Rheumatology Flashcards

(37 cards)

1
Q

Contraindication to infliximab (TNF alpha inhibitors)

A

Co-existing multiple sclerosis
Serious infection inc TB
Hypersensitivity
High dose in mod/severe heart failure

NOT C/I in preg/lactation

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2
Q

Which antibody in limited cutaneous systemic sclerosis (not all CREST symptoms present)

A

Anti-centromere

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3
Q

In limited systemic sclerosis, why dyspnoea?

A

Pulm artery HTN

If topi-isomerase positive(systemic sclerosis): ILD

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4
Q

Langerhan’s cell histiocytosis
(ILD + vertebral involvement + DI)

A

Confirmed on transbronchial lung biopsy
Positive CD1a and S100
Brubeck granules on electron microscopy

HRCT: apical cystic/cavitating lesions, later honeycombing

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5
Q

Raynaud’s worsened by which drugs

A

Atenolol
Methysergide (for migraine)

Swap with Ramipril for HTN control

Treat with Nifedipine (not Verapamil)

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6
Q

Biggest risk factor for developing RA?

A

Smoking

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7
Q

What are the features of alkaptonuria?

A

Deficiency of homogentisic acid oxidase
Dark urine, dark pigmentation of sclera, connective tissues
Ochronosis = cartilage pigmentation
Knee and spine involvement

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8
Q

Sjögren’s syndrome antibodies

A

Anti Ro
Anti La

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9
Q

TNF alpha antibodies

A

Infliximab
Adalimumab
Etanercept

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10
Q

Treatment of Charcot arthropathy?

A

Immobilisation in cast for 3-6 months
?Bisphosphonates

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11
Q

Treatment of APLA in pregnancy

A

low molecular weight heparin and Aspirin

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12
Q

Methotrexate toxicity

A

myelosuppression
raised ALT

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13
Q

Treatment of amyloid in familial Mediterranean fever

A

Colchicine

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14
Q

Systemic inflammatory amyloidosis

A

Hepatomegaly
Heavy proteinuria
Raised ALP

Associated with Rheumatoid

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15
Q

Pain pattern in PMR

A

Worse in the morning, improves throughout the day

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16
Q

Drug induced lupus

A

Hydralazine
Methyl dopa
Thiazides (anti Ro positive)
Procainamide
Isoniazid
Timolol
Phenytoin
Carbamazepine
Valproate
Simvastatin
Captopril
Penicillamine
Procainamide
Minocycline
Griseofulvin

Anti histone!!

17
Q

Avascular necrosis confirmed by?

18
Q

Treatment or halting of scleroderma renal crisis?

A

ACE inhibitors
Prostacyclin infusion

19
Q

Dermatomyositis antibody

20
Q

Osteomalacia (Vit D deficiency) X-ray findings

A

Looser’s zones: low density bands extending from cortex inwards

21
Q

Psoriatic arthritis can also present with what unique feature?

A

Flexor tendon synovitis

22
Q

Lofgren syndrome

A

Acute sarcoidosis with polyarthralgia

23
Q

Side effects of Tocilizumab

24
Q

HSP investigations?

25
Multicentric reticulo-histiocytosis
Nail fold nodules like coral beads
26
Poor prognosis of systemic sclerosis
Anti RNA polymerase III
27
Scleroderma renal crisis
Prevention: avoid glucose-corticoids Treatment: Use ACE inhibitors
28
Hereditary haemochromatosis
Liver disease Impotence Hypogonadism DM Skin hyperpigmentation Chondrocalcinosis- calcium pyrophosphate crystal deposition causing arthropathy
29
Most common cause of infection/osteomyelitis in puncture wound/ear piercing in non-diabetic?
Pseudomonas Otherwise S. aureus
30
Lupus pernio
Cutaneous sarcoidosis
31
Morphea
Form of scleroderma without visceral organ involvement
32
Discoid lupus
Cutaneous SLE
33
T score -4, risk of VTE, esophagitiss
Teriparatide (PTH analogue)
34
Arthritis mutilans
Psoriatic arthritis: distal RA: proximal (long standing) Chronic deformity treated with MTX (as DMARD) and Prednisolone (for pain)
35
Sarcoid unique joint feature?
Ankle synovitis
36
Treatment of primary Raynaud's
Nifedipine MR Losartan
37
Erythema nodosum antibody association?
HLA B27