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BPT annoying facts > Rheumatology 4 > Flashcards

Rheumatology 4 Flashcards

1
Q

Early diffuse Scleroderma with ILD - monitoring regimen?

A

DLCO - 3 monthly for 3 years then annually

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2
Q

Predictors of Diffuse Scleroderma with ILD?

A

HRCT = > 20% fibrosis
then
FVC < 70%

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3
Q

Treatment for Diffuse Scleroderma with ILD?

A

MMF - 1st line

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4
Q

Group I pHTN is idiopathic but what’s the proposed mechanism?

A

pre-capillary

angioproliferative vasculopathy affects pulmonary ARTERIES - remodelling and RIGHT HEART FAILURE

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5
Q

Group 5 pHTN mechanism?

A

pulmonary veno-occlusive disease

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6
Q

Characteristic of pre-capillary pHTN (Group 1,3,4) measurement?

A

mPAP > 20 mmHG

PCWP < 15 mmHG

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7
Q

In systemic Sclerosis - what concurrent disorder confers worst prognosis?

A

Iron deficiency

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8
Q

Scleroderma renal crisis - risk factors?

If associated with neurologic involvement (headache, visual changes) - what drug?

A

RNA polymerase III
Tendon friction rubs

IV nitroprusside - to quickly lower HTN

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9
Q

Esophageal and gastric dysmotility in Scleroderma - treatment?

A

Shortening gastric emptying process, reduce reflux

  • Busprirone ( 5-HT1a receptor agonist)
  • Masopride (5-HT4 receptor agonist) -
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10
Q

Dermatomyositis has what type of cells?

Inclusion body myositis has what type of cells?
response to treatment?

A

CD4 T cells

CD4 and CD8 T cells, plasma cells
-less responsive to immunosuppressant

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11
Q

MDA-5 antibodies - significance?

A

Melanoma differentiation associated gene-5

-HIGH RISK OF ILD

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12
Q

CDAM ( clinically amyopathic dermatomyositis) - clinical significance?

A

No muscle involvement but malignancy

MDA-5 positive

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13
Q

Antibodies in myositis confers higher risk of malignancy?

A

Anti-TIF1

Anti-NXP

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14
Q

Antibodies in myositis confers worst prognosis?

antibodies in myositis confers best prognosis?

A

Anti-SRP/Anti Jo-1

Anti-Mi2

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15
Q

Aspirin suppresses what cytokine in GCA?

A

IFNy

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16
Q

IL6 role in GCA?

A

cause TH to differentiate into TH17 which secretes IL17

17
Q

When avoid probenecid in gout?

A

history of urate nephrolithiasis

CKD ( not effective)

18
Q

What disorder found in Limited Scleroderma apart from CREST?

What disorder found in diffuse scleroderma?

A

Limited Scleroderma;
Group I pHTN
Centromere antibodies

Diffuse Scleroderma
Group III pHTN, ILD ( lungs!)
SCL-70 antibodies

19
Q

Sacro-iliitis INFECTIVE - whats the usual cause? and treatment?

A

Brucella
TB

Treatment is Doxycyline and Rifampicin

20
Q

Which antibodies in myositis have subacute cutaneous lupus?

A

Anti SSA/Ro

21
Q

Treatment for scleroderma renal crisis?

A

Short acting ACEI - captopril to reach BP of 120/70

2nd line - Dihydropyridine CCB can be added

22
Q

Treatment for Reactive arthritis?

A

Self-limiting
NSAIDS - acute phase
Intra-articular steroids - in mono/oligo-arthritis/bursitis
Systemic steroids - polyarthritis

23
Q

In paget’s disease - if intolerant to zolendronic acid or CrCL < 30ml/min - alternative?

A

Calcitonin

24
Q

What lymphoma strongly associated with sjogren syndrome?

A

B- cell Non-Hodgkin Lymphoma

25
Q

Allopurinol mechanism of action?

A

Purine + Pyrimidine analogue - compete and attract XO to metabolism them

  • less real purine being metabolised to uric acid
26
Q

Best proven medications for Fibromyalgia?

A

Amitriptyline
Pregabalin
5HT2 antagonist (cyclobenzaprine)

27
Q

When to give IVIG in IBM?

A

ONLY IF oropharyngeal dysphasia

28
Q

Ctx - bone resorption marker is useful for?

A

Monitoring osteoporosis and MM

29
Q

Pseudogout a/w what condition?

A

HyperPTH

FHH

30
Q

What is catastrophic APL?

Treatment for it?

A

Multiple thrombi affecting 3 or more organ systems - organ failure

Whack everything -
PLEX + IVIG
Steroids
Anticoagulation

31
Q

Difference between primary and secondary Raynaud’s phenomenon?

A

Secondary Raynaud = Endothelial dysfunction

-Reduced NO, increased Endothelin-1 = vasoconstriction

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