MRCP Part 1 Rheumatology - Vocabulary Flashcards

Vocabulary-style practice flashcards generated strictly from the high-yield MRCP Part 1 Rheumatology lecture notes.

HLA-DR4

The HLA type most strongly associated with rheumatoid arthritis, present in $\sim 70\%$ of RA patients and $\sim 90\%$ of patients with Felty's syndrome.

Felty's syndrome

A complication characterized by the triad of rheumatoid arthritis, splenomegaly, and neutropenia.

Anti-CCP

The most specific antibody for rheumatoid arthritis ($90-95\%$ specificity), which also serves as the poorest prognostic marker in RA.

Rheumatoid factor

An antibody with $70-80\%$ sensitivity in RA but poor specificity, also present in Sjögren's, SLE, infective endocarditis, and systemic sclerosis.

DIP joints

Distal interphalangeal joints, which are characteristically spared in rheumatoid arthritis, helping distinguish RA from osteoarthritis and psoriatic arthritis.

LESS mnemonic

A mnemonic describing early/late X-ray changes in RA: Loss of joint space, Erosions, Soft tissue swelling, and Soft bones (osteopenia).

Rheumatoid pleural effusion

The most common cause of a low-glucose pleural effusion in patients with rheumatoid arthritis.

Cricoarytenoid arthritis

An RA complication that poses a risk for post-operative stridor or airway compromise, diagnosed via flow-volume loop spirometry.

Proteus mirabilis

An organism implicated in the pathogenesis of rheumatoid arthritis in susceptible individuals.

Systemic (AA) amyloidosis

A renal complication suspected in poorly controlled RA with proteinuria and hypoalbuminaemia, requiring rectal biopsy for diagnosis.

2010 ACR RA classification threshold

A diagnostic threshold score of $\ge 6/10$ across joint involvement, serology, acute-phase reactants, and symptom duration to classify definite RA.

ANA (Antinuclear antibody)

The best initial screening test for SLE, positive in $99\%$ of cases; a negative result carries the highest negative predictive value.

Anti-Smith antibody

The antibody most specific for SLE ($> 99\%$ specific), though it has a low sensitivity of only $30\%$.

Anti-dsDNA antibody

An antibody that directly correlates with SLE disease activity and is used for monitoring disease flares.

Active SLE complement pattern

A serum pattern showing low $C3$ and $C4$ levels due to complement consumption by circulating immune complexes.

Anti-Ro (SSA) and anti-La (SSB)

Maternal antibodies strongly associated with neonatal lupus and congenital heart block.

Jaccoud's arthropathy

Gross hand deformities without joint erosion, caused by recurrent synovitis damaging tendons; seen in SLE, rheumatic fever, and Parkinson's.

Antihistone antibodies

Antibodies present in $95\%$ of drug-induced lupus cases, where anti-dsDNA is typically negative.

APTT paradox in APS

The key laboratory paradox in antiphospholipid syndrome consisting of a prolonged APTT ex-vivo despite a strong clinical predisposition to thrombosis.

Lupus anticoagulant

An antiphospholipid antibody that serves as the single greatest predictor of future thrombosis in antiphospholipid syndrome.

Jaw claudication

The most specific clinical sign of Giant Cell Arteritis (GCA), present in $65\%$ of affected patients.

Temporal artery biopsy

The definitive diagnostic test for GCA, which can be falsely negative in up to $50\%$ of cases due to skip lesions.

Monosodium urate crystals

Needle-shaped, negatively birefringent crystals seen under polarized microscopy in acute gout.

Rat-bite erosions

Classic radiological finding in chronic gout consisting of 'punched-out' erosions with overhanging edges.

Allopurinol

First-line urate-lowering drug, strictly contraindicated in individuals carrying the HLA-B*5801 allele due to severe SJS/TEN risk.

Calcium pyrophosphate crystals

Rhomboid-shaped, weakly positively birefringent crystals found in joint aspirates in pseudogout.

Chondrocalcinosis

The pathognomonic X-ray finding of cartilage calcification seen in pseudogout.

HLA-B27

Human leukocyte antigen allele positive in $90-95\%$ of patients with ankylosing spondylitis.

Bone marrow oedema

The earliest pathological change detected on MRI in patients with ankylosing spondylitis.

Anterior uveitis

The most common extra-articular manifestation of ankylosing spondylitis, occurring in $\sim 40\%$ of cases.

Syndesmophytes

Vertical bony outgrowths formed by ossification of the annulus fibrosus in ankylosing spondylitis ('bamboo spine'), contrasting with horizontal osteophytes.

Schober's test

A quantitative clinical test used to evaluate restriction of lumbar spine flexion in ankylosing spondylitis.

Pencil-in-cup deformity

Classic radiological appearance of DIP joint erosion and collapse seen in psoriatic arthritis.

Reactive arthritis triad

The classic Reiter's syndrome triad consisting of urethritis, conjunctivitis, and arthritis.

Anti-centromere antibody

The antibody characteristically positive in limited cutaneous systemic sclerosis (CREST syndrome).

CREST syndrome

A subtype of limited systemic sclerosis defined by Calcinosis, Raynaud's, oEsophageal dysmotility, Sclerodactyly, and Telangiectasia.

Anti-Scl-70 (anti-topoisomerase I)

Antibody strongly associated with diffuse cutaneous systemic sclerosis and severe interstitial lung disease.

Anti-RNA polymerase III

Antibody associated with scleroderma renal crisis and an increased risk of underlying malignancy.

Labial gland biopsy

Minor salivary gland biopsy that serves as the most definitive diagnostic test for Sjögren's syndrome.

Schirmer's test

An objective test measuring tear production; defined as positive if there is $< 5\,\text{mm}$ wetting in $5\,\text{minutes}$.

Henoch-Schönlein purpura (HSP)

An IgA-mediated small vessel vasculitis featuring a classic tetrad of purpura, abdominal pain, arthritis, and renal involvement.

Leukocytoclastic vasculitis

The pathognomonic skin biopsy appearance in HSP demonstrating small vessel vasculitis with IgA immune deposition.

Anti-Jo-1

The defining antibody of antisynthetase syndrome, characteristically presenting with ILD, Raynaud's, fever, and mechanic's hands.

Anti-Mi-2

An antibody highly specific ($\sim 25\%$ sensitive) for dermatomyositis.

Heliotrope rash and Gottron's papules

The two pathognomonic cutaneous manifestations of dermatomyositis, affecting the periorbital area and extensor digits respectively.

Pathergy test

A skin hypersensitivity test that is specific to Behçet's syndrome.

c-ANCA (PR3-ANCA)

ANCA pattern targeting proteinase-3, highly associated with granulomatosis with polyangiitis (GPA/Wegener's).

p-ANCA (MPO-ANCA)

ANCA pattern targeting myeloperoxidase, predominantly associated with microscopic polyangiitis.

Churg-Strauss syndrome (EGPA)

A systemic vasculitis characterized by a clinical triad of asthma, paranasal sinusitis, and blood eosinophilia.

Takayasu's arteritis

A large-vessel vasculitis classically affecting young women ($8:1$ female predominance) aged $25-30$, presenting with absent limb pulses or blood pressure disparity.

Looser's zones

Transverse pseudofractures visible on plain radiographs, characteristic of adult osteomalacia.

Anti-U1 RNP

High-titre antibody required to establish the diagnosis of mixed connective tissue disease (MCTD).

Adult-onset Still's disease

A disease characterized by quotidian fever $> 39\,^{\circ}\text{C}$, arthralgia, salmon-pink rash, negative RF/ANA, and markedly elevated serum ferritin with low glycosylated fraction.

Meltzer's triad

The clinical triad of palpable purpura, arthralgia, and myalgia, pathognomonic for cryoglobulinaemia.

Finkelstein's test

A physical exam maneuver used to diagnose De Quervain's tenosynovitis of the extensor pollicis brevis and abductor pollicis longus tendons.