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MRCP part 1 > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Polymyositis features

A

proximal muscle weakness +/- tenderness
Raynauds
respiratory muscle weakness
interstitial lung disease
dysphagia, dysphonia
CK
elevated muscle enzymes
anti-synthetase antibodies; anti-Jo-1 antibodies

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2
Q

features of antiphospholipid syndrome

A

venous/arterial thrombosis
recurrent miscarriages
livedo reticularis
associated with SLE
rise in APTT
thrombocytopenia

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3
Q

antiphospholipid antibodies

A

anticardiolipin antibodies
anti-beta2 glycoprotein
lupus anticoagulant

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4
Q

management of antiphospholipid syndrome

A

primary thromboprophylaxis with low-dose aspirin
lifelong warfarin

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5
Q

rheumatoid arthritis antibodies

A

RF
Anti-CCP before RF positive

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6
Q

dermatomyositis antibodies

A

ANA positive in majority
antibodies against histidine-tRNA ligase (Jo-1)
SRP antibodies
anti-Mi-2 antibodies

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7
Q

limited cutaneous systemic sclerosis antibodies

A

anti-centromere antibodies

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8
Q

diffuse cutaneous systemic sclerosis antibodies

A

anti scl-70 antibodies

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9
Q

predisposing factors to gout

A

diuretics; thiazides, furosemide
drugs: ciclosporin, alcohol, cytotoxic agents, pyrazinamide, aspirin
CKD
lead toxicity
myeloproliferative/lymphoproliferative disorder
cytotoxic drugs
severe psorasis
Lesch-Nyhan syndrome

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10
Q

radiological features of gout

A

joint effusion
punched-out erosions with sclerotic margins
eccenteric erosions
soft tissue tophi

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11
Q

urate-lowering (allopurinol or febuxostat) therapy in gout

A

2 weeks after acute attack
>2 attacks in 12 months
tophi
renal disease
uric acid renal stones
prophylaxis if on cytotoxics or diuretics

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12
Q

risk factors for pseudogout

A

haemochromatosis
hyperparathyroidism
low magnesium and low phosphate
acromegaly, Wilsons disease

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13
Q

lupus antibodies

A

ANA positive
RF
anti-DsDNA
anti-smith

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14
Q

management of SLE

A

NSAIDs sun lotion
hydroxychloroquine

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15
Q

neonatal lupus antibodies

A

anti-Ro (SSA) antibodies

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16
Q

Limited cutaneous systemic sclerosis features

A

Raynaud’s
scleroderma; face and distal limbs
a subtype of limited systemic sclerosis is CREST syndrome: Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia

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17
Q

systemic sclerosis antibodies

A

ANA
RF
anti-scl-70 associated with diffuse cutaneous systemic sclerosis
anti-centromere associated with limited cutaneous systemic sclerosis

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17
Q

Diffuse cutaneous systemic sclerosis features

A

scleroderma; trunk and proximal limbs
interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH)

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18
Q

mixed connective tissue disease features

A

Raynaud’s phenomenon
Polyarthralgia/arthritis
Myalgia
Dactylitis

19
Q

mixed connective tissue disease antibodies

A

ANA
anti Dr-DNA
scleroderma (anti=Scl70)
anti-U1 RNP

20
Q

features of ankylosing spondylitis

A

Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
and cauda equina syndrome
peripheral arthritis

21
Q

XRAY features of ankylosing spondylitis

A

sacroiliitis: subchondral erosions, sclerosis
squaring of lumbar vertebrae
‘bamboo spine’ (late & uncommon)
syndesmophytes: due to ossification of outer fibers of annulus fibrosus
chest x-ray: apical fibrosis

22
Q

Polyarteritis nodosa features

A

fever, malaise, arthralgia
weight loss
hypertension
mononeuritis multiplex, sensorimotor polyneuropathy
testicular pain
livedo reticularis
haematuria, renal failure

23
Q

polyarteritis nodosa antibodies

A

pANCA

24
Q

sulfasalazine side effects

A

oligospermia
Stevens-Johnson syndrome
pneumonitis / lung fibrosis
myelosuppression, Heinz body anaemia, megaloblastic anaemia
may colour tears → stained contact lenses

25
Q

Lateral epicondylitis (tennis elbow) features

A

pain and tenderness localised to the lateral epicondyle
pain worse on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended
episodes typically last between 6 months and 2 years. Patients tend to have acute pain for 6-12 weeks

26
Q

Medial epicondylitis (golfer’s elbow) features

A

pain and tenderness localised to the medial epicondyle
pain is aggravated by wrist flexion and pronation
symptoms may be accompanied by numbness / tingling in the 4th and 5th finger due to ulnar nerve involvement

27
Q

Radial tunnel syndrome features

A

symptoms are similar to lateral epicondylitis making it difficult to diagnose
however, the pain tends to be around 4-5 cm distal to the lateral epicondyle
symptoms may be worsened by extending the elbow and pronating the forearm

28
Q

Cubital tunnel syndrome features

A

initially intermittent tingling in the 4th and 5th finger
may be worse when the elbow is resting on a firm surface or flexed for extended periods
later numbness in the 4th and 5th finger with associated weakness

29
Q

olecranon bursitis

A

Swelling over the posterior aspect of the elbow. There may be associated pain, warmth and erythema. It typically affects middle-aged male patients.

30
Q

sjogrens syndrome antibodies

A

RF
ANA positive
anti-Ro (SSA)
anti-La (SSB)

31
Q

sjogrens features

A

dry eyes: keratoconjunctivitis sicca
dry mouth
vaginal dryness
arthralgia
Raynaud’s, myalgia
sensory polyneuropathy
recurrent episodes of parotitis
renal tubular acidosi

32
Q

ehlder-danlos

A

TY3 collagen
elastic, fragile skin
joint hypermobility: recurrent joint dislocation
easy bruising
aortic regurgitation, mitral valve prolapse and aortic dissection
subarachnoid haemorrhage
angioid retinal streaks

33
Q

dermatomyositis antibodies

A

ANA
anti-synthetase antibodies: histidine tRNA (Jo-1)
SRP
anti-Mi-2

34
Q

osteoporosis risk factors

A

sedentary lifestyle
premature menopause
Caucasians and Asians
endocrine disorders: hyperthyroidism, hypogonadism (e.g. Turner’s, testosterone deficiency), growth hormone deficiency, hyperparathyroidism, diabetes mellitus
multiple myeloma, lymphoma
gastrointestinal disorders: inflammatory bowel disease, malabsorption (e.g. coeliac’s), gastrectomy, liver disease
chronic kidney disease
osteogenesis imperfecta, homocystinuria

35
Q

secondary causes of Raynauds phenomenon

A

connective tissue disorders
leukaemia
type I cryoglobulinaemia, cold agglutinins
use of vibrating tools
drugs: oral contraceptive pill, ergot
cervical rib

36
Q

heart and eye features of marfans syndrome

A

dilation of aortic sinuses
mitral valve prolapse
upwards lens dislocation
blue sclera
myopia

37
Q

pseudoxanthoma elasticum features

A

retinal angioid streaks
plucked chicken skin
mitral valve prolapse
GI haemorrhage

38
Q

HLA B51

A

Behcets

39
Q

HLA B27

A

ankylosing spondylitis
arthropathies

40
Q

HLA B8

A

Grave’s disease

41
Q

HLA DR3

A

SLE

42
Q

drug-induced lupus antibodies

A

ANA positive
dsDNA negative
anti-histone positive

43
Q

antiphospholipid syndrome antibodies

A

anticardiolipin antibodies
anti-beta2 glycoprotein I
lupus anticoagulant

44
Q
A

MRCP part 1 (5 decks)

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