Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FCPS Preperation > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Most abundant protein of bone is?

A

Type 1 collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bone mineral composed of?

A

Ca and PO4 crystal : hydroxyapetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Over mineralisation occurs in

A
  1. Osteogenesis imperfecta
  2. Long term bisphosphonate therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

After how many days osteoclast undergoes apoptosis?

A

10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Markers of bone formation and resorption?

A

Propeptide fragments for bone formation and pyridinium molecules for bone resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which enzyme is responsible for bone mineralisation?

A

ALP

Produced by osteoblast degrades pyrophosphate an inhibitor of mineralisation thus enhanced mineralisation of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Factor responsible for PO4 homeostasis?

A

FGF-23

Produced by osteoclast act on kidney promote PO4 excreation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Factor stimulate bone formation

A

→ Wnt
→ thyroid hormone
→ PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Factor stimulates bone resorption?

A

→ RANKL
→ PTH
→ Thyroid Hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Factor inhibit bone resorption

A

→ Osteoprotagerin
→ Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Factors inhibit bone formation?

A

→ Sclerostin
→ Glucocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What changes occur in articular cartilage with ageing?

A

+ ↓ chondroitin sulphate
+ ↑ Keratan sulphate
+ ↓ Water content and shock absorbing properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What changes occur in articular cartilage in OA?

A

+ Abnormal chondrocyte divisions
+ Loss of proteoglycan from matrix
+ ↑ Water content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Menisci of the knee get nutrition from?

A

SF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which cell secretes SF?

A

Type B synoviocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first line investigation in acute mono arthritis?

A

Joint Aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of synovial joints are

A

+ Most limb joint
+ TMJ
+ Costovertebral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Turbid Fluid with high neutrophil count found in

A

+ Septic arthritis
+ Reactive arthritis
+ Crystal arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Uniform blood staining on synovial fluid causes due to

A

Bleeding diathesis
Trauma
Pigmented villonodular synovitis
Severe inflammatory synovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Features of urate crystal

A

Diagnostic of Gout
Long and needle shaped
Strong light intensity
Negative birefringence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Radiological features of Rheumatoid arthritis

A
  1. Periarticular osteoporosis
  2. Joint space narrowing
  3. Joint sublaxation
  4. Marginal joint erosion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Radiological Features of OA

A

Osteophyte
Joint space narrowing (focal)
Subchondral cyst
Subchondral Sclerosis
Joint Deformity
Calcified loose bodies over synovium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Radionuclide bone scintigraphy used mainly in Dx of?

A

Metastatic bone disease
Paget’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is used in radionuclide bone scintigraphy?

A

TC labelled bisphosphonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

DXA is used in?

A

Dx and Mx of osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What causes high BMD in presence of osteoporosis

A

Aortic calcification
Vertebral fractures
Degenerative disc disease
OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the causes of elevated CPK (creatinine phosphokinase)

A

Inflammatory myositis, vasculitis
MND
Muscular Dystrophy
MI, trauma
Alcohol, drug, statins
Hypothyroidism
Viral myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes normal CRP with High ESR

A

SS UP HOME

S- SLE
S- Systemic sclerosis

U- Ulcerative Colitis
P- Pregnancy

H- Heart failure
O- Old Age
M- Multiple Myeloma
E- ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Antibodies associated with SLE

A
  1. Anti La Ab (Anti-SSB)
  2. Anti Ro Ab (Anti-SSA)
  3. Anti Sm Ab (Anti- Smith)
  4. Anti ribonucleoprotein Ab ( Anti RNP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ab responsible for mixed connective tissue disease?

A

Anti- RNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ab responsible for systemic sclerosis

A
  1. Anti RNA polymerase
  2. Anti Scl-70 (anti+tropoisomerase I ab)
  3. Anti centromere ab ( Cutaneous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Ab responsible for Dermatomyositis and polymyositis

A

Anti Jo 1 ab ( anti histidyle tRNA synthetase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the diagnostic triads in inflammatory myositis and suspected myopathy on Electromyography

A

★Spontaneous fibrillation
★Short duration AP in polyphasic disorganized outline
★Repetitive bouts of high voltage oscillation on needle contact with diseased muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Causes of monoarthritis

A

Gout
Pseudogout
Trauma
Haemarthrosis
Spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis

35
Q

Acute pain with, young men, 1st MTP involvement, needle shaped negative birefringence crystal with H/O taking Anti TB drugs/ Diuretics / Alcohol

A

Gout

36
Q

Acute onset with H/O diarrhoea or genital infection

A

Reactive arthritis

37
Q

Acute onset, older woman with pre existing OA

A

Pseudogout

38
Q

Acute onset with red, hot swollen joints with skin erythema + fever + H/O DM, Immunosuppression, RA, I/V drug misuse what is the dx and Mx

A

Septic arthritis
I/V antibiotic should be given promptly

39
Q

Following injury large joint effusion

A

Hemarthosis

40
Q

Investigation of choice for acute monoarthritis

A

Joint aspiration

41
Q

Old age + gradual onset (usually knee)

A

OA

42
Q

Common cause of Polyarthritis

A

Rheumatoid arthritis
Viral arthritis
Osteoarthritis
SLE
Psoriatic arthritis
Enteropathic arthritis
Axial Spondyloarthritis
Chronic Gout
Chronic sarcoidosis
CPA
Poncet’s Disease
JIA

43
Q

Hallmark of inflammatory polyarthritis

A

★ Morning Stiffness
★ Worsening of symptoms with inactivity
★ Synovial tenderness and swelling

44
Q

Which joints involved in psoriatic arthritis

A

PIP, DIP Sacroilitis and other large joints

45
Q

Which joints involved in Rheumatoid arthritis

A

MCP, PIP, MTP, other small and large joints of both upper and lower limb

46
Q

Features of psoriatic arthritis

A

Asymmetrical
Joints involved : PIP, DIP Sacroilitis, large and small joint
Nail pitting / Onycholysis
Dactylitis / Enthesitis

47
Q

Features of Osteoarthritis

A

Symmetrical
Joint involved: PIP, DIP, 1stCMP, hip, knee and spine
Heberden’s and boucher’s node

48
Q

Causes of reynaud’s phenomenon

A

Systemic sclerosis, Anti phospholipid syndrome, SLE, Sjogren syndrome

49
Q

Causes of pathological fractures

A

★ Malignancy
★ Paget’s Disease
★ Osteomalacia

50
Q

Features of mechanical low back pain

A

★ Pain varies e physical activity (improved with rest)
★ Onset often sudden and precipitated by lifting or bending
★ Recurrent episodes
★Pain limited to back or upper leg
★No clear nerve root distribution
★ No systemic features
★ Self limiting with recovery at 6 weeks in 90%

51
Q

Red flags for possible spinal pathology

A

≈History
★ Age >55 years and <20 years
★ Constant progressive pain unrelived by rest
★ thoracic pain
★Ca, HIV, TB, Systemic glucocorticoid use, osteoporosis
★Systemic upset, sweat, weight loss
★Major trauma

≈Examination
★Spinal deformity
★ Saddle anaesthesia
★ Progressive neurological sign / muscle wasting
★ Multiple levels of root sign

52
Q

Endocrine causes of proximal muscle weakness

A

Hypothyroidism
Hyperthyroidism
Addison’s disease
Cushing Syndrome

53
Q

Inflammatory causes of proximal muscle weakness

A

Polymyositis
Dermatomyositis
Inclusion body myositis
Sarcoid
Myasthenia gravis
Other autoimmune connective tissue disease

54
Q

Metabolic causes of proximal muscle weakness

A

Myophosphorylase deficiency
Carnitine deficiency
Phosphofructokinase deficiency
Hypokalemia
Osteomalacia
Hypercalcemia

55
Q

What are the drugs responsible for proximal muscle weakness

A

Alcohol
Cocaine
Glucocorticoid
Statins and fibrate
Zidovudine
TNF inhibitors

56
Q

Features of cauda equina syndrome

A
  1. Difficulty with micturition
  2. Loss of anal sphincter tone or fecal incontinence
  3. Saddle anaesthesia
  4. Gait Disturbance
  5. Pain, numbness or weakness affecting one or both legs
57
Q

Where Cox-1 enzyme is expressed

A

Gastric mucosa → protect against mucosal damage
Platelet → regulate platelet aggregation
Kidneys → regulate renal blood flow

58
Q

Site of cox 2

A

Induced at the site of inflammation producing pg that causes local pain and swelling

59
Q

Which has the highest risk among NSAIDS of GI bleeding and perforation?

A

Indometacin

60
Q

Which has the lowest risk among NSAIDS of GI bleeding and perforation?

A

Celecoxib
Etoricoxib

61
Q

What is the most important risk factor for NSAIDS induced GI bleeding and perforation? (Peptic ulcer)

A

Age>60 yrs
Past history of PUD

62
Q

Vision monitoring is required for which drug?

A

Hydroxychloroquine

63
Q

Bp monitoring is required for which drug?

A

Leflunomide
Ciclosporin A

64
Q

GFR measurements are required for

A

Cyclophosphamide
Ciclosporin A

65
Q

Which drug isn’t required FBC and LFT monitoring

A

Hydroxychloroquine
Ciclosporin A
Targeted sDMARD except tofacitinib

66
Q

Trigger finger

A

Result if stenosing tenosynovitis in the flexor tendon sheath e intermittent locking of finger in flexion

Cause:
- Spontaneous
- RA

Mx: Glucocorticoid injection

67
Q

Spondylolysis

A

Break in the integrity of vertebral neural arch
Principal cause: Acquired defect in the pars interarticularis due to a fracture

Commonly seen in: Gymnasts, dancers, runners

68
Q

Spondylolisthesis

A

A defect causes slippage of a vertebra one blow

69
Q

Scoliosis

A

Abnormal lateral curvature of spine more than 10 degrees

Cause:
+ Idiopathic
+ Neuromuscular disorder such as muscular dystrophy, cerebral palsy, neurfibromatosis
+ Marfan Syndrome

70
Q

Carpal Tunnel Syndrome

A

Caused by compression of the median nerve at the wrist

Common cause:
Hypothyroidism
DM
RA
Obesity
Pg (3rd trimester)

71
Q

Site of involvement of following Disease
1. Diabetic neuropathy
2. Syringomyelia
3. Leprosy
4. Tabes dorsalis

A
  1. Hind foot
  2. Shoulder, elbow, wrist
  3. Hands and Feet
  4. Knees, spine
72
Q

Hypertrophic pulmonary osteoarthropathy

A

Characterised by clubbing and painful swelling of limbs, periosteal new bone formation and arthralgia / arthritis

Most Common cause
Bronchial carcinoma
Mesothelioma

73
Q

Tumours that most commonly metastasise to bone are

A

+ Myeloma
+ Bronchus
+ Breast
+ Thyroid
+ Kidney
+ Prostate

74
Q

What is the most common primary bone tumour

A

Osteosarcoma

75
Q

Osteosarcoma

A

Most common primary bone tumour
Age: Under 30
Presentation : Local pain and Swelling
X-ray: Expansion of bone with surrounding soft tissue mass, often containing island of calcification

76
Q

Osteogenesis imperfecta

A

Group of disorders characterised by severe osteoporosis and multiple fractures in childhood

Caused by mutation in COL1A1 and COL1A2 genes which encode proteins that make Type 1 collagen

77
Q

Osteonecrosis

A

Death of bone due to impairment of blood supply

78
Q

Common site of Osteonecrosis

A

Femoral head, Humeral head, Navicular and Scaphoid

79
Q

Osteonecrosis associated with

A

Direct trauma
Thrombophilia
Antiphospholipid syndrome
Gaucher’s disease
Hemoglobinopathies such as sickle cell disease

Predisposing factors:
High dose Glucocorticoid treatment
Alcohol excess
SLE
HIV
Radiotherapy

80
Q

X-ray findings of Osteonecrosis

A

Normal in early stages but later may show evidence of osteosclerosis and deformity of affected bone

81
Q

Confirmatory investigation for Osteonecrosis

A

MRI

82
Q

What are the characteristics of deformity in RA?

A

Ulnar deviation of finger
Swan neck deformity
Boutonniere or button hole deformity
Z deformity of the thumb
Dorsal subluxation of ulna at distal radio ulnar joint
Triggering finger
Subluxation of the MTP joint of foot (Cock-up toe)
In hind foot: Valgus deformity
Flat foot

83
Q

Nerve involved in peripheral neuropathy of RA

A

Median nerve
Ulnar nerve at wrist and elbow
Lateral popliteal nerve at head of fibula
Posterior tibial nerve (tarsal tunnel syndrome)

FCPS Preperation (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions