Rheumatology - Flashcards

A comprehensive set of flashcards covering key rheumatology facts, diseases, antibodies, treatments, and drug mechanisms from the notes.

What is the main non-collagenous protein in bone?

Osteocalcin

Rheumatoid factor is an IgM antibody that reacts with?

The Fc portion of IgG

Felty’s syndrome consists of which three components?

Rheumatoid arthritis with splenomegaly and neutropenia

When should TNF blockers (e.g., etanercept, adalimumab) be stopped before major surgery?

2–4 weeks prior to the procedure

What therapy is used for chronic fatigue syndrome in graded exercise therapy?

Graded exercise therapy

In compartment syndrome, when is an open fasciotomy indicated?

If compartment pressure > 40 mmHg

Type I cryoglobulinaemia associations?

Myeloma, Waldenström’s macroglobulinaemia, Raynaud’s phenomenon

Type II cryoglobulinaemia associations?

Hepatitis C, rheumatoid arthritis, Sjögren’s syndrome, systemic lupus erythematosus

Type III cryoglobulinaemia associations?

Rheumatoid arthritis and Sjögren’s syndrome

Name drugs commonly causing drug-induced lupus.

Procainamide, hydralazine, simvastatin, isoniazid, phenytoin, penicillamine

Which genetic disorder can predispose to gout?

Lesch–Nyhan syndrome

Canakinumab may be considered for gout when which therapies are contraindicated?

Steroids, colchicine, and NSAIDs

What effect does allopurinol have on azathioprine?

Increases toxicity of azathioprine

Allopurinol can increase INR; rasburicase is a better choice for warfarinised patients but not licensed. True or false?

True (rasburicase is a better choice but not licensed for warfarinised patients)

High alkaline phosphatase with normal/low calcium/phosphate/vitamin D suggests which conditions?

Paget’s disease or osteomalacia

Interpreting T scores: what does T < -2.5 indicate and what does -1 to -2.5 indicate?

T < -2.5 = osteoporosis; T between -1 and -2.5 = osteopenia

What is the recommended sequence of osteoporosis therapies?

Bisphosphonates → Denosumab → Strontium → Teriparatide

Bisphosphonates are contraindicated under what eGFR value?

eGFR < 35 ml/min/1.73 m²

First-line treatment for Behçet’s disease?

Colchicine

Amyloidosis types and associations.

AL: light-chain type (MM, lymphoma); AA: reactive (IBD, SLE, RA, vasculitis, TB); aTTR: hereditary or wild-type transthyretin amyloidosis

What test is most definitive for Sjögren’s syndrome?

Labial gland biopsy

SLE is commonly associated with which type of glomerulonephritis?

Diffuse proliferative glomerulonephritis

Still’s disease (JIA) presents with what triad?

Arthralgia, daily fevers, salmon-pink rash

Reduced DLCO is seen in which disease?

Systemic sclerosis

Scleroderma renal crisis features?

Severe hypertension, renal failure/AKI, heart failure, hemolytic anemia

Polyarteritis nodosa (PAN) is a type III hypersensitivity and can affect which organs?

Any organ except the lungs; PAN should be suspected in young patients with stroke or MI; biopsy shows fibrinoid necrosis in medium-sized vessels with pleomorphic cellular infiltrate

Wegener’s granulomatosis (GPA) treatment?

Prednisolone + cyclophosphamide

EPGA is associated with which disorder and what kidney lesion does it cause?

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss); necrotising crescentic glomerulonephritis

SAPHO syndrome stands for which features?

Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis

SLE antibody profile?

ANA, anti-dsDNA, anti-Smith (Sm)

Drug-induced lupus antibody?

Anti-histone antibodies

Neonatal lupus antibody?

Anti-Ro (SS-A)

Sjögren’s syndrome antibodies?

Anti-Ro (SS-A) and Anti-La (SS-B)

Inclusion Body Myositis (IBM) characteristic features?

Painless weakness with selective involvement of long finger flexors and quadriceps; asymmetric

Multicentric reticulohistocytosis features?

Erosive changes in multiple joints + nail-fold nodules that look like coral beads

Relapsing polychondritis hallmark symptoms?

Ear pain, epistaxis, saddle-shaped nose, conjunctivitis, fever, possible encephalitis

Familial Mediterranean Fever (MEFV) inheritance and features?

Autosomal recessive; fever, abdominal pain, pleuritis, pericarditis, arthritis; MEFV gene; treatment: colchicine, anakinra

Antibodies and associated cancers: Anti-Hu (ANNA-1)

Small cell lung cancer; sensory neuropathy, encephalomyelitis

Anti-Yo (PCA-1) antibodies and associated cancers?

Ovarian or breast cancer; cerebellar degeneration

Anti-Ri (ANNA-2) antibodies and associated cancers?

Breast or lung cancer; opsoclonus–myoclonus and brainstem encephalitis

Anti-CV2/CRMP5 antibodies associations?

Small cell lung cancer or thymoma; chorea and peripheral neuropathy

Anti-Ma2 antibodies associations?

Testicular cancer; limbic/brainstem encephalitis

Anti-amphiphysin antibodies associations?

Breast cancer and small cell lung cancer; stiff-person syndrome

Anti-recoverin antibodies associations?

Small cell lung cancer; retinopathy

Anti-Zic4 antibodies associations?

Small cell lung cancer; cerebellar syndrome

Drugs and MOA: NSAIDs mechanism

Inhibit COX-1 and COX-2 → decreased prostaglandin synthesis; anti-inflammatory and analgesic

Colchicine mechanism

Inhibits microtubule polymerization → decreased neutrophil activation

What are examples of JAK inhibitors (tsDMARDs)?

Tofacitinib, Baricitinib, Upadacitinib

Xanthine oxidase inhibitors and examples

Allopurinol, Febuxostat

Uricosuric agents and examples

Probenecid, Benzbromarone