Term
| What can both chronic inflammatory disease and NSAID therapy cause in an FBC? |
|
Definition
|
|
Term
| What kind of anaemia can occur in autoimmune disease? |
|
Definition
|
|
Term
| What is polymorphonuclear leukocytosis? |
|
Definition
| An increased number of neutrophils. |
|
|
Term
| What does polymorphonuclear leukocytosis suggest? |
|
Definition
| infection or inflammation. |
|
|
Term
| What effect does prolonged corticosteroid use have on the white cell count? |
|
Definition
|
|
Term
| In SLE, what can happen to the white cell count? |
|
Definition
|
|
Term
| In bone marrow suppression from DMARDs, what can happen to the white cell count? |
|
Definition
|
|
Term
|
Definition
| Systemic Lupus Erythematosis |
|
|
Term
|
Definition
|
|
Term
| What is often found in the FBC in active inflammatory disease? |
|
Definition
|
|
Term
| Give two conditions where thrombocytopenia is found. |
|
Definition
| SLE and antiphospholipid syndrome. |
|
|
Term
| What is the proper name for a low platelet count? |
|
Definition
|
|
Term
| Does a low or normal white cell count always exclude sepsis? |
|
Definition
| No, not if the clinical situation indicates otherwise. |
|
|
Term
|
Definition
| Erthrocyte Sedimentation Rate |
|
|
Term
|
Definition
|
|
Term
|
Definition
| The rate of aggregation of erthrocytes, which increases with the concentration of plasma proteins such as fibrinogen and immunoglobulins. |
|
|
Term
| What happens to the upper limit of ESR with age? |
|
Definition
|
|
Term
|
Definition
| C-Reactive Protein, a non-specific marker of inflammation that rises in infectious and inflammatory disorders. |
|
|
Term
| Which rises more rapidly, esr or crp? |
|
Definition
|
|
Term
| How quickly does CRP typically rise following an inflammatory event? |
|
Definition
|
|
Term
| When might renal impairment occur? |
|
Definition
| In gout or connective tissue disorders. |
|
|
Term
| What would happen to the levels of urea in the blood in renal impairment? |
|
Definition
|
|
Term
| What aspect of the liver function test is raised in Paget's disease? |
|
Definition
|
|
Term
| What do methotrexate, sulphasalazine and NSAIDs all have in common? |
|
Definition
| They are used in some musculoskeletal problems and they can all be hepatotoxic. |
|
|
Term
| Which acid is usually raised in those with gout? |
|
Definition
|
|
Term
| Can uric acid be normal during an acute flair or gout? |
|
Definition
|
|
Term
| When does hypocalcaemia classically occur? |
|
Definition
|
|
Term
| When can hyperclacaemia occur? |
|
Definition
|
|
Term
| When is creatine kinase raised? |
|
Definition
| Following trauma or inflammation. |
|
|
Term
| Why are autoantibodies not hugely useful? |
|
Definition
| They can occur in healthy people, giving false positives, and hence have little diagnostic value. |
|
|
Term
| When could autoantibodies justifiably be asked for? |
|
Definition
| When there is a real clinical suspicion of an autoimmune condition. |
|
|
Term
| What is rheumatoid factor? |
|
Definition
| An antibody directed against fragment Fc of IgG. |
|
|
Term
| What proportion of those with RA have rheumatoid factor? |
|
Definition
|
|
Term
| What does ACPA stand for? |
|
Definition
| Anticitrullinated Peptide Antibodies |
|
|
Term
| What is ACPA highly specific to? |
|
Definition
|
|
Term
| How soon before RA can ACPA be detected? |
|
Definition
|
|
Term
| What aspects of RA is ACPA associated with? |
|
Definition
| joint errosion and more aggresive disease. |
|
|
Term
| Can ACPA be found in those who are Rheumatoid Factor negative? |
|
Definition
|
|
Term
| What does ANCA stand for? |
|
Definition
| Antineutrophil Cytoplasmic Antibodies. |
|
|
Term
|
Definition
| Antibodies directed against enzymes present in neutrophil granules, associated with vasculitic and inflammatory conditions. |
|
|
Term
| What are the two main patterns of immunofluorescence when it comes to ANCA? |
|
Definition
| Cytoplasmic and Perinuclear. |
|
|
Term
| What does c-ANCA stand for? |
|
Definition
| Cytoplasmic - Antineutrophil Cytoplasmic Antibodies. |
|
|
Term
| What does p-ANCA stand for? |
|
Definition
| Perinuclear - Antineutrophil Cytoplasmic Antibodies. |
|
|
Term
| Which protein does c-ANCA most commonly bind to? |
|
Definition
|
|
Term
| Which protein does p-ANCA most commonly bind to? |
|
Definition
|
|
Term
| What is the old name for Granulomatosis with polyangiitis? |
|
Definition
|
|
Term
| Which antibodies are found in 80% of patients with Granulomatosis with polyangiitis? |
|
Definition
| Antibodies to PR3 (proteinase 3) |
|
|
Term
| Which antibodies are commonly found in polyarteritis nodosa? |
|
Definition
| Antibodies to MPO (myeloperoxidase) |
|
|
Term
| What two antibodies are found in antiphospholipid syndrome? |
|
Definition
| Lupus anticoagulant and anticardiolipin. |
|
|
Term
| What happens to serum levels of complement proteins when the complement system is activated? |
|
Definition
|
|
Term
| What kind of chains can be found in myeloma? |
|
Definition
|
|
Term
| What happens to levels of C3 and C4 in active lupus? |
|
Definition
|
|
Term
| What happens to levels of C3 and C4 in some types of vasculitis? |
|
Definition
|
|
Term
| What is the most important investigation in suspected septic or crystal athritis |
|
Definition
| Synovial fluid analysis/Aspiration. |
|
|
Term
| What colour is synovial fluid normally? |
|
Definition
|
|
Term
| What are two possible causes of blood in synovial fluid following aspiration? |
|
Definition
| Haemarthrosis or puncture of a blood vessel on aspiration. |
|
|
Term
| What causes synovial fluid to turn cloudy? |
|
Definition
| Increased cell count due to inflammation or septic arthritis. |
|
|
Term
| What are the two causes of puss in synovial fluid, and which is the more likely? |
|
Definition
| Septic and crystal arthritis, of which septic is more likely. |
|
|
Term
| What causes synovial fluid to turn chalky? |
|
Definition
|
|
Term
| When should a gram stain and culture of synovial fluid always be carried out? |
|
Definition
| If there is any suspicion of septic arthritis. |
|
|
Term
| What kind of bifringence do urate crystals exhibit? |
|
Definition
|
|
Term
| What does negative bifringence mean? |
|
Definition
| Those crystals parallel to the plane of light appear yellow, those perpendicular appear blue. |
|
|
Term
| Does the absence of organisms on microscopy of synovial fluid exclude infection? |
|
Definition
|
|
Term
|
Definition
| A nerve conduction study. |
|
|
Term
|
Definition
|
|
Term
| What are NCS and EMG? (In broad terms) |
|
Definition
| Electrophysiological tests used to diagnose and assess neuromuscular problems. |
|
|
Term
| What doe electrophysiological tests help to differentiate between? |
|
Definition
| Primary muscle disease and neuropathic disorders. |
|
|
Term
|
Definition
| The conduction velocity of motor and sensory nerves, localising and assessing the severity of peripheral nerve lesions. |
|
|
Term
|
Definition
| Spontaneous and voluntary electrical activities of muscles. |
|
|
Term
| What are plain radiographs good at imaging? |
|
Definition
|
|
Term
Put the following in order from lightest to darkest on an x-ray:
Muscle
Fat
Bone
Air |
|
Definition
|
|
Term
| When do women need to avoid x-rays? |
|
Definition
|
|
Term
| What 2 views are normally required when x-raying a fracture? |
|
Definition
| anteroposterior and lateral. |
|
|
Term
| Name 2 special x-ray views that are sometimes required. |
|
Definition
|
|
Term
| Give three advantages of ultrasound. |
|
Definition
| It's cheap, safe and portable. |
|
|
Term
| What would be your first choice to image the shoulder to check for rotator cuff injuries? |
|
Definition
|
|
Term
| What would be your first choice to image the hip to check for joint effusion? |
|
Definition
|
|
Term
| What would be your first choice to image the shoulder to check for a fracture? |
|
Definition
|
|
Term
| What is MRI great for imaging? |
|
Definition
| Bone marrow or soft tissue. |
|
|
Term
| What would be your first choice for imaging a nerve root compression? |
|
Definition
|
|
Term
| What would be your first choice for imaging a meniscal injury? |
|
Definition
|
|
Term
| What would be your first choice for imaging inflammatory back disease? |
|
Definition
|
|
Term
| What can MRI be used to image in rheumatology? |
|
Definition
| Synovitis and erosive damage. |
|
|
Term
| Give 5 examples where you will see increased uptake in a bone scan. |
|
Definition
| Increased uptake typically takes place in growth plates, arthritis, metastases, Paget disease and infection. |
|
|
Term
| What is the most commonly used isotope for bone scans? |
|
Definition
|
|
Term
| Give 2 examples where you will see decreased uptake in a bone scan. |
|
Definition
| Some tumours (haemopoietic), and in avascular bone. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What would be your first choice for imaging a nerve root compression? |
|
Definition
|
|
Term
| What would be your first choice for imaging a meniscal injury? |
|
Definition
|
|
Term
| What would be your first choice for imaging inflammatory back disease? |
|
Definition
|
|
Term
| What can MRI be used to image in rheumatology? |
|
Definition
| Synovitis and erosive damage. |
|
|
Term
| Give 5 examples where you will see increased uptake in a bone scan. |
|
Definition
| Increased uptake typically takes place in growth plates, arthritis, metastases, Paget disease and infection. |
|
|
Term
| What is the most commonly used isotope for bone scans? |
|
Definition
|
|
Term
| Give 2 examples where you will see decreased uptake in a bone scan. |
|
Definition
| Some tumours (haemopoietic), and in avascular bone. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What does DEXA stand for? |
|
Definition
| Dual Energy X-ray Absorptiometry. |
|
|
Term
|
Definition
| Where a patient has air or contrast injected into their joint prior to imaging. |
|
|
Term
| What kind of pathology are MRI arthrograms good for diagnosing? |
|
Definition
| Intra-articular pathology. |
|
|
Term
| When are plain x-ray arthrograms still used? |
|
Definition
| Imaging hip conditions in children. |
|
|
