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Flashcard 150896345

Tags

#medicine #rheumatology

Question

What are the Red ﬂags for sinister causes of back pain ?

Answer

Aged < 20 yrs or > 55 yrs old
Acute onset in elderly people
Constant or progressive pain
Nocturnal pain
Worse pain on being supine
Fever, night sweats, weight loss
History of malignancy
Abdominal mass
Thoracic back pain
Morning stiff ness
Bilate al or alternating leg pain
Neurological disturbance (incl sciatica)
Sphincter disturbance
Current or recent infection
Immunosuppression, eg steroids/ HIV
Leg claudication or exercise-related leg weakness/ numbness (spinal stenosis)

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Flashcard 150896352

Tags

#medicine #rheumatology

Question

What nerve roots does the Straight leg test ?

Answer

L4 , L5 , S1

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Flashcard 150896359

Tags

#medicine #rheumatology

Question

What are the likely causes of back pain in adults > 50 yrs

Answer

Degenerative,
osteoporotic vertebral collapse,
Paget’s Disease
malignancy
Multiple Myeloma
spinal stenosis

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Flashcard 150896366

Tags

#medicine #rheumatology

Question

What are the most likely causes of back pain in adults 15 – 30 yrs?

Answer

Prolapsed disc
trauma
fractures
ankylosing spondylitis ( AS ; p 552 )
spondylolisthesis (a forward shift of one vertebra over another, which is congenital or due to trauma)
pregnancy

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Flashcard 150896373

Tags

#medicine #rheumatology

Question

What are the most likely causes of back pain in adults 30 – 50 yrs ?

Answer

Degenerative spinal disease
prolapsed disc
malignancy

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Flashcard 150896380

Tags

#medicine #rheumatology

Question

What are the important blood test to perform in Back Pain ?

Answer

FBC , ESR and CRP (myeloma, infection, tumour), U&E , ALP (Paget’s ), serum/urine electrophoresis (myeloma), PSA .

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Flashcard 150896387

Tags

#medicine #rheumatology

Question

What are the features of Acute cauda equina compression?

Answer

Alternating or bilateral root pain in legs
Saddle anaesthesia (perianal)
Loss of anal tone on PR
Bladder ± bowel incontinence

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Flashcard 150896394

Tags

#medicine #rheumatology

Question

What are the features of Acute cord compression?

Answer

Bilateral pain
LMN signs (p 451 ) at level of compression
UMN and sensory loss below
Sphincter disturbance

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Flashcard 150896401

Tags

#medicine #rheumatology

Question

What is the most common joint condition ?

Answer

Osteoarthritis (OA)

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Flashcard 150896408

Tags

#medicine #rheumatology

Question

What is the typical age of onset for Osteoarthritis ??

Answer

onset typically >50 yrs

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Flashcard 150896415

Tags

#medicine #rheumatology

Question

What are the commonly affected joints in Osteoarthritis?

Answer

DIP joints
Thumb carpometacarpal joints
Knees

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Flashcard 150896425

Tags

#medicine #rheumatology

Question

What are the symptoms of Localized osteoarthritis ?

Answer

Pain on movement and crepitus
Worse at end of day
Background pain at rest
Joint gelling — stiffness after rest up to ~ 30 min
Joint instability

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Flashcard 150896432

Tags

#medicine #rheumatology

Question

What are the clinical signs associated with Osteoarthritis ?

Answer

Joint tenderness
Derangement and bony swelling (Heberden’s nodes at DIP, Bouchard’s nodes at PIP )
Decreased Range of movement
Mild synovitis

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Flashcard 150896439

Tags

#medicine #rheumatology

Question

What are the aspects of Management in Osteoarthritis?

Answer

Multidisciplinary approach
Exercise
Weight lost
Regular paracetamol ± topical NSAID
Joint replacement - Last Resort

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Flashcard 150896446

Tags

#medicine #rheumatology

Question

What is the most commonly affected Joint in Septic Arthritis ?

Answer

The knee is affected in >50 % cases

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Flashcard 150896453

Tags

#medicine #rheumatology

Question

What are the risk factors for Septic Arthritis?

Answer

Pre-existing joint disease (especially rheumatoid arthritis)
Diabetes mellitus
Immunosuppression
Chronic renal failure
Recent joint surgery
Prosthetic joints (where infection is particularly difficult to treat)
IV drug abuse
Age >80 yrs

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Flashcard 150896460

Tags

#medicine #rheumatology

Question

What is the key investigation in Septic Arthritis ?

Answer

Urgent joint aspiration for synovial ﬂuid microscopy and culture

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Flashcard 150896467

Tags

#medicine #rheumatology

Question

What are the common causative organisms of Septic Arthritis ?

Answer

Staph. aureus
Streptococci
Neisseria gonococcus
Gram – ve bacilli

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Flashcard 150896474

Tags

#medicine #rheumatology

Question

What is the management for Septic Arthritis?

Answer

Flucloxacillin
Splint for ≤ 48 h
Adequate analgesia
Physiotherapy.

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Flashcard 150896481

Tags

#medicine #rheumatology

Question

What are the two main side effects with NSAIDs ?

Answer

Gastrointestinal bleeding and Renal impairment

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Flashcard 150896488

Tags

#medicine #rheumatology

Question

What information should be provided to Patients when receiving NSAID medication ?

Answer

Drugs are to relieve symptoms: on good days, don’t take any. In rheumatoid arthritis, cod liver oil (eg 10 g/d) reduces reliance on NSAID S by 30 %.
Abdominal pain may be a sign of impending GI problems: stop the tablets, and come back for more advice if symptoms continue.
Report black stools ± faints at once.
Don’t supplement prescribed NSAID with ones bought over the counter (eg ibuprofen): mixing NSAID can increase risks 20 -fold.
Smoking and alcohol increase NSAID risk

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Flashcard 150896495

Tags

#medicine #rheumatology

Question

What is the cardiovascular risk associated with NSAIDs ?

Answer

small increased risk of MI and stroke

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Article 150896510

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202007000100010

Flashcard 150896515

Tags

#medicine #rheumatology

Question

What is Rheumatoid Arthritis?

Answer

A chronic systemic inﬂammatory disease, characterized by a symmetrical, deforming, peripheral polyarthritis.

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Flashcard 150896522

Tags

#medicine #rheumatology

Question

What is the Genetic Links in Rheumatoid Arthritis ?

Answer

HLA DR4 / DR1 linked

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Flashcard 150896529

Tags

#medicine #rheumatology

Question

What is the typical presentation of Rheumatoid Arthritis ?

Answer

Symmetrical swollen, painful, and stiff small joints of hands and feet, worse in the morning. This can ﬂuctuate and larger joints may become involved.

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Flashcard 150896536

Tags

#medicine #rheumatology

Question

What are the features of Felty's Syndrome ?

Answer

Felty’s syndrome: Rheumatoid Arthritis + splenomegaly + neutropenia

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Flashcard 150896543

Tags

#medicine #rheumatology

Question

What are the features of Early Rheumatoid Arthritis ?

Answer

Early (inﬂammation, no joint damage): swollen MCP, PIP, wrist, or MTP joints (often symmetrical). Look for tenosynovitis or bursitis

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Flashcard 150896550

Tags

#medicine #rheumatology

Question

What are the features of Late Rheumatoid Arthritis ?

Answer

Later (joint damage, deformity): ulnar deviation of the ﬁngers and dorsal wrist subluxation. Boutonnière and swan-neck deformities of ﬁngers or Z -deformity of thumbs occur.

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Flashcard 150896557

Tags

#medicine #rheumatology

Question

What are the Extra Articular Features of Rheumatoid Arthritis ?

Answer

Nodules — elbows & lungs
lymphadenopathy
vasculitis
Fibrosing alveolitis
Obliterative bronchiolitis
Pleural & pericardial effusion
splenomegaly
episcleritis
scleritis
scleromalacia
keratoconjunctivitis sicca
osteoporosis
amyloidosis

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Flashcard 150896564

Tags

#medicine #rheumatology

Question

What is the relationship between Rheumatoid Factor and Disease Severity ?

Answer

A high titre is associated with severe disease, erosions and extra-articular disease.

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Flashcard 150896571

Tags

#medicine #rheumatology

Question

What antibody is highly specific for Rheumatoid Arthritis ?

Answer

Anticyclic citrullinated peptide antibodies ( ACPA /anti- CCP ) are highly speciﬁc (~ 98 %) for RA

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Flashcard 150896578

Tags

#medicine #rheumatology

Question

What are the side effects of Methotrexate ?

Answer

pneumonitis (get urgent respiratory help),
oral ulcers,
hepatotoxicity
Immunosuppression

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Flashcard 150896585

Tags

#medicine #rheumatology

Question

What is used to assess the disease activity of Rheumatoid Arthritis ?

Answer

28 joint Disease Activity Score

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Flashcard 150896592

Tags

#medicine #rheumatology

Question

What joint is most commonly affected by Gout ?

Answer

>50 % occur at the metatarsophalangeal joint of the big toe

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Flashcard 150896599

Tags

#medicine #rheumatology

Question

How does Gout typically present ?

Answer

An acute monoarthropathy with severe joint inﬂammation

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Flashcard 150896606

Tags

#medicine #rheumatology

Question

What biochemical increase is Gout associated with ?

Answer

It is associated with raised plasma urate.

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Flashcard 150896613

Tags

#medicine #rheumatology

Question

What are the possible aetiologies of Gout ?

Answer

Hereditary
Dietary purines
Alcohol excess
Diuretics
Leukaemia
Cytotoxics (tumour lysis)

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Flashcard 150896620

Tags

#medicine #rheumatology

Question

What does Polarized light microscopy of synovial ﬂuid in suspected Gout show ?

Answer

Negatively birefringent urate crystals

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Flashcard 150896627

Tags

#medicine #rheumatology

Question

How should Acute Gout be treated ?

Answer

High-dose NSAID or coxib
Rest and Elevation of Joint
Ice Packs

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Flashcard 150896634

Tags

#medicine #rheumatology

Question

When should Gout Prophylaxis be started ?

Answer

Start if >1 attack in 12 months, tophi or renal stones.

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Flashcard 150896641

Tags

#medicine #rheumatology

Question

What medication is used in Gout Prophylaxis ?

Answer

Allopurinol

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Flashcard 150896648

Tags

#medicine #rheumatology

Question

What lifestyle changes can help prevent Gout ?

Answer

Lose weight.
Avoid prolonged fasts, alcohol excess, purine-rich meats and low-dose aspirin

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Flashcard 150896655

Tags

#medicine #rheumatology

Question

How does Pseudogout (acute CPP Crystal Arthritis) typically present ?

Answer

an acute monoarthropathy typically of larger joints in elderly patients.

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Flashcard 150896662

Tags

#medicine #rheumatology

Question

What does the polarized light microscopy of synovial ﬂuid show in Calcium Pyrophosphate Deposition ?

Answer

Weakly positively birefringent crystals

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Flashcard 150896669

Tags

#medicine #rheumatology

Question

How should CPPD acute attacks be managed ?

Answer

cool packs
rest
aspiration
intra-articular steroids

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Annotation 150896681

any na portalach randkowych marzy tylko o tym, by wybrać się na randkę bez zobowiązań, ze śniadaniem... Czy tak jest faktyczni

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last reprioritisation on		suggested re-reading day
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Seks bez zobowiązań - czy każdy facet to lubi? - Sympatia.pl
Spotkania bez zobowiązań to podobno idealne rozwiązanie dla większości mężczyzn. Utarło się, że prawie każdy facet zalogow<span>any na portalach randkowych marzy tylko o tym, by wybrać się na randkę bez zobowiązań, ze śniadaniem... Czy tak jest faktycznie? Mę

Annotation 150896685

no idealne rozwiązanie dla większości mężczyzn. Utarło się, że prawie każdy facet zalogow any na portalach randkowych

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last reprioritisation on		suggested re-reading day
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Seks bez zobowiązań - czy każdy facet to lubi? - Sympatia.pl
Stock Spotkania bez zobowiązań to podob<span>no idealne rozwiązanie dla większości mężczyzn. Utarło się, że prawie każdy facet zalogowany na portalach randkowych marzy tylko o tym, by wybrać się na randkę bez zobowiązań, ze śniadaniem... Czy tak jest faktycznie? &#1

Annotation 150896700

e-management,

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started reading on		finished reading on

Super Memory
Super Memory Super Memory: Forget about forgetting This website is devoted to improving memory, self-growth, creativity, time-management, and speed-learning software SuperMemo (see: Site Summary for a quick overview) Articles: Good sleep for good learningGenius and creativitySix steps to excellent memo

Edited, memorised or added to reading queue

on 18-Jun-2015 (Thu)

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