Yearclub Revision

Question 1

What antibodies are raised in anti-phospholipid syndrome?

Answer 1

ANA (unspecific)
Anti-cardiolipin
Lupus anticoagulant

Question 2

What antibody is diagnostic in SLE?

Answer 2

Anti-dsDNA

Question 3

What disease is associated with gritty eyes and dry mouth?

Answer 3

Sjogrens syndrome

Question 4

What are the symptoms of limited vs diffuse systemic sclerosis?

Answer 4

Both: Raynauds phenomenon,
Limited: tight/thickened skin below elbows and knees + face
Diffuse: tight/thickened skin all over including torso

Question 5

What antibody is positive in limited and diffuse systemic sclerosis (CREST)?

Answer 5

Limited: anti-centromere
Diffuse: anti scl-70

Question 6

What effect does anti-phospholipid syndrome have on pregnancy?

Answer 6

Repeat miscarriages

Question 7

How is anti-phospholipid syndrome treated?

Answer 7

Lifelong LMWH (warfarin teratogenic)

Question 8

How is polymyalgia rheumatic managed?

Answer 8

Steroids

Question 9

What is the difference between polymyositis and polymyalgia rheumatic presentation?

Answer 9

Both: Pain and stiffness

Polymyositis = weakness

Question 10

What is the risk with bilateral leg symptoms and indication of bladder or bowel disturbance?

Answer 10

Cauda Equina syndrome

Question 11

How is Cauda Equina syndrome investigated?

Answer 11

Urgent MRI + PR

MRI = determine level of disc prolapse

Question 12

How is cauda equina syndrome managed?

Answer 12

Urgent discectomy (to relieve pressure)

Question 13

What injury is associated with lifting something heavy and is worse on coughing? How is it managed?

Answer 13

Acute disc prolapse

Conservative management

Question 14

Who does spinal stenosis present in?

Answer 14

Older people

Long history

Question 15

How is an osteochondroma treated?

Answer 15

Radio + chemotherapy

Question 16

What increases the risk of avascular necrosis?

Answer 16

Long term steroids
Excess of alcohol,
Chemotherapy,
Trauma

Question 17

What is the most common infecting organism in septic arthritis and how does it present compared to osteomyelitis?

Answer 17

Sudden onset pain (much worse than osteomyelitis)

Staph, aureus

Question 18

How is a subtrochanteric fracture managed?

Answer 18

IM nail

Question 19

How is a femoral shaft fracture managed initially then definitively?

Answer 19

Initial: Thomas splint
Definitive: Closed reduction with IM nail

Question 20

What nerve is injured in foot drop?

Answer 20

Common fibular nerve (knee dislocation)

Question 21

What nerve is injured in wrist drop?

Answer 21

Radial nerve (posterior arm muscles)

Question 22

What antibodies are indicated in GPA, EGPA and MPA and against what?

Answer 22

GPA: cANCA against PR3
EGPA: pANCA against MPO
MPA: pANCA against MPO

Question 23

What is Behçets disease and how does it present?

Answer 23

Systemic vasculitis of unknown cause

Presents with oral and genital ulcers, ocular/GI involvement

Question 24

How is Behçets disease investigated?

Answer 24

Skin pathergy test

On needle prick, papule forms within 48 hours

Question 25

What is Bergers disease and how does it present?

Answer 25

``` IgA nephropathy (glomerulonephritis) Presents with haematuria ```

Question 26

What is Henoch-Schönlein purpura and how does it present?

Answer 26

Small vessel vasculitis | Presents in children following an URTI with lower limb purpuric rash (+/- arthritis of knees, ankles and elbows)

Question 27

What is Ehler-Danlos syndrome and what causes it?

Answer 27

Hypermobility syndrome | Due to defect in collagen

Question 28

What is the difference between epimysium, perimysium and endomysium?

Answer 28

Epimysium: surrounds whole muscle Perimysium: surrounds single fascicle Endomysium: surrounds single muscle fibre

Question 29

What is the progression in units of a muscle?

Answer 29

Sarcomere < myofibril < muscle fibre < fascicles | Sarcomere = smallest functional unit

Question 30

What lines in a muscle fibre divide individual sarcomeres?

Answer 30

Z lines

Question 31

What is the difference between isotonic and isometric muscle contractions?

Answer 31

IsoTonic: Tension remains constant (movement) IsoMetric: length (in Metres) remains constant (postural)

Question 32

Who does SUFE vs Perthes present in?

Answer 32

SUFE: overweight boys Perthes: hyperactive young boys

Question 33

What are Ortolani and Barlow gets used for?

Answer 33

DDH (dislocation/relocation)

Question 34

What type of arthritis involves the DIP joints?

Answer 34

Osteoarthritis

Question 35

What is the difference between a Galeazzi and Monteggia injury?

Answer 35

GRUesome MURder GRU: galeazzi, radial fracture, ulnar dislocation MUR: monteggia, ulnar fracture, radial dislocation

Question 36

what antibody is used for diagnosis of RA?

Answer 36

Anti-CCP

Question 37

What is the first line treatment of RA and what is used if risk of pregnancy?

Answer 37

Methotrexate (teratogenic) | Sulfasalazine (if risk of pregnancy)