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RHEUMATOLOGY Flashcards

(52 cards)

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1
Q

BISPHOSPHONATES

A

-Osteoporosis
-Hypercalcemia
-Pagets disease
-Pain from cancer mets

-IV BIS. HIGHER RISK FOR OSTEONECROSIS OF JAW
-‘all patients with cancer and patients with poor dental status should have a dental check-up … before bisphosphonate treatment’

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2
Q

METHOTREXATE AND TRIMETHOPRIM

A

-Synergistic anti folate effect that leads to BONE MARROW SUPRESSION

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3
Q

METHOTREXATE TOXICITY

A

-Caused by adminstration of methotrexate with aspirin secondary to reduced excretion

-TREATED WITH FOLINIC ACID

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4
Q

Most imp investigation in Marfan

A

ECHO: Due to Aortic aneurysm and dissection

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5
Q

RA XRAY

A

PERIARTICULAR EROSIONS MORE SPECIFIC THAN LOSS OF JOINT SPACE

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6
Q

ACTIVE SLE

A

LOW C3 C4

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7
Q

McARDLES SYNDROME

A

-Muscle pain and cramps following short exercise
-Myoglobinuria and elvated CK
-Low lactate during exercise
-Second wind phenomena
-AUTOSOMAL RECESSIVE
-MYOPHOSPHORYLASE DEFECIENCY

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8
Q

SEPTIC ARTHRITIS

A

MOST COMMON IS HEMATOGENOUS SPREAD

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9
Q

ADHESIVE CAPSULITIS

A

WOMAN OLDER THAN 50 WITH DIABETES
restriction of EXTERNAL ROTATION and active and passive movements
confirmed by arthrography

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10
Q

MIXED CONNECTIVE TISSUE DISEASE

A

Anti RNP
-RAYNAUDS
-HAND SWELLING BUT NO SYNOVITIS
-PAIN :ARTHRALGIA MYALGIA
POSITIVE ANA

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11
Q

PAINS

A

1) Internal Rotation of Hip joint implies Avascular Necrosis of Femoral bone
2) External Rotation of shoulder joint - Frozen shoulder
3) aBDUction of shoulder joint (arc) - Supraspinatus tendonitis (Rotator cuff)
4) Extension of wrist or supination of forearm causing elbow pain - Tennis elbow (Lateral epicondylitis)
5) Flexion of wrist or pronating forearm causing elbow pain - Golf elbow (Medial epicondylitis)
6) Pain increased on pronating forearm ( no references of wrist movements and tenderness distal to elbow joint) - Radial tunnel syndrome
7) Pain at wrist (base of thumb) while moving towards ulnar side - De Quervain tenosynovitis

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12
Q

PANCYTOPENIA WITH LOW TPMT LEVELS

A

AZATHIOPRINE

other side effects;
-NON MELANOMA SKIN CANCER
-PANCREATITIS

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13
Q

FIBRILIN IN MARFAN

A

GLYCOPROTEIN WHICH USUALLY WRAPS AROUND ELASTIN

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14
Q

SULFASALAZINE

A

PATIENTS ALLERGIC TO SULFA MAYBE ALLERGIC TO ASPIRIN OR SULPHONAMIDES

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

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15
Q

BONE PAIN PROXIMAL MYOPATHY AND WADDLING GATE

A

OSTEOMALACIA

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16
Q

DERMATOMYOSITIS

A

PROXIMAL MUSCLE WEAKNESS AND SKIN LESION:
-HELIOTROPE RASH
-GOTRONS PAPULES
-MECHANICS HAND
MACULAR RASH
-PHOTOSENSITIVE
-NAIL FOLD CAPILLARY DILATATION

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17
Q

OSTEOGENESIS IMPERFECTA

A

AUTOSOMAL DOMINANT
BDSM:
-BLUE SCLERA
-DENTAL IMPERFECTIONS
-SENSORINEURAL HEARING LOSS DUE TO OSTEOSCLEROSIS
-MULTIPLE FRACTURES

INV ALL NORMAL

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18
Q

HEARING LOSS

A

-OSTEOPOROSIS
-PAGET
-OSTEOGENESIS IMPERFECTA

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19
Q

PSEUDO GOUT

A

-HYPERPARA
-HYPOTHYROID
-LOW MG AND PO4
-HEMOCHROMATOSIS
ACROMEGALY
-WILSONS

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20
Q

LONG TERM TREATMENT FOR SLE

A

HYDROXYCHLOROQUINE

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21
Q

DACTILYTIS AND DIP ARTHRITIS

22
Q

Calcification found on X RAY

Study These Flashcards
A

CHONDROCALCINOSIS PSEUDO GOUT

23
Q

LIVEDORETICULARIS

Study These Flashcards
A

-SLE
-ANTIPHOSPHOLIPID
-PAN

24
Q

Cyclophosphamide

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A

PREMATURE OVARIAN FAILURE

INFERTILITY IN MEN AND WOMEN

25
PAN
-MONONEURITIS MULTIPLEX -Negative ANCA -HEP B SURFACE ANTIGEN -LUNG IS SPARED -HEMATURIA WITH NO CASTS NO GN -NO GRANULOMA
26
VASCULITIS IN WEGNERS
NOT PRESENT IN UPPER RESPIRATORY BIOPSY
27
AVN
PROGRESSIVE PAIN LIMITED MOBILITY MRI
28
EHLERS DANLOS
-AD -JOINT HYPERMOBILITY AND FREQUENT DISLOCATIONS -ELASTIC EXTENDABLE SKIN -MITRAL VALVE PROLAPSE : MID DIASTOLIC CLICK
29
AZATHIOPRINE
CONVERTED TO ACTIVE FORM: MERCAPTOPURINE INHIBITS PURINE SYNTHESIS
30
S1 INJURY FEATURES
-SENSORY LOSS OF POSTEROLATERAL ASPECT OF LEG AND LATERAL FOOT -WEAKNESS IN PLANTAR FLEXION -POSITIVE SCIATIC STRETCH TEST
31
MARFAN
DURAL ECTASIA
32
CALCIFICATION OF TRIANGULAR FIBROCARTILLAGE
CHONDROCALCINOSIS PSEUDOGOUT
33
TEMPORAL ARTERITIS
PALE AND EDEMATOUS DISC DUE TO ANTERIOR ISCHEMIC OPTIC NEUROPATHY
34
GOUT PATIENTS TAKING WARFARIN
AVOID NSAIDS USE COLCHICINE OR STEROIDS (AVOID IN DM)
35
HYDROXYCHLOROQUINE
BULLS EYE RETINOPATHY: -PHOTOPHOBIA AND FLASHING LIGHTS -DECREASED VISUAL ACUITY -CENTRAL MACULA DEPIGMENTATION SURROUNDED BY HYPERPIGMENTATION
36
STILL'S DISEASE
-RF AND ANA AND RHEUMATOID NODULES ARE NEGATIVE -FEVER ARTHRALGIA MACULOPAPULAR SALMON PINK RASH -FIRST LINE NSAIDS THEN STEROIDS THEN METHOTREXATE THEN IL1 (ANAKINRA) THEN RITUXIMAB -STILL : Salmon pink rash Temperature Inflammatory markers raised ; ESR,CRP,Ferritin Lymphadenopathy Liver ; raised transaminase
37
Keratoderma Blennorrhagica
-hard nodules on the sole of the foot -diagnostic for reactive arthritis -MAYBE ALSO YELLOW RASH
38
LEFLUNOMIDE
-MONITOR WITH BP AND CBC AND LFT -SIDE EFFECTS: -MYELOSUPRESSION -PNEUMONITIS -DIARRHEA -HTN -WEIGHT LOSS -POLYNEURPATHY -Use CHOLESTYRAMINE to stop it
39
MERALGIA PARASTHETICA
-Diagnosed by PELVIC COMPRESSION JUST BELOW THE ASIS TREATMENT IS BY INJECTION OF LOCAL ANESTHETIC
40
DISCOID LUPUS
-RAISED ERYTHEMATOUS RASH -CAUSES SCARRING ALOPECIA -Rx: TOPICAL STEROIDS THEN HYDROXYCHLOROQUINE
41
Atypical shaft femur stress fractures
BISPHOSPHONATES
42
LEG PAIN INCREASED ON WALKING AND RELIEVED BY SITTING DOWN AND CROUCHING
SPINAL STENOSIS -Also normal vascular examination -MRI diagnostic
43
PAIN WORSE ON EXTENSION AND ON FACET PALPATION
FACET JOINT
44
Inhibition of 5inosine monophosphate dehydrogenase
MYCOPHENOLATE MOFETIL DECREASES LYMPHOCYTES PRODUCTION
45
MARKERS OF BONE TURNOVER
-procollagen type I N-terminal propeptide (PINP) -serum C-telopeptide (CTx) -urinary N-telopeptide (NTx) -urinary and serum hydroxyproline
46
TENDERNESS OVER LATERAL HIP WITH HIP PAIN AND LIMITATION OF MOVEMENTS
TROCHANTERIC BURSITIS AKA GREATER TROCHANTERIC PAIN SYNDROME
47
TNF INHIBITORS IN ANKYLOSING IMPROVE ALL BUT?
RADIOLOGICAL PROGRESSION -IMPROVED ONLY BY NSAIDS -DMARDS ONLY USEFUL WITH PERIPHERAL JOINTS INVOLVEMENT
48
FEATURE LESS COMONLY SEEN IN DRUG LUPUS
GLOMERULONEPHRITIS
49
Hand-Arm vibration syndrome
-Secondary Raynauds -Loss of fine touch and proprioception
50
Arthroscopy findings in RA
-Marked profileration of vascularity on synovial membrane with increased permeability
51
XRAY In Mixed lytic and sclerotic phase of Pagets disease
-Bone expansion -Trabecular and cortical thickening -After treatement new bone is lamellar not woven
52
Disabling osteoarthritis in elderly who live alone
Joint replacement

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