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Flashcard 150896706

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#medicine #rheumatology

Question

What is Ankylosing spondylitis ?

Answer

a chronic inﬂammatory disease of the spine and sacroiliac joints, of unknown aetiology

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Flashcard 150896713

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#medicine #rheumatology

Question

What gene is commonly present in Ankylosing Spondylitis ?

Answer

HLA B27

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Flashcard 150896720

Tags

#medicine #rheumatology

Question

What is the prevalence of Ankylosing Spondylitis ? (Who do we most commonly see it in)

Answer

Men present earlier ≈ 6:1 at 16 yrs old, and ~ 2:1 at 30 yrs old

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Flashcard 150896727

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#medicine #rheumatology

Question

What is the classical Ankylosing Spondylitis presentation ?

Answer

a man <30 yrs old with gradual onset of low back pain, worse at night, with spinal morning stiff ness relieved by exercise. Pain radi ates from sacroiliac joints to hips/buttocks, and usually improves towards the end of the day. There is progressive loss of spinal movement.

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Flashcard 150896734

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#medicine #rheumatology

Question

What are the extra-articular manifestations of Ankylosing Spondylitis ?

Answer

Acute iritis
osteoporosis (up to 60 %),
aortic valve incompetence ( <3 %)
pulmonary apical fibrosis
Psoriasiform Rashes
Oral Ulcers
Inflammatory Bowel Disease

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Flashcard 150896750

Tags

#medicine #rheumatology

Question

What is a bamboo spine associated with ?

Answer

Ankylosing Spondylitis

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Flashcard 150896757

Tags

#medicine #rheumatology

Question

What are the Spondyloarthropathies ? (4)

Answer

Ankylosing Spondylitis
Enteropathic Spondylitis
Psoriatic Arthritis
Reactive Arthritis

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Flashcard 150896764

Tags

#medicine #rheumatology

Question

What are the steps of Treatment in Ankylosing Spondylitis ?

Answer

Exercise and Physiotherapy
NSAIDs (TNF alpha blockers are second line)
Local Steroid Injection
Consider Bisphosphonates (Increased Osteoporotic Spinal Fractures)

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Flashcard 150896771

Tags

#medicine #rheumatology

Question

What conditions are associated with Enteric Arthropathy ?

Answer

Inﬂammatory bowel disease
GI bypass
Coeliac Disease
Whipple’s disease

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Flashcard 150896778

Tags

#medicine #rheumatology

Question

What is Reiter's Syndrome

Answer

A triad of urethritis, arthritis, and conjunctivitis

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Flashcard 150896791

Tags

#medicine #rheumatology

Question

What often proceeds Reactive Arthritis ?

Answer

Urethritis (Chlamydia or Ureaplasma sp.)
Dysentery (Campylobacter, Salmonella, Shigella, or Yersinia sp.)

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Flashcard 150896798

Tags

#medicine #rheumatology

Question

What is a Reactice Arthritis ?

Answer

A sterile arthritis

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Flashcard 150896805

Tags

#medicine #rheumatology

Question

How long after infection does Reactive Arthritis Present ?

Answer

1 – 4 weeks

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Flashcard 150896812

Tags

#medicine #rheumatology

Question

What other conditions may be associated with Reactive Arthritis ?

Answer

Iritis
Keratoderma blenorrhagica (brown, raised plaques on soles and palms)
Circinate balanitis (painless penile ulceration secondary to Chlamydia)
Mouth ulcers
Enthesitis

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Flashcard 150896819

Tags

#medicine #rheumatology

Question

What are the important investigations in Reactive Arthritis ?

Answer

FBC
ESR & CRP
Culture stool if diarrhoea
Infectious serology
Sexual health review

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Flashcard 150896826

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#medicine #rheumatology

Question

What is Dactylitis

Answer

Inﬂammation of an entire digit (‘sausage digit’), due to soft tissue oedema, and tenosynovial and joint inﬂammation.

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Flashcard 150896833

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#medicine #rheumatology

Question

What is Enthesitis ?

Answer

Inﬂammation of the site of insertion of tendon or ligament into bone. (eg plantar fasciitis, Achilles tendonitis, costochondritis)

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Flashcard 150896840

Tags

#medicine #rheumatology

Question

What are the common features of Spondyloarthropathies ? (7)

Answer

Seronegativity ( = rheumatoid factor – ve).
HLA B27 association
‘Axial arthritis’: pathology in spine (spondylo-) and sacroiliac joints.
Asymmetrical large-joint oligoarthritis (ie <5 joints) or monoarthritis.
Enthesitis
Dactylitis
Extra-articular manifestations

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Flashcard 150896847

Tags

#medicine #rheumatology

Question

What are the Autoimmune connective tissue diseases ?

Answer

SLE
Systemic sclerosis
Primary Sjögren’s syndrome
Idiopathic inﬂammatory myopathies
Mixed connective tissue disease
Relapsing polychondritis
Behçet’s disease

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Flashcard 150896854

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#medicine #rheumatology

Question

What parts of the body does Limited cutaneous systemic sclerosis affect ?

Answer

face, hands and feet

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Flashcard 150896861

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#medicine #rheumatology

Question

What antibody is associated with Limited cutaneous systemic sclerosis ?

Answer

anticentromere antibodies

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Flashcard 150896868

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#medicine #rheumatology

Question

What are the clinical features of Limited cutaneous systemic sclerosis ?

Answer

(CREST syndrome)

Calcinosis (subcutaneous tissues)
Raynaud’s
Esophageal and gut dysmotility
Sclerodactyly (swollen tight digits)
Telangiectasia

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Flashcard 150896875

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#medicine #rheumatology

Question

What is often present in Limited cutaneous systemic sclerosis as a subclinical condition ?

Answer

Pulmonary hypertension

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Flashcard 150896882

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#medicine #rheumatology

Question

What antibodies are associated with Diffuse cutaneous systemic sclerosis ?

Answer

Antitopoisomerase- 1 [Scl 70 ] antibodies and anti- RNA polymerase

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Flashcard 150896889

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#medicine #rheumatology

Question

What conditions are associated with Relapsing polychondritis

Answer

aortic valve disease
polyarthritis
vasculitis

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Flashcard 150896896

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#medicine #rheumatology

Question

Where does a Relapsing polychondritis typically affect ?

Answer

The pinna (ﬂoppy ears)
Nasal septum,
Larynx (hence stridor)
Joints

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Flashcard 150896903

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#medicine #rheumatology

Question

How is Systemic Sclerosis Treated ?

Answer

Immunosuppressive regimens
Monitor BP and renal function
Regular ACE - i or A2RB
Raynaud's Treatment

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Flashcard 150896916

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#medicine #rheumatology

Question

How does Polymyositis and Dermatomyositis present ?

Answer

insidious onset of progressive symmetrical proximal muscle weakness and autoimmune-mediated striated muscle inﬂammation (myositis), associated with myalgia ± arthralgia.

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Flashcard 150896923

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#medicine #rheumatology

Question

What are the extra muscular signs of Polymyositis and Dermatomyositis ?

Answer

Fever
Arthralgia
Raynaud’s
Interstitial lung ﬁbrosis
Myocardial involvement (myocarditis, arrhythmias).

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Flashcard 150896930

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#medicine #rheumatology

Question

What are the skin signs in Dermatomyositis ?

Answer

Macular rash (shawl sign is + ve if over back & shoulders)
Lilac-purple (heliotrope) rash on eyelids often with oedema
Nailfold erythema (dilated capillary loops)
Gottron’s papules
Subcutaneous calciﬁcations

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Flashcard 150896937

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#medicine #rheumatology

Question

What antibodies are associated with Polymyositis and dermatomyositis ?

Answer

anti- Mi2
anti- Jo1

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Flashcard 150896944

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#medicine #rheumatology

Question

What are the Muscle enzymes ?

Answer

ALT, AST, LDH, CK & aldolase

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Flashcard 150896951

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#medicine #rheumatology

Question

How is Polymyositis and Dermatomyositis treated ?

Answer

Prednisolone

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Flashcard 150896958

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#medicine #rheumatology

Question

What is Systemic lupus erythematosus ?

Answer

a multisystemic autoimmune disease in which autoantibodies are made against a variety of autoantigens

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Flashcard 150896965

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#medicine #rheumatology

Question

Who does SLE Typically affect ?

Answer

Women of child-bearing age

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Flashcard 150896972

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#medicine #rheumatology

Question

How is disease activity in SLE monitored ?

Answer

Anti-ds DNA antibody titres
Complement: C3. C4 (Decreased)
ESR (Increased).

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Flashcard 150896982

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#medicine #rheumatology

Question

ESR is raised in SLE. What happens to the CRP ?

Answer

CRP normal. If raised consider infection and arthritis

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Flashcard 150896989

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#medicine #rheumatology

Question

What are the clinical features of Antiphospholipid Syndromes ?

Answer

CLOTS: Coagulation defect, Livedo reticularis, Obstetric (recurrent miscarriage), Thrombocytopenia ( Decreased platelets).

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Flashcard 150896996

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#medicine #rheumatology

Question

How many of the revised criteria for Diagnosing SLE must be present to diagnose ?

Answer

≥ 4 out of 11 criteria

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Flashcard 150897003

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#medicine #rheumatology

Question

What are the CNS disorders of SLE ?

Answer

Seizures
Psychosis

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Flashcard 150897016

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#medicine #rheumatology

Question

What are the features of Renal Disease to diagnose SLE ?

Answer

Persistent proteinuria >0 . 5 g/d (or >3+ on urinalysis) OR
Cellular casts — may be red cell, granular, or mixed.

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Flashcard 150897023

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#medicine #rheumatology

Question

What is the Malar rash (butterﬂy rash) seen in SLE ?

Answer

Fixed erythema, ﬂat or raised, over the malar eminences, tending to spare the nasolabial folds

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Flashcard 150897030

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#medicine #rheumatology

Question

What are the conditions of serositis seen with SLE ?

Answer

Pleuritis (presents as pleuritic pain or dyspnoea due to pleural effusion — 80 % have lung function abnormalities) OR
Pericarditis (chest pain, ECG, pericardial rub or signs of pericardial effusion)

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Flashcard 150897037

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#medicine #rheumatology

Question

Describe a Discoid rash ?

Answer

Erythematous raised patches with adherent keratotic scal es and follicular plugging ± atrophic scarring

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Flashcard 150897044

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#medicine #rheumatology

Question

What are the haematological changes seen with SLE ?

Answer

Haemolytic Anaemia
Leukopenia <4≈10 9 /L on ≥ 2 occasions
Lymphopenia <1 . 5 ≈ 10 9 /L on ≥ 2 occasions
Thrombocytopenia <100≈10 9 /L, in the absence of a drug effect

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Flashcard 150897051

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#medicine #rheumatology

Question

what are the 11 Revised criteria (serial or simultaneous) for diagnosing SLE ?

Answer

Malar rash (butterﬂy rash)
Discoid Rash
Photosensitivity
Oral Ulcers
Non - erosive arthritis
Serositis
Renal Disorders
CNS Disorders
Haematological Disorders
Immunological Disorder
Antinuclear Antibody

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Flashcard 150897058

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#medicine #rheumatology

Question

What type of Vasculitis affects Large Vessels ?

Answer

Giant cell arteritis
Takayasu’s arteritis

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Flashcard 150897065

Tags

#medicine #rheumatology

Question

What types of vasculitis affects Medium sized vessels ?

Answer

Polyarteritis nodosa
Kawasaki disease

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Flashcard 150897072

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#medicine #rheumatology

Question

What is Vasculitis ?

Answer

an inﬂammatory disorder of blood vessel walls, causing destruction (aneurysm/rupture) or stenosis. It can aff ect the vessels of any organ, and presentation depends on which organs are involved.

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Flashcard 150897079

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#medicine #rheumatology

Question

What are the ANCA negative vasculitis of small vessels ?

Answer

Henoch-Schönlein purpura
Goodpasture’s syndrome
Cryoglobulinaemia

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Flashcard 150897089

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#medicine #rheumatology

Question

What are the ANCA positive vasculitis of small vessels ?

Answer

p- ANCA

Microscopic polyangiitis
Glomerulonephritis
Churg – Strauss syndrome

c- ANCA

Wegener’s granulomatosis

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Flashcard 150897096

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#medicine #rheumatology

Question

What are the investigation findings with Vasculitis ?

Answer

ESR/CRP Increase.
ANCA may be positive
Increased Creatinine if renal failure.
Urine: proteinuria, haematuria, casts on microscopy.
Angiography ± biopsy may be diagnostic

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Flashcard 150897106

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#medicine #rheumatology

Question

What are the symptoms of Giant Cell Arteritis ?

Answer

Headache
Temporal artery and scalp tenderness (eg when combing hair)
Jaw claudication
Amaurosis fugax
Sudden blindness, typically in one eye.

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Flashcard 150897113

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#medicine #rheumatology

Question

What are the Extracranial symptoms of Giant Cell Arthritis ?

Answer

dyspnoea
morning stiffness
unequal or weak pulses

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Flashcard 150897120

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#medicine #rheumatology

Question

How long does Giant Cell Arteritis usually last ?

Answer

Typically a 2 -year course, then complete remission.

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Flashcard 150897127

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#medicine #rheumatology

Question

What is the appropriate immediate treatment if suspecting Giant Cell Arteritis ?

Answer

Do ESR and start oral prednisolone immediately.

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Flashcard 150897134

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#medicine #rheumatology

Question

What is a consequence of Giant Cell Arteritis ?

Answer

Irreversible bilateral visual loss

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Flashcard 150897141

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#medicine #rheumatology

Question

How is Small/Medium artery vasculitis treated ?

Answer

Steroids
IV cyclophosphamide

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Flashcard 150897148

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#medicine #rheumatology

Question

Within what time period should a biopsy be done if suspecting Giant Cell Arteritis ?

Answer

Temporal artery biopsy within 7 days of starting steroids. Skip lesions occur, so don’t be put off by a negative biopsy

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Flashcard 150897155

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#medicine #rheumatology

Question

What is Polyarteritis nodosa ?

Answer

A necrotizing vasculitis that causes aneurysms and thrombosis in medium- sized arteries, leading to infarction in affected organs, with severe systemic symptoms.

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Flashcard 150897162

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#medicine #rheumatology

Question

What are the clinical features of Microscopic polyangiitis

Answer

Rapidly progressive glomerulonephritis
Pulmonary haemorrhage

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Flashcard 150897169

Tags

#medicine #rheumatology

Question

What is the important antibody in Microscopic Polyangiitis ?

Answer

pANCA Positive

status	not learned	measured difficulty	37% [default]	last interval [days]
repetition number in this series	0	memorised on		scheduled repetition
scheduled repetition interval		last repetition or drill

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Flashcard 150897176

Tags

#medicine #rheumatology

Question

What drugs are used in treating Polyangiitis Nodosa and Microscopic Polyangiitis ?

Answer

Corticosteroids
Cyclophosphamide

status	not learned	measured difficulty	37% [default]	last interval [days]
repetition number in this series	0	memorised on		scheduled repetition
scheduled repetition interval		last repetition or drill

pdf

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Edited, memorised or added to reading queue

on 20-Jun-2015 (Sat)

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