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Rheumatology Flashcards

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1
Q

If a patient presents with numbness and burning pain over the anterolateral skin of the thigh, which condition may you suspect first?

A

Meralgia paraesthetica

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2
Q

Which X-ray changes are associated with RA?

A
  1. Loss of joint space
  2. Juxta-articular osteoporosis
  3. Soft tissue swelling
  4. Periarticular erosions
  5. Subluxation
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3
Q

What is De Quervain’s syndrome?

A

Inflammation of the sheaths of the extensor pollicis brevis and adductor pollicis longus tendons

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4
Q

Which criteria cause a patient to be labelled high risk for osteoporotic fracture?

A
  1. >75
  2. Glucocorticoid treatment
  3. Previous hip/vertebral fracture
  4. Further fractures during treatment
  5. High risk on FRAX scoring
  6. T score < -2.5 after treatment
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5
Q

If a patient has raised APTT, normal PT and thrombocytopenia, which condition is suspected?

A

Anti-phospholipid syndrome

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6
Q

On a full blood count, which readings will be characteristically high and also low for a patient with osteomalacia?

A

High - ALP

Low - Calcium, phosphates, vitamin D

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7
Q

What must NSAIDs be co-prescribed with?

A

PPIs

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8
Q

CREST syndrome is associated with which other rheumoatological condition?

A

Limitied cutaneous systemic sclerosis

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9
Q

The pencil in cup deformity is associated with which condition?

A

Psoriatic arthritis

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10
Q

Which conditions encompass CREST syndrome?

A
  1. Calcinosis
  2. Raynaud’s syndrome
  3. Oesophageal dysmotility
  4. Sclerodactyly
  5. Telangiestasia
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11
Q

After which length of time will patients be reviewed when taking bisphosphonates?

A

5 years

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12
Q

Which social factor increases the risk of AVN?

A

Alcohol excess

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13
Q

What is one of the earliest clinical signs for ankylosing spondylitis?

A

Reduced lateral flexion

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14
Q

Trochanteric bursitis is known by which other name?

A

Greater trochanteric pain syndrome

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15
Q

What is a severe side effect of hydroxychloroquine?

A

Severe and permanent retinopathy

(HEYEdroxychloroquine)

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16
Q

Which treatment works great for polymyalgia rheumatica?

A

15mg prednisolone

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17
Q

Isoniazid can cause which two major conditions?

A
  1. Lupus (drug induced)
  2. Peripheral neuropathy
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18
Q

What causes meralgia paraesthetica?

A

Compression of lateral cutaneous nerve

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19
Q

Bisphosphonates can cause ___________ problems

A

Bisphosphonates can cause oesophageal problems

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20
Q

Which class of drugs increases the risk of AVN?

A

Long term steroids

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21
Q

What will be done in a review after 5 years for a patient on bisphosphonates?

A

Update FRAX and DEXA scores

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22
Q

Which drug may cause drug-induced lupus?

A

Isoniazid

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23
Q

Which pulses are affected in Buerger’s disease?

A

Pedal pulses

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24
Q

What is the class of drugs which are first line for ankylosing spondylitis?

A

NSAIDs

(DMARDs too if peripheral joint involvement)

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25
Pseudogout causes changes in the joint space similar to which other condition?
OA
26
What is the classical sign associated with Buerger's disease on angiogram?
Tortuous corkscrew shaped collateral vessels
27
If a patient is deemed to be low risk for osteoporotic fracture during their 5 year review for bisphosphonates, how will their treatment be altered?
1. Discontinue bisphosphonate use 2. Reassess after 2 years or subsequent fracture
28
Behcet's syndrome involves a triad of which symptoms?
1. Oral ulcers 2. Genital ulcers 3. Anterior uveitis
29
Which test can be done for De Quervain's tenosynovitis?
Finkelstein's test
30
What are the normal ranges for ESR in a) Men b) Women
a) 0-22mm/hr b) 0-29mm/hr
31
Dactylitis is associated with which group of rheumatological conditions?
Seronegative arthropathies
32
Which type of people are commonyl affected by trochanteric bursitis?
1. Women 50-70 2. Runners
33
Keratoderma blenorrhagica is commonly seen in which rheumatological condition?
Reactive arthritis
34
ESR will be _______ in temporal arteritis
ESR will be **raised** in temporal arteritis
35
36
What is given to patients to counteract the development of drug induced peripheral neuropathy from taking isoniazid?
Pyridoxine | (a vitamin B6)
37
Polymyalgia rheumatica is assocuated with which type of onset?
Fast (\< 1 month)
38
What causes trochanteric bursitis?
Repeated movement of fibroelastic iliotibial tract (IT band)
39
How should a patient's medication for gout be altered during a flare up?
Remains the same (do not stop allopurinol for those already on it)
40
How can lateral epicondylitis be defined?
Pain at the lateral epicondyle worse on restricted wrist extension/supination whilst the elbow is extended
41
The femoral nerve stretch test will be positive when there is what?
Referred lumbar spine pain
42
What is the first line treatment for OA?
Paracetamol and topical NSAIDs (if knee/hand involvement)
43
Which type of inheritance is Ehler-Danlos syndrome associated with?
Autosomal dominant
44
In which population is Buerger's disease most common?
Young male smokers
45
If anti-phospholipid syndrome occurs as a secondary disease, which condition is it most likely to be assocuated with?
SLE
46
At which point will it be decided that a patient requires allopurinol for gout?
\>/= 2 attacks in 12 months
47
If a patient has an allergic reaction to aspirin, they have a high liklihood of also being allergic to which other drug?
Sulfasalazine
48
What percentage of patients with psoriasis suffer from a related athropathy?
10-20%
49
In terms of X-raying the ankle, what are the Ottaw rules in order to make a decision?
Pain in the malleolar zone plus one of: 1. Bony tenderness at lateral malleolar zone 2. Bony tenderness at medial malleolar zone 3. Inability to walk 4 weight bearing steps after injury and on presentation
50
Which DMARD is associated with hypertension?
Leflunomide
51
Reactive arthritis encompasses which syndrome?
Reiter's syndrome (a triad of uveitis, urethritis, arthritis)
52
Where is pain experienced in trochanteric bursitis?
Lateral side of thigh
53
Which sex and age bracket at most commonly affected by De Quervain's tenosynovitis?
Females 30-50
54
Drug induced lupus is associated with which antibodies?
Anti-histone antibodies
55
Which type of internal malignancy is associated with dermatomyositis?
1. Lung 2. Ovarian 3. Breast
56
Which antibiotics should be avoided with methotrexate?
Anti-folate antibiotics | (Trimethoprin and co-trimoxazole)
57
Why should anti-folate antibiotics be avoided with methotrexate?
Both have a risk of bone marrow aplasia | (additive folate depletion)
58
Which X-ray sign is pathognomonic of pseudogout?
Chondrocalcinosis | (visible calcification of cartilage)
59
Which antibody is associated with diffuse systemic sclerosis?
Anti-SCL 70
60
Which antibody is associated with limited systemic sclerosis?
Anti-centromere
61
In a patient with De Quervain's, where will pain be felt?
Radial side of wrist Tenderness over radial styloid process
62
Which drug can interfere with uric acid excretion?
High dose (600mg+) aspirin
63
What is osteopetrosis?
Marble bone disease Dense, thick bones prone to fracture
64
Which mode of inheritance is associated with Ehler-Danlos sydrome?
AD
65
Which test can be used for De Quervain's and what does it involve?
Finklestein's test Pain over radial styloid on forced flexion/abduction of thumb
66
Which DMARD is associated with causing hypertension?
Leflunomide
67
What does De Quervain's involve?
Inflammation of sheaths of extensor pollicis brevis and abductor pollicis longus tendons
68
Which type of problems do bisphosphonates commonly ellicit?
Oesophageal problems
69
Behcet's syndrome encompassess which triad?
1. Oral ulcers 2. Genital ulcers 3. Anterior uveitis
70
Which drug can cause an increase in atypical stress fractures in the proximal femoral shaft?
Alendronate
71
At which T-score should patients under 65 be offered bone protection if they are at risk of corticosteroid induced osteoporosis?
T \< 1.5
72
If a patient is taking warfarin or other anticoagulant, which type of ant-inflammatory medication should be avoided?
NSAIDs | (risk of gastric bleed)
73
The clinical manifestations of dermatomyositis are due to the effects of which antibody?
ANA
74
What is the normal range for platelets?
150-450 platelets/nL
75
If a patient with rheumatoid arthritis is going to have surgery, which X-rays should they have prior and why?
Anteroposterior and lateral cervical spine radiographs Atlanto-axial subluxation is associated with RA Precautions may be to be taken in surgery

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