Rheumatology

Question 1

Treatment for suspected vision loss secondary to temporal arteritis?

Answer 1

IV Methylprednisalone

Question 2

Weakness in polymyalgia rheumatica?

Answer 2

No true weakness of limb girdles, any weakness due to pain inhibition

Question 3

Treatment for mod/severe psoriatic arthropathy?

Answer 3

Methotrexate

Question 4

Manifestation of Wegner’s granulomatosis?

Answer 4

Renal impairment
Resp, systemic and ENT symptoms

Question 5

Fundoscopy finding with Temporal Arteritis?

Answer 5

Swollen pale disc with blurred margins

Question 6

Treatment of choice for SLE?

Answer 6

Hydroxychloroquine

Question 7

X-ray findings in AnkSpond?

Answer 7

Subchondral erosions
Sclerosis
Squaring of lumbar vertebrae

Question 8

Methotrexate and what AB = BAD and what happens when that is mixed?

Answer 8

C0-trimoxazole

May caus ebone suppression and severe pancytopenia

Question 9

What must you do before starting someone on a biologic?

Answer 9

Chest x-ray to check for TB

Question 10

What must be performed on all ptnts with sus RA?

Answer 10

X-ray of hands

Question 12

Patient on paracetamol with thumb/knee arthritis. What do you next give them if that’s not effective?

Answer 12

Topical NSAIDs

Question 13

Osteopenia detected in one site means what generally?

Answer 13

Generalised osteopenia, systemic process and cannot be localised

Question 14

Table of blood levels for osteoporosis, osteomalacia, Primary hyperparathyroidism, CKD, and Paget’s?

-Calcium
-Phosphate
-ALP
-PTH

Answer 14

Question 15

What does the Z score from DEXA scan incooporate?

Answer 15

Age
Gender
Ethnic factors

Question 16

1st line treatment for SLE?

Answer 16

Hydroxychlorquinine

Question 17

Primary Sogren’s Auto-AB?

Answer 17

Anti-Ro

Question 18

What are you more at risk of if you have Sjogren’s?

Answer 18

Lymphoma (Lymphoid malignancies)

Question 19

TNF-alpha inhibitors may have what effect on person’s immune system?

Answer 19

Reactivate TB

Question 20

When starting a patient on allopurinol what do you also start?

Answer 20

Colchicine for 6 months

Question 21

Treatment for patients with Anti-phospholipid syndrome who haven’t had a thrombosis?

Answer 21

Low-dose aspirin

Question 22

WHat finding best supports diagnosis of ankspon?

Answer 22

Pelvic x-ray showing sacro-iliitis

Question 23

WHta can cause drug-induced lupus (spoilers probably a type of drug?)

Answer 23

Isoniazid

Question 24

Monitoring for patients on methotrexate?

Answer 24

FBC
U&Es
LFTs

Every 3 months

Question 25

Out of these drugs which is safe for an SLE patient to take in pregnancy?

Answer 25

-Cyclophosphamide
-Azathioprine
-Methotrexate
-Mycophenolate
-Rituximab

Question 26

Treatment options of SLE in pregnancy?

Answer 26

Azathioprine
Hydroxychloroquine
Steroids

Question 27

Reactive arthritis treatment?

Answer 27

NSAIDs

Question 28

Treatment of newly diagnosed RA NICE Guidelines?

Answer 28

Start ASAP with methotrexate (or sulfasalazine or leflunomide)
and
Oral steroids

Question 29

Reactive arthritis comes on in what time frame following infection?

Answer 29

1-4 weeks

Question 30

Biochemical picture of Paget’s?

Answer 30

Normal Ca, Ph, Vit D
Raised ALP

Question 31

What do you give a patient who is osteoporotic and has normal levels calcium and vitamin D?

Answer 31

Just alendronate, no need to supplement what they have

Question 32

What levels monitor an SLE flare?

Answer 32

Complement levels (C3,4)
They are usually low during active disease

Question 33

Inflammatory arthritis involving DIPs and dactylitis points to what diagnsois?

Answer 33

Psoriatic arthritis

Question 34

Biochem of osteogenesis imperfecta?

Answer 34

Normal ca, PTH, ALP and PO4

Question 35

AnkSpond features + the way of remembering them?

Answer 35

THE A’S

-Apical fibrosis
-Anterior uveitis
-Aortic regurgitation
-Achilles tendonitis
-AV node block
-Amyloidosis

Question 36

Septic arthritis most common organism?

Answer 36

Staph A

Question 37

What should you always consider and rule out in diagnoses of dermatomyositis?

Answer 37

Internal malignancy
Namely:
-Breast
-Lung
-Ovarian
-GI

Question 38

YA with septic arthritis…causative organism?

Answer 38

Neisseria Gonorrhoea