Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

(61 cards)

Start Studying
1
Q

What are the X-ray changes seen in rheumatoid arthritis?

A

Juxta-articular osteopenia
Soft tissue swelling
Joint deformity
Loss of joint space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the red flags in a back pain history? 5 things

A 
Night pain
History of malignancy
Neurological disturbance
Abdominal mass
Sphincter disturbance
Saddle anaesthisia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name 3 early symptoms of rheumatoid arthritis?

A

Swelling
Pain
Stiff small joints worse in the morning
Possible tenosynovitis or bursitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 4 late changes of rheumatoid arthritis?

A

Ulnar deviation of fingers
Boutonnière deformity of fingers
Swan-neck deformity of fingers
Z-deformity of thumb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give 5 extra-articular signs of rheumatoid arthritis?

A 
Nodules-elbows and lungs
Vasculitis
Pleural and pericardial effusion
Raynauds
Carpal tunnel syndrome
Osteopororis
Fibrosing alveolitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which blood test would you take in a suspect rheumatoid patient?

A

Rheumatoid factor (70%)
Anti-CCP (98%)
FBC-anaemia of chronic disease
ESR/CRP/PV-raised in response to synovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the diagnostic criteria for rheumatoid arthritis?

A 
4/7 of
Morning stiffness (>1 hour lasting >6 weeks duration)
Arthritis in >3 joints
Arthritis of hand joints
Symmetrical arthritis
Rheumatoid nodules
Positive rheumatoid factor
Radio graphic changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the DAS28 and what score is being aimed for?

A

Disease activity score-assesses tenderness and swelling at 28 joints

Aiming for <3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can you treat rheumatoid arthritis non pharmacologically? 4 things

A 
MDT approach
Support groups
Stop smoking
Encourage regular exercise
Physio
OT for aids, splints etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the class of drugs used as first line long term treatment in Rheumatoid arthritis and give 3 examples?

A

DMARDs

Methotrexate
Sulfasalazine
Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a potentially serious SE of DMARDs and how can you avoid it?

A

Myelosuppression

Regular FBC monitoring is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient fails to respond to DMARDs in RA, what is the next line of drugs? Give examples?

A

TNF alpha inhibitors
Infliximab
Etanercept
Adalimumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If DMARDs and TNF alpha inhibitors fail to control Rheumatoid arthritis, what’s the next line?

A

Rituximab in combination with Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the criteria for diagnosing SLE?

A 
>4 of: A RASH POINts an MD
•Arthritis (>2 joints)
•Renal disorder (proteinuria or cellular casts)
•ANA positive
•Serositis (pleuritis or pericarditis)
•Haematological disorder (anaemia, leukopenia, thrombocytopenia)
•Photosensitivity
•Oral ulcers
•Immunological disorder
•Neurological disorder (seizures, psychosis)
•Malar rash
•Discoid rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 4 seronegative arthropathies?

A

Ankylosing spondylitis
Enteropathic spondyloarthropathies
Psoriatic arthritis
Reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Sjögren’s syndrome?

A

Autoimmune disease destroying exocrine glands with associated polyarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What tests can be undertaken to monitor the effectiveness of methotrexate? 2 tests

A

Creatinine
FBC
LFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the symptoms of polymyalgia rheumatica? 4 things

A

•Symmetrical aching, tenderness and morning stiffness in shoulders and proximal limb muscles

  • Mild polyarthritis
  • Tenosynovitis
  • Carpal tunnel syndrome

•Fatigue,fever, weight loss, anorexia and depression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you manage Polymyalgia rheumatica?

A

Prednisalone

Along with PPI and Bisphosphanates (alendronate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is polymyalgia rheumatica associated with?

A

Giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name 4 symptoms of temporal arteritis?

A 
Headache
Scalp tenderness
Jaw claudication
Temporary loss of vision in one eye
Sudden blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat giant cell arteritis?

A

Prednisalone (40-60mg PO) immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Feltys syndrome?

A

Association of rheumatoid arthritis with splenomegaly and leukopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What organisms are commonly responsible for septic arthritis in infants and sexually active adults?

A

Infants-Haemophilus influenzae

Adults-Neisseria gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the medical term for a sausage shaped toe?
Dactylitis
26
What is the test used for checking lumbar flexion?
Schober test
27
Give 4 extra skeletal features that could be present in Ankylosing spondylitis?
``` Anorexia Fatigue Weight loss Fever Uveitis Aortic incompetence Pulmonary fibrosis ```
28
Give 3 ways you could manage Raynauds?
Hand warmers Battery powered gloves Oral vasodilators Sympathectomy
29
What serological abnormality is found in lupus?
Raised levels of double stranded DNA | Low C3 and C4 complement levels
30
Give 5 causes of Gout?
``` Hereditary High dietary purines Alcohol excess Diuretics Leukaemia Renal impairment ```
31
What will light microscopy of synovial fluid show in Gout?
Needle shaped Negatively birefringent urate crystals under polarised light
32
What is the treatment of acute Gout?
Strong NSAID (diclofenac) Colchicine - if NSAIDs CI Steroids - if there is renal impairment
33
How do you prevent Gout?
``` Lose weight Avoid alcohol excess Avoid purine rich foods Avoid prolonged fasts Use allopurinol after acute attack ```
34
What is the difference between Gout and Pseudogout?
Gout shows negative bifringent crystals under microscopy whilst Pseudogout shows positive.
35
Give 3 risk factors for developing Rheumatoid A?
Smoking Female Genetic (HLA DR4)
36
What is pannus in Rheumatoid A?
A growth which is composed of thick synovial tissue. This produces enzymes which destroy articular cartilage and attract more inflammatory cells => increasing disease severity
37
How do you treat an acute flare of Rheumatoid Arthritis? 2 things
Steroids - Methylprednisalone | NSAIDs (For symptom control) - Ibuprofen, Diclofenac etc.
38
What is the test and give 3 antibodies you can test for in SLE?
Immunoflorescence ANA (Anti-smith and Anti-dsDNA) Rheumatoid factor
39
Give 3 ways to monitor disease activity in SLE?
``` Anti-dsDNA titres Complement levels (decrease in C3/4) ESR (raised) ```
40
Give 6 methods to manage SLE starting with simple measures?
High factor sun block creams NSAIDs - treat minor symptoms Anti-malarial (hydroxychloroquine) - if NSAIDs aren't working Low dose steroids - chronic disease Azathioprine - maintenance High dose prednisalone - severe flare ups
41
What is Antiphospholipid syndrome? 4 things
CLOT Coagulation defects Livedo reticularis (capillary dilatation & stasis) Obstetric complications (recurrent miscarriages) Thrombocytopoenia
42
How can you treat Anti-phospholipid syndrome? 2 things
Aspirin | Warfarin - in recurrent thromboses
43
What is SLE?
Antibodies produced against a variety of antigens. Type 3 hypersensitivity leading to immune complexes that deposits in various organs.
44
What is Systemic sclerosis ?
Autoimmune disease with increased fibroblast activity => abnormal tissue growth Characterised by autoantibodies, vascular disease and fibrosis => skin (scleroderma, GI tract & other organs
45
What are the clinical features of Limited systemic sclerosis? 5 things
CREST Calcinosis - calcium deposits in subcutaneous tissue Raynauds phenomenon Esophageal and gut dysmotility Sclerodactyly - thick/tight skin of fingers/toes Telangiectasia
46
What is the antibody associated with limited systemic sclerosis?
Anti-centromere (ACA)
47
What is diffuse systemic sclerosis? Which 2 antibodies are associated?
Affects the skin in a difuse pattern Also fibrosis in lungs, heart and kidneys Anti-topoisomerase-1 (scl70) Anti-RNA polymerase
48
How do you treat systemic sclerosis? 4 things
No cure Involve physios & OT Immunosuppression (organ involvement) - IV cyclophosphamide ``` Treat complications: Raynauds - hand warmers GI - antacids, PPI Cardiac - antiarrythmics Renal - ACEi ```
49
Give 6 clinical features of Sjögren's syndrome?
Lacrimal - Xeropthalmia (low tears), dry eyes Parotid - Parotid gland swelling, xerostomia, tooth decay Others - vaginal dryness, dry cough Systemic features - polyartheritis, raynauds, vasculitis
50
In Sjögren's syndrome how can you test for conjuctival dryness?
Schirmer's test - Strip of filter paper under lower eyelid. Measure distance tears are absorbed. <5mm in 5mins is positive
51
Who is more likely to present with ankylosing spondylitis and whats the genetic association?
Young (s) males | HLA B27
52
Give 4 clinical features of ankylosing spondylitis?
Sacroilitis - night back pain, spinal stiffness, loss of movement Acute anterior uveitits Enthesitis - pain at tendon/ligament insertion points Question mark posture
53
Give 3 ways to treat ankylosing spondylitis?
Intense exercise (OT & Physios) Pharmo - NSAIDs, local steroid injections, monoclonal antibodies Surgery -
54
Give 5 clinical features seen in psoriatic arthritis?
``` Joints - inflamed, red, tender Psoriasis Nail changes - onycholysis, nail pitting Enthesitis Dactylitis ```
55
What X-ray deformity of the hands can be seen in severe Psoriatic arthritis?
Pencil in cup deformity
56
What is reactive arthritis characterised by? 3 things
Arthritis Urethritis/Cervicitis Conjuctivitis
57
What are the different types of vasculitits? 6 things
Large vessel - Temporal arteritis, Takayasu's arteritis Medium vessel - Polyarteritis nodosa, Kawasaki's disease Small vessel: ANCA +ve (Wegener's, Churg Strauss syndrome) ANCA -ve (Goodpastures, Henoch Schonlein purpura)
58
How do you investigate temporal arteritis? If the test is negative should you exclude TA?
Temporal artery biopsy | No, as the disease can manifest in skip lesions
59
What is polymyositis and give 2 clinical features?
Chronic inflammtory myopathy (inflammation in muscles) ``` Proximal muscle weakness (unlike PMR which is stiffness) Muscle weakness (dysphagia, dysphonia) ```
60
Give 5 clinical features of dermatomyositis?
``` Macular rash Lilac purple rash Nail fold erythema Gottrons papules (roughened papules over knuckles, elbows and knees) Mechanic's hands (rough skin cracking) ```
61
What is the definition of Juvenile idiopathic arthritis?
Persistent arthritis lasting for >6weeks with an onset of <16years old

Medicine (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions