Rheumatology

Question 1

Osteoarthritis pain with activity

Answer 1

Gets worse

Question 2

Rheumatoid arthritis: with activity pain -

Answer 2

Improves

Question 3

Rheumatoid arthritis specific test

Answer 3

Anti-CCP antibody

Question 4

Rheumatic fever specific test

Answer 4

ASO (antistreptolisin) titre

Question 5

Rheumatoid arthritis treatment

Answer 5

Step one: methotrexate
Step two : methotrexate + sulphasalazine + hydroxychloroquine

In pregnant: hydroxychloroquine

Question 6

Man with RA trying to get pregnant
On methotrexate and sulfasalazine

Answer 6

Stop both as they cause reversible infertility

Question 7

Rieter’s disease = reactive arthritis

Answer 7

Can’t see
Can’t pee
Can’t climb a tree

1-3 w After STI or enteric infection

Also sausage fingers
Rash
Diarrhoea
Mouth sores

Question 8

Gout attack and chronic kidney disease

Answer 8

Continue allopurinol and give corticosteroid

(Indomethacin if no kidney disease)

Question 9

Pseudogout affects joints that already have

Answer 9

Osteoarthritis

Question 10

At what age is ankylosing spondylitis?

Answer 10

Young men 20-30

Question 11

Suspected SLE investigation

Answer 11

1 ANA test - not specific but highly sensitive

2 anti DS DNA antibodies to confirm

If negative
3. Anti-Smith antibodies.

Question 12

Recurrent abortions and low haemoglobin and platelets Inv

Answer 12

Anti cardiolipin antibodies

Question 13

Raynaud phenomenon treatment

Answer 13

Protection from cold
Avoid smoking
Nifedipine
Glyceryl trinitrate

Question 14

Lab test confirming systemic sclerosis

Answer 14

1 ANA - not specific
2 anti-Scl-70 (anti-topoisomerase I)

3 and anti-centromere antibodies

Question 15

WEAKNESS of shoulder and pelvic girdle muscles + skin rash =

Answer 15

Dermatomyositis

Question 16

Creatine kinase high

Answer 16

Polymyositis

Also aldolase high

Question 17

Sjogren syndrome can progress to

Answer 17

Non-Hodgkin lymphoma

Question 18

Sjogren s lab Inv

Answer 18

1 ANA
2 anti Ro and anti La - specific

Biopsy of salivary glands

Question 19

What type of arthritis in carpometacarpal joint of the thumb?

Answer 19

Osteoarthritis

As well as metatarsophalangeal joint of the thumb

Although metacarpophalangeal and proximal inter phalangeal are in RA

Question 20

First line treatment for RA

Answer 20

NSAIDs

Then methotrexate and steroids

Question 21

Joint most commonly affected in pseudo gout

Answer 21

Knee

Question 22

Diagnosis of giant cell arteriitis confirmation

Answer 22

Temporal artery biopsy

Not ESR !!!

Question 23

Treatment of giant cell arteriitis

Answer 23

Prednisolone

Question 24

CREST syndrome diagnosis

Answer 24

Calcinosis
Raynaud phenomenon etc

Anticentromere antibodies

Question 25

Diffuse cutaneous systemic sclerosis diagnosis

Answer 25

Anti DNA topoisomerase (Scl-70) antibodies

Question 26

MS is in one person in

Answer 26

1000

Question 27

Screening test for Sjogren syndrome

Answer 27

Schirmer test - assesses tear production by measuring the wetness of filter paper placed in lower eyelid for five minutes

Question 28

Test for wegener granulomatosis

Answer 28

C-ANCA

Question 29

Polymorphonuclear cells in joint fluid

Answer 29

Infectious arthritis

Question 30

Drug that doesn’t cause SLE

Answer 30

Nitrofurantoin

Question 31

Joint pain and low haemoglobin And rash

Answer 31

Suspect SLE

Question 32

Pain in neck shoulders elbows lower back legs

Answer 32

Fibromyalgia

Question 33

What increases the risk of getting pseudo gout?

Answer 33

Haemachromatosis

Question 34

Normal joint space and periarticular swelling on x-ray

Answer 34

Gout

Question 35

Urate lowering therapy (allopurinol) is required in

Answer 35

Gout with renal insufficiency Frequent flares Tophi

Question 36

SLE testing

Answer 36

ANA first Then Anti DS DNA

Question 37

Treatment of UTI for patient on methotrexate

Answer 37

Cephalexin

Question 38

methotrexate causes deficiency of vitamin

Answer 38

Folic acid

Question 39

Cornerstone of SLE treatment

Answer 39

Hydroxychloroquine

Question 40

Increased use of fructose containing food would

Answer 40

Increase uric acid level

Question 41

Painful oral ulcer and genital ulcers Arthritis Eye inflammation

Answer 41

Behcet disease Different from SLE where mouth ulcers are painless Treatment topical steroids

Question 42

URTI LRTI Haematuria Mouth ulcers

Answer 42

Wegener granulomatosis

Question 43

Instant response to steroids

Answer 43

Giant cell arteriitis

Question 44

Why do we need high dose prednisolone immediately in giant cell arteritis

Answer 44

To prevent blindness

Question 45

Antibody testing for Churg-strauss

Answer 45

P-ANCA