Rheumatology

Question 1

Which drug has side effects of pneumonitis, liver cirrhosis and myelosupression?

Answer 1

Methotrexate

Question 2

What are the common side effects of sulfasalazine?

Answer 2

Rashes
Low sperm count
Heinz body anaemia
ILD

Question 3

Luflunomide can cause which side effects?

Answer 3

Liver impairment
ILD
Hypertension

Question 4

Which common rheumatology drug has ocular side effects and what are they?

Answer 4

Retinopathy
Corneal deposits

Hydroxychloroquine

Question 5

Which rheumatology drugs cause proteinuria?

Answer 5

Gold and penicillamine

Question 6

Which common rheum drugs cause reactivation of TB?

Answer 6

TABs and etanercept

Question 7

Which antibodies test for Sjogrens?

Answer 7

Anti Ro (70%)
Anti La (30%)
ANA (70%)
RF (50%)

Question 8

Anti smooth muscle antibodies can be tested for in what

Answer 8

Autoimmune Hepatitis

Question 9

Anti centromere antibodies can be a sign of what

Answer 9

CREST

Question 10

Anti Sm are specific for what?

Answer 10

SLE

Question 11

How does methotrexate work

Answer 11

Inhibits dihydrofolate reductase

Question 12

How long after stopping MTX should women abstain from pregnancy?

Answer 12

6 months

Question 13

How often are bloods done in relation to MTX treatment?

Answer 13

LFT, UEs, FBC before and weekly until stable
Then every 2-3 months

Question 14

Which drugs should not be prescribed with MTX

Answer 14

aspirin
trimethoprim
co-trimoxazole

Question 15

Which enzyme is required to metabolise azathioprine?

Answer 15

Thiopurine methyltransferase (TPMT)

Question 16

How does azathioprine work?

Answer 16

Inhibits purine synthesis

Question 17

Bone marrow depression
Pancreatitis
None melanoma skin cancer
N+V

Side effects of which drug

Answer 17

Azathiprine

Question 18

Around 80% of patients with dermatomyositis are positive to which antibody?

Answer 18

ANA

Question 19

Which antibiotics are used in the management of septic arthritis?

Answer 19

1. Flucloxacillin. Clindamycin if penicillin allergic

Question 20

What are the T score results and what do they mean

Answer 20

> 0 = reassure
0 - -1.5 = repeat DEXA 1-3 years
< -1.5 = offer bone protection with aledronate (bisphosophonate +/- calcium and vitamin D)

Question 21

Antiphosopjholipd syndrome results in which blood results

Answer 21

Anti phosphospholipid positive (30%)
Thrombocytopenia
Extended APTT

Question 22

Crsytals in pseudo gout show what?

Answer 22

Positive bifringence

Question 23

In young patients with pseudogout, which other conditions might they have?

Answer 23

Haemochromatosis
Hyperparathyroidism
Low Mg
Low phos
Acromegaly
Wilsons DIsease

Question 24

When should aledronate be started in patients without DEXA

Answer 24

> 75 with fragility fracture

Question 25

What are the types of Hypersensitivity reactions?

Answer 25

1 = anaphylaxis 2 = antibody cell complex 3 = antibody antigen complex 4 = cell mediated

Question 26

Which antibodies are associated with drug induced lupus?

Answer 26

Antihistone (80-90%) ANA (100%)

Question 27

Which common drugs can cause drug induced lupus?

Answer 27

Procainamide Hydralazine

Question 28

What are the blood results seen in Osteomalacia?

Answer 28

Low vit D, Ca, Phos High ALP, High PTH

Question 29

Why does Vit D/Ca correction need to be given to patients receiving bisphosphonates?

Answer 29

It can make hypocalcaemia worse

Question 30

Which foods are high in purine?

Answer 30

Liver, kidneys, seafood, yeast

Question 31

Which bones are most affected in Paget's disease?

Answer 31

Skull, spine, pelvis, leg bones

Question 32

What causes Paget's

Answer 32

Uncontrolled bone turnover

Question 33

What are the 6 As of Anky Spond

Answer 33

Apical fibrosis Anterior uveitis Aortic regurg AV node block Achilles tendonitis Amyloidosis

Question 34

Which X-Ray changes are seen in OA

Answer 34

Loss of joint space Osteophytes Subchondral sclerosis Subchondral cysts LOSSteoarthritis

Question 34

What does Schooners test, test?

Answer 34

Forward flexion which is reduced. Normal is >5cm increase

Question 35

Which drugs can be used in the management of Anky Spond, when conventional treatments have failed?

Answer 35

Etanercept Adalimumab

Question 36

What is second line in urate lowering therapy?

Answer 36

Febuxostat

Question 37

Drug induced lupus is dsDNA negative

Answer 37

True

Question 38

Which drugs less commonly cause lupus?

Answer 38

Isoniazid Minocycline Phenytoin

Question 39

Which DMARDS are used in RA

Answer 39

Methotrexate Sulfasalazine Leflunomide Hydroxychloroquine

Question 40

Which is the most common connective tissue disease which can cause Raynauds

Answer 40

Scleroderma

Question 41

First line treatment in Raynaud's

Answer 41

CCB

Question 42

What does CREST stand for?

Answer 42

Calcinosis Raynauds Oesophageal dysmotility Sclerodactyly Telangiactiasia

Question 43

Which antibody test is useful in DIFFUSE cutaneous systemic sclerosis?

Answer 43

Anti SCL

Question 44

Which antibody test is useful in LIMITED cutaneous systemic sclerosis?

Answer 44

Anti centromere

Question 45

This antibody is positive in 90% of systemic sclerosis patients

Answer 45

ANA

Question 46

What are second line options if patients are intolerant to alendronate

Answer 46

Risedronate Etidronate

Question 47

SLE is more common in which groups?

Answer 47

F, black

Question 48

Which are the most common primary malignant and benign bone tumours?

Answer 48

Malignant: osteosarcoma Benign: oesteochondroma