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Phase 2A :!: > Rheumatology > Flashcards

Rheumatology Flashcards

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1
Q

What is ankylosing spondylitis?

A

a chronic progressive inflammatory arthropathy associated with HLA-B27 gene which ultimately may lead to radiographical changes in the spine and sacroiliac joints.

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2
Q

what percentage of patents with AS have HLA-B27 gene? what chromosome is it found on?

A

90%

autosomal dominant on chromosome 6

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3
Q

what are 3 risk factors for AS?

A

HLA-B27
FHx
male

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4
Q

what are 5 presentations of AS?

A 
severe inflammatory (improved by NSAIDs) back/ butt pain and stiffness
worse in morning (>30 mins)
bamboo spine on X-ray
uvitis and systemic symptoms
enthesitis
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5
Q

what age group most commonly presents with AS?

A

late teens to 20s

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6
Q

what are 4 investigations for AS?

A

spine and sacral Xray
FBC - normocytic anaemia
CRP and ESR - elevated
HLA-B27 gene testing

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7
Q

what are 7 radiological signs of AS?

A 
bamboo spine 
squaring of vertebral bodies 
subchondral sclerosis 
subchondral erosions
syndesmophtes
ossifications 
fusions
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8
Q

what are 3 differentials for AS?

A

osteoarthritis
psoriatic arthritis
reactive arthritis

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9
Q

what is the treatment for AS? (in order)

A

NSAIDs
steroids - flare ups
anti-TNF - infliximab or etancercept
IL-7 MAB - secukinumab

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10
Q

what are 3 complications of AS?

A

osteoporosis
vertebral fractures
anaemia

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11
Q

what are the 5 seronegative spodyloarthropathies?

A 
psoriatic 
ankylosing spondylitis
reactive arthitis
IBD associated arthritis
juvenile idiopathic arthritis
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12
Q

what are the 8 common symptoms of the seronegative spodyloarthropathies?

A 
SPINE ACHE
sausage digits - dactylitis
psoriasis
inflammatory back pain 
NSAID responsive
enthesitis - inflammation at point tendon attaches to bone 
Arthritis
Crohn's/Colitis/CRP elevated
HLA-B27
eyes - uveitis
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13
Q

what is fibromyalgia?

A

a chronic pain syndrome diagnosed by the presence of widespread body pain

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14
Q

does fibromyalgia affect more men or women?

A

women

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15
Q

what are the overlapping pain conditions with fibromyalgia?

A 
IBS
TMJD
interstitial cystitis
vulvodynia
tension headaches
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16
Q

what are 3 risk factors for fibromyalgia?

A

FHx
rheumatic conditions
age 30-60

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17
Q

what are 5 clinical manifestations of fibromyalgia?

A 
chronic pain
diffuse tenderness of examination
fatigue unrelieved by rest/sleep disturbance
morning stiffness
headaches
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18
Q

what are 3 differentials for fibromyalgia?

A

rheumatoid arthritis
vitamin D deficiency
chronic fatigue syndrome

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19
Q

what is the treatment for fibromyalgia?

A 
education
exercise
CBT
antidepressants - amitriptyline, SNRIs 
analgesia - naproxen/tramadol
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20
Q

what is the criteria for a fibromyalgia diagnosis?

A

widespread pain (front back left right both sides of diaphragm), 3+ months, tenderness of at least 11/18 designated tender point sites

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21
Q

What is giant cell arteritis?

A

a granulomatous vasculitis of large and medium-sized arteries. It primarily affects branches of the external carotid artery, and it is the most common form of systemic vasculitis in adults

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22
Q

Who does giant cell arteritis usually affect?

A

females 50+

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23
Q

what are 3 risk factors for giant cell arteritis?

A

genetics
smoking
atherosclerosis

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24
Q

what are 5 presentations of giant cell arteritis?

A 
severe headache - temporal pounding 
scalp pain/tenderness
aching and stiffness - neck, shoulders, hips
extreme limb, tongue or JAW claudication
loss of vision
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25
what are 3 investigations of giant cell arteritis?
CRP/ESR - raised FBC - may have normochromic, normocytic anaemia, normal WBCs and elevated platelets temporal artery biopsy - gold
26
what are 3 differentials for giant cell arteritis?
polymyalgia rheumatica solid organ cancers and haematological malignancies SLE
27
what is the management of giant cell arteritis?
high dose corticosteroids - prednisolone tocilzumab - biological and Glucocorticoid aspirin
28
what are 3 complications of giant cell arteritis?
blindness aortic aneurysm large vessel stenosis
29
what are the histological features of giant cell arteritis?
cellular infiltrate - CD4+ T lymphocytes, macrophages and giant cells in vessel wall granulomatous inflammation of intimacy and media
30
What is gout?
an inflammatory arthritis caused by deposition of monosodium urate crystals within joints
31
what are grout crystals like?
monosodium urate - negatively bifringent | needle shaped
32
what are 4 triggers of gout?
CKD diuretics - thiazide and loop purine rich diet obesity
33
what joints does gout usually affect?
``` big toe - MTP (metatarsophalangeal) foot ankle fingers knee wrist elbow ```
34
what is gout most commonly caused by?
renal under excretion of urate - 90%
35
what are 3 risk factors for gout?
older age consumption of meat, seafood and alcohol use of diuretics
36
what is the pathophysiology of gout?
High urate levels result in super saturation and crystal formation leading to gout => uric acid crystals in joint interact with undifferentiated phagocytes and trigger acute inflammation by inducing TNF-alpha and activating signalling pathways
37
what are 4 clinical manifestations of gout?
rapid onset of severe joint pain in few joints joint stiff, red, hot tophi
38
what are 3 investigations for gout?
joint aspiration - gold serum uric acid levels joint X-ray
39
what are 3 differentials for gout?
reactive arthritis septic arthritis rheumatoid arthritis
40
what is the management of an acute gout attack?
NSAID - not in renal problems colchicine corticosteroids - 2 IL-1 inhibitors
41
what is an adverse effect of colchicine?
causes diarrhoea
42
what is the mangement of chronic gout?
lifestyle advise uric acid lowering drugs - allopurinol or febuxostat uricosuric agent - sulfinpyrazone
43
what are 3 complications of gout?
joint destruction kidney disease - acute uric acid nephropathy urate nephrolithiasis
44
what is osteoarthritis?
a non-inflammatory degenerative arthritis characterised by progressive synovial joint damage
45
what are 3 risk factors for osteoarthritis?
older age - 50+ obesity physically demanding job/sport
46
what are the 5 X-ray manifestations of osteoarthritis?
``` JOSSA joint space narrowing osteophyte formation subchondral sclerosis subchondral cysts abnormalities of bone contour ```
47
what is the pathophysiology of osteoarthritis?
there is a failure in maintaining the homeostatic balance of the cartilage matrix synthesis and degradation, resulting from reduced formation or increased catabolism
48
what are 5 presentations of osteoarthritis?
``` pain functional difficulty crepitus bony deformaties effusions ```
49
what joints does osteoarthritis usually affect?
weight bearing joints asymmetrically
50
what are 3 investigations for osteoarthritis?
X-ray RF and anti-CCP antibody - negative serum CRP/ESR - may be slightly elevated
51
what are 3 differentials for osteoarthritis?
bursitis Gout/pseudogout rheumatoid arthritis
52
what is the management for osteoarthritis?
1 - oral paracetamol + topical NSAID + topical capsaicin + PPI (stomach protection) + opiates
53
what are 3 complications of osteoarthritis?
functional decline spinal stenosis NSAID related GI bleeding
54
what are heberden's node?
osteoarthritic nodes of the DIP joints
55
what are Bouchard's nodes?
osteoarthritic nodes of the PIP joints
56
what kind of appearance does erosive OA have on Xray?
gulls wing
57
What is osteomyelitis?
an inflammatory condition of bone caused by an infecting organism
58
what is the most common cause of osteomyelitis?
S. Aureus
59
what are the 3 paths of infection in osteomyelitis?
direct innoculation contiguous spread from adjacent tissues haematogenous spread
60
who is mainly affected by osteomyelitis?
extremes of age
61
what organisms mainly cause osteomyelitis in infants?
S. Aureus group B strep aerobic gram -ve bacili candida albicans
62
what organisms mainly causes osteomyelitis in children?
S. Aureus | group B strep
63
what organisms mainly cause osteomyelitis in adults?
S. Aureus coagulase negative staph aerobic gram negatives anaerobic gram +ve peptostreptococci
64
what organisms mainly cause osteomyelitis in the elderly?
gram negative bacili
65
what organisms usually cause osteomyelitis in IVDU?
S. Aureus | Pseudomonas aeruginosa - most likely in clavicle and pelvis
66
what are 3 risk factors for osteomyelitis?
pHx of osteomyelitis penetrating injury IVDU
67
what re 5 manifestations of osteomyelitis?
``` limp/reluctance to weight bear systemic symtoms local inflammation limb deformity spinal cord/nerve root compression ```
68
what are 3 investigations for osteomyelitis?
blood cultures ESR/CRP plain film X-ray
69
what is the gold standard for osteomyelitis?
bone biopsy, cultures and histopathology
70
what are 3 differentials for osteomyelitis?
septic arthritis juvenile idiopathic arthritis reactive arthritis
71
what is the treatment of osteomyelitis?
debridement - surgery to remove necrotic bone | antibiotics - IV for up to 6 weeks
72
what re 3 complications of osteomyelitis?
drug reactions amputation recurrence
73
what is osteoporosis?
Systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue with consequent increase in bone fracture and fragility
74
what is the numerical categorisation of osteoporosis?
bone mineral density (BMD) MORE than 2.5 standard deviations BELOW the gender matched young adult mean value (T score < -2.5)
75
who is osteoporosis most common is?
post menopausal women especially caucasian and Asian
76
what is the cause of osteoporosis?
Low bone mass and abnormal bone architecture => size and shape of bone, bone turn over, micro-architecture, bone mineralisation => can be due to low peak bone mass, loss of bone mass with age, poor bone architecture mismatch between bone resorption and formation
77
what are 5 risk factors for osteoporosis?
``` FHx low BMI/weight androgen deprivation (men) and aromatase inhibitors (women) corticosteroid use smoking ```
78
what are 5 presentations of osteoporosis?
``` kyphosis impaired vision impaired gait back pain imbalance and lower extremity weakness ```
79
what is the gold standard investigation for osteoporosis?
dual energy X-ray absorpitometry - DXA scan
80
what are 3 differentials for osteoporosis?
multiple myeloma osteomalacia CKD-bone mineral disorder
81
what is the treatment for osteoporosis?
bisphosphonates - alendronic acid HRT denosumab teriparatide calcium + vitamin D
82
how do bisphosphonates work?
slow down osteoclast activity => reduce bone breakdown
83
how does Denosumab work?
anti-resorbative - inhibits osteoclast activity
84
how does teriparatide work?
anabolic - synthetic parathyroid hormone, increases osteoblastic activity
85
what are 3 complications of osteoporosis?
fracture chronic pain syndrome jaw necrosis associated with bisphosphonates
86
what is a T-score?
standard deviation score using DXA scan
87
what are the T score ranges?
>-1 = normal -1 - -2.5 = osteopenia < -2.5 = osteoporosis < -2.5 + a fracture = severe osteoporosis
88
What is pseudo gout?
an acute inflammatory arthritis of one or more joints due to calcium pyrophosphate deposition on joint surfaces
89
what are 3 risk factors for pseudo gout?
advanced age >65 injury/trauma hyperparathyroidism
90
what kind of crystals are deposited in psudogout?
calcium pyrophosphate crystals | positively bifringent rhomboid shaped crystals
91
what are 5 manifestations of pseudogout?
``` red painful and tender joints sudden worsening of osteoarthritis joint effusion fever malaise ```
92
what are 3 investigations for pseudogout?
synovial fluid aspirate analysis - gold joint X ray - chondrocalcinosis serum calcium + PTH
93
what are 3 differentials for pseudogout?
gout septic arthritis osteoarthritis
94
what is the management for pseudogout?
NSAIDs or Colchicine corticosteroid intra-articular DMARDs - methotrexate and hydroxchloroquine joint replacement
95
what is the general order of affected joints in pseudogout?
Knee > wrist > shoulders > ankles >elbows
96
What is psoriatic arthritis?
a seronegative chronic inflammatory joint disease associated with psoriasis
97
what are 3 risk factors for psoriatic arthritis?
psoriasis FHx Hx of joint/tendon trauma
98
what are two features of psoriatic arthritis that distinguish it from RhA?
Dactylitis - sausage fingers | DIP joint involvement
99
what are 5 manifestations of psoriatic arthritis?
``` painful stiff joints - DIP dactylitis spinal stiffness psoriasis enthesitis ```
100
what are 3 investigations for psoriatic arthritis?
X-ray hands and feet ESR/CRP - normal PEST screening tool
101
What are 4 X-ray features of psoriatic arthritis?
``` Pencil in cup deformity periostitis ankylosis osteolysis dactylitis ```
102
what are 3 differentials for psoriatic arthritis?
rheumatoid arthritis gout errosive osteoarthritis
103
what is the mangement for psoriatic arthritis?
NSAIDs Intraarticular corticosteroids DMARDs - methotrexate, sulfasalazine TNF-alpha inhibitors ustekinumab
104
what are 3 complications of psoriatic arthritis?
CVD aortitis methotrexate hepatotoxicity
105
What is reactive arthritis?
A sterile inflammatory arthritis that occurs after exposure to certain gastrointestinal and genitourinary infections.
106
what is the classic triad of reactive arthritis? what is the way to remember it?
Post-infective arthritis non-gonococcal urethritis conjunctivitis Can't see, can't wee, can't climb up a tree
107
is reactive arthritis usually asymmetrical?
YES - also usually only affects one joint - mono arthritis
108
who is reactive arthritis most common in?
Men with HLA-B27
109
what are 5 causative organisms for reactive arthritis?
GU - chlamydia trachomatis, gonorrhoea GI - salmonella, shingella, yersinia enterocoliti
110
what are 3 risk factors for reactive arthritis?
HLA-B27 male chlamydial/GI infection
111
what are 5 symptoms of reactive arthritis?
can't see, can't wee, can't climb up a tree warm swollen joint iritis/conjunctivitis circinate balantis - head of penis dermatitis mouth ulcers
112
what are 3 investigations for reactive arthritis?
ESR/CRP - elevated joint aspiration infectious serology
113
what are 3 differentials for reactive arthritis?
gout pseudogout septic arthritis
114
what is the management of reactive arthritis?
PRESUME SEPTIC UNTIL PROVEN OTHERWISE NSAIDs - naproxen/ibruprofen corticosteroids injections DMARDs - methotrexate
115
what are 3 complications of reactive arthritis?
circinate balanitis uveitis keratoderma blennorhagicum
116
What is rheumatoid arthritis?
An autoimmune chronic inflammatory erosive arthritis primarily affecting the small joints of the hands and feet
117
what percentage of the population have rheumatoid arthritis and who is it most common in?
1% most common in women 50-55 years
118
what are 2 risk factors for RhA?
genetics | smoking
119
what are 5 manifestations of RhA?
``` Active symmetrical arthritis > 6 weeks morning stiffness lasting >30 mins rheumatoid nodules rheumatoid deformities pleuritic chest pain ```
120
what are the 3 types of RhA deformity?
Swan's neck Boutonniere - pip always bent Ulnar deviation
121
what are 3 investigations for RhA?
Rheumatoid factor - positive anti-CCP - positive in 70% X-ray - erosions
122
what are 3 differentials for RhA?
psoriatic arthritis infective arthritis gout
123
What is the management of RhA?
DMARDs - methotrexate, sulfasalazine, hydroxychloroquine corticosteroids NSAIDs
124
what are 3 complications of RhA?
work disability increased coronary artery disease increased joint replacement surgery
125
What is septic arthritis?
the acute infection of 1 or more joints caused by pathogenic inoculation of microbes. It occurs either by direct inoculation or via haematogenous spread and can destroy a joint in under 24 hours.
126
what is the most common joint to be infected with septic arthritis?
knee
127
what is the most common causative organism for septic arthritis?
S. Aureus
128
who 2 gram negative bacteria cause septic arthritis? what patients in?
E. COLI and PSEUDOMONAS AERUGINOSA IVDU immunosuppressed neonates elderly
129
what are 2 gram positive causative bacteria of septic arthritis? what patients affected?
Strep group A (pyogenes) - <5yrs | Staph epidermis - prosthetic joints
130
what are 4 risk factors for septic arthritis?
underlying joint disease/prosthetic joint IVDU immunosuppression
131
what are 5 manifestations of septic arthritis?
``` hot, swollen, painful, red restricted and acute fever affecting single joint (90%) erythema migrans ```
132
what are 3 investigations for septic arthritis?
joint aspiration - gold FBC - leukocytosis CRP and ESR - high blood cultures
133
what are 3 differentials for septic arthritis?
osteoarthritis pseudogout Gout
134
what is the management of septic arthritis?
``` IV antibiotics STOP methotrexate and anti-TNF alpha double steroids (if on) aspiration and joint wash out rest and splint ```
135
what are 3 complications of septic arthritis?
sepsis osteomyelitis joint destruction
136
What is systemic lupus erythramatosus?
a chronic systemic autoimmune condition caused by a type 3 hypersensitivity reaction
137
who most commonly presents with SLE?
women in their childbearing years | most commonly of African or asian descent
138
What are 5 environmental triggers for SLE?
``` UV light Smoking Medications Sex hormones EBV ```
139
What is the pathophysiology of SLE?
Environmental triggers cause cell death creating apoptotic bodies. There is reduced clearance or these apoptotic bodies and cellular and the immune system of these patients doesn't recognise the cellular debris as self and so attack the cell material, forming nuclear antigen-antibody complexes. These complexes can deposit in different tissues and activate complement causing inflammation and damage - a type III hypersensitivity reaction
140
what are 10 manifestations of SLE?
``` malar (butterfly)/ photosensitive /discoid rash lupus nephritis fever and fatigue arthralgia/arthritis Raynaud's disease pericarditis and myocarditis anaemia pleuritis and peritonitis psychosis, seizures, migraine ```
141
what are 4 blood tests for SLE?
FBC - may have anaemia, thrombocytopaenia and leukopaenia U+E - check for lupus nephritis ESR - raised CRP - normal
142
what are 3 antibody tests for SLE?
ANA (anti-nuclear antibodies) - most sensitive Anti-dsDNA - most specific Anti-smith antibodies - most specific, not sensitive Rheumatic factor - 20% positive
143
what are 3 differentials for SLE?
Rheumatoid Arthritis- SLE less symmetrical antiphospholipid syndrome mixed connective tissue disease
144
what is the treatment for SLE?
hydroxychloroquine (anti-malarial) NSAIDs corticosteroids - prednisolone immunosuppressants - methotrexate
145
what are 4 complications of SLE?
anaemia osteoporosis kidney failure - lupus nephritis pericarditis
146
how long does morning stiffness in OA last?
<30 mins
147
what is FRAX?
predicts risk of fragility fracture over the next 10 years age, BMI, smoking, alcohol
148
what group of people does N. Gonorrhoea cause septic arthritis in?
sexually active young adults
149
what antibiotics are used in septic arthritis?
IV flucoxacillin - gram pos (clindamycin in allergy) IV cefotaxime - gram neg
150
what are 4 risk factors for SLE?
female FHx middle aged
151
what are 4 benign bone caners?
osteochondroma giant cell tumour osteoblastomas osteoid osteomas
152
what are 3 malignant bone cancers?
osteosarcoma Ewing sarcoma chondrosarcoma
153
what are the 5 most common secondary bone tumour metastasis?
``` breast prostate lungs thyroid kidneys ```
154
what are 4 manifestations bone cancer?
bone pain, swelling and fractures generally worse at night constitutional symptoms lung metastasis
155
what are 3 investigations for bone cancer?
ALP - from bone elevated X-ray hypercalcaemia
156
what are 4 X-ray signs of bone cancer?
giant cell - soap bubbles lessions osteosarcoma - sunburst Ewing - onion skin chondrosarcoma - moth-eaten
157
what is mechanical back pain?
the source of the pain is in the spinal joints, discs, vertebrae, or soft tissues.
158
what are 3 risk factors for mechanical back pain?
female increasing age fibromyalgia
159
what is the imaging of choice for mechanical back pain?
MRI
160
what is the gold standard investigation of osteomalacia?
iliac bone biopsy with double tetracycline labelling rare as invasive
161
what is osteomalacia?
a metabolic bone disease characterised by incomplete mineralisation of the underlying mature organic bone matrix (osteoid) following growth plate closure in adults. soft bones - rickets in children
162
what causes osteomalacia?
vitamin D deficiency | calcium or phosphate deficiency
163
what are 3 investigations for osteomalacia?
serum calcium and phosphate serum 25-hydroxyvitamin D PTH level
164
what do you give in osteomalacia if deficiency in malabsorption?
vitamin D2 or IM calcitrol
165
which disks are most commonly affected in vertebral disc degeneration?
lower lumbar spine
166
what age group get disc prolapse?
young people - 20-40 years
167
what are 4 manifestations of acute vertebral disc disease ?
sudden onset sever back pain with trigger decreased range of motion tingling, numbness, paresthesia muscle weakness and atrophy
168
what is Paget's disease?
A chronic bone disorder that is characterised by focal areas of increased bone remodelling, resulting in overgrowth of poorly organised bone.
169
what are 3 risk factors for Paget's disease?
FHx 50+ infection
170
what are the 3 stages of Paget's disease?
lytic phase - excessive osteoclasts mixed phase - excessive resorption and disorganisation of bone formation sclerotic phase – osteoblast lay down excessive disorganised bone
171
what are 5 manifestations of Paget's disease?
pain growth of bones in face - leontiasis, hearing loss, vision loss kyphosis lower limb muscle weakness
172
what disease can cause cotton wool appearance of skull on x-ray?
Paget's disease
173
what chromosome is the mutation that causes Marfan's on?
chromosome 15
174
what is the inheritance pattern of marfans?
autosomal dominant
175
what are 10 symptoms of Marfan's?
``` tall, long arms, long legs long fingers and toes pigeon chest or intruding chest scoliosis inability to extend allows to 180 degrees hypermobility downward slant of eyes crowded teeth stretch marks flat feet ```
176
where is type 1 collagen found?
skin, tendons, organs, bones
177
where is type 2 collagen found?
cartilage
178
where is type 3 collagen found?
supporting mesh of soft organs
179
where is type 4 collagen found?
basal lamina (basement membranes)
180
where is type 5 collagen found?
cells surfaces, hair, placenta
181
what are 6 manifestations of Elher's Danlos syndrome?
``` hyper mobility and joint pain recurrent dislocation scoliosis and spine pain hyper elastic skin easy bruising atrophic skin ```
182
what is antiphospholipid syndrome?
antiphospholipid antibodies which cause clinical features characterised by thromboses and pregnancy related morbidity
183
what other condition is antiphospholipid syndome associated with?
SLE in 20-30% of cases
184
what sex is antiphospholipid syndrome more common in?
females
185
what are 4 signs of antiphospholipid syndrome?
CLOTs Coagulation defects Livedo reticularis - lace lie purple discolouration of skin Obstetric issues - miscarriage Thrombocytopenia
186
what are 3 investigations of antiphospholipid syndrome?
anticardiolipin test - IgG or IgM antibodies lupus anticoagulant test Anti-B2-glycoprotein test
187
what is the management of antiphospholipid syndrome?
warfarin pregnancy - aspirin and SC heparin
188
what is salter-harris classification?
fractures in children affecting the growth plate
189
what is the Z score?
bone density compared to average for their age and gender
190
what drug class is allopurinol and what is its MOA?
Xanthine oxidase inhibitor Xanthine oxidase metabolises xanthine into uric acid => inhibits metabolism so therefore lowers plasma uric acid
191
where is hidden psoriasis found?
genitals soles scalp ears
192
what is the name of 1 bisphosphonate?
Alendronate
193
how do you take bisphosphonates?
take on empty stomach once a week and remain upright for at least half an hour afterwards
194
What are the bloods like in Paget's disease?
ALP - high Calcium - normal Phosphate - normal
195
what is the 1st line treatment of Paget's disease?
bisphosphonates - alendronate
196
what are 3 complications of Paget's disease?
osteosarcoma leontiasis fractures
197
what are 5 of the diagnostic criteria for giant cell arteritis?
50+ temporal artery abnormality abnormal temoral artery biopsy elevated ESR
198
what is the name of the blotchy skin pattern in antiphospholipid syndrome?
Livedo reticularis
199
what disease can antiphospholipid syndrome be mistaken for due to positive antibody test?
Syphilis
200
what reflex comes from S1?
Ankle jerk
201
what is Sjogren's syndrome?
autoimmune disorder of diminished lacrimal and slivery gland secretions presents with fatigue, dry eyes, dry mouth, dry vagina
202
what antibodies are in sjogren's syndrome?
anti-Ro (SS-A) and anti-La (SS-B) antibodies rheumatoid factor - RF antinuclear antibodies - ANA
203
what is a key eponymous test for sjorgren's syndrome and what is it?
Schirmer's test filter paper placed in corner of eye to measure secretions
204
what is the treatment for Sjögren's syndrome?
1 - artificial tears, salivary substitutes, paracetamol, IVIg 2 - ophthalmic ciclosporin drops, cholinergic drugs NSAIDs
205
what is felty's triad?
complication of RhA RhA Splenomegally neutropenia
206
what are the 5 extra-articular manifestations of AS?
5 As ``` Anterior uveitis Autoimmune bowel disease Apical lung fibrosis Aortic regurgitation Amyloidosis ```
207
what test is used to determine spinal motility?
Schober's test find L5 and make mark 10cm above, ask patient to bend over as far as possible and mark 5cm below L5 => if distance between 2 marks <20cm =. reduced lumbar movement

Phase 2A :!: (14 decks)

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