

Answer 10

Allupurinol and colchicine

Question 11

Ix gout

Answer 11

-vely birefringent needle shaped urate crystals

Question 12

Sx pseudo gout

Answer 12

Knee, wrist and shoulders mainly affected

Chondrocalcinosis

Question 13

Ix pseudo gout

Answer 13

+ve birefringent rhomboid shaped crystals

Question 14

Management of pseudo gout

Answer 14

Aspirate join fluid and steroids

Question 15

What are the crystals made of in pseudo gout

Answer 15

Calcium phosphate

Question 16

Reactive arthritis sx

Answer 16

Can’t see = conjunctivitis
Can’t pee = urethritis
Can’t climv a tree = arthritis

Question 17

Which HLA is associated with reactive arthritis

Answer 17

HLA-B27

Question 18

Treatment for reactive arthritis

Answer 18

Rest
NSAIDS
DMARDs

Question 19

HLA for ankylosing spondylitis

Answer 19

HLA B27

Question 20

Sx ankylosing spondylitis

Answer 20

Pain in bum/lower back
Pain decreases with exercise
Spinal stiffness
IBD

Question 21

Dx ankylosing spondylitis

Answer 21

Pain with pressure on sacrum

<30 with morning stiffness >30 mins

Question 22

Investigations ankylosing spondylitis

Answer 22

Sacroilitis in early stages

Bamboo spine in late stages

Question 23

Treatment ankylosing spondylitis

Answer 23

Exercise and NSAIDs

Question 24

What is poly myalgia rheumatica

Answer 24

Inflammation of shoulders, neck and pelvis

Question 25

Sx polymyalgia rheumtica

Answer 25

Morning stiffness, distal joints initially spared, bilateral pain

Question 26

Treatment for polymyalgia rheumatica

Answer 26

Steroids

Question 27

What is giant cell arteritis

Answer 27

Inflammation of medium-large arteries

Question 28

Sx giant cell arteritis

Answer 28

Headaches, vision loss, scalp and jaw pain

Question 29

Treatment for giant cell arteritis

Answer 29

Prednisolone

Question 30

What is fibromyalgia?

Answer 30

Pain all over body

Question 31

Sx fibromyalgia

Answer 31

Morning stiffness Analgesia ineffective Pain worse with stress/cold etc

Question 32

Dx fibromyalgia

Answer 32

Pain in 11/18 specified places

Question 33

Management fibromyalgia

Answer 33

Pregabalin, duloxetine and amitriptyline

Question 34

What is Ehler's dances syndrome

Answer 34

Connective tissue disorder due to defective collagen synthesis

Question 35

Sx Ehler-danlos

Answer 35

Flat feet Poor healing Aneurysms

Question 36

Most common subtype of Ehlers danlos

Answer 36

``` Vascular subtype (collagen 3) Easy bruising and aneurysms ```

Question 37

What is the classical subtype of ehler's danlos

Answer 37

Hyperelastic skin = collagen 3

Question 38

Treatment ehler's danlos

Answer 38

No treatment

Question 39

What is Behcet's syndrome?

Answer 39

Autoimmune inflammation of arteries and veins

Question 40

HLA associated with Behcet syndrome

Answer 40

B51

Question 41

Sx Behcet syndrome

Answer 41

Oral ulcers, painful genital ulcers and anterior uveitis

Question 42

Treatment for Behcet's syndrome

Answer 42

Steroids and colchicine

Question 43

What is SLE ?

Answer 43

Autoimmune connective tissue disease

Question 44

Sx SLE

Answer 44

``` Photosensitive rash on face Malaise Fever Arthritis Nephrosis ```

Question 45

Mx SLE

Answer 45

NSAIDs or DMARDS