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Rheumatoid arthritis | Infectious arthritis | Osteoarthritis |Ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease | Systemic lupus erythematosus, Sjogren's syndrome, poly- and dermatomyositis, scleroderma (systemic sclerosis) | Vasculitis, including temporal arteritis and polymyalgia rheumatica | Gout, pseudogout, and chondrocalcinosis
| Rheumatic manifestations of diseases | Osteoporosis, osteomalacia, and Paget's disease | Low back pain and soft tissue rheumatism. | anti-inflammatory, disease modifying and immunosuppressive drugs | rheum emergencies | epidemiology | management of chronic diseases

  • Familiarity with the classification, clinical features, laboratory findings, and pathophysiology of joint disease as well as the natural history and physical and psychological impact of both inflammatory and non inflammatory joint disorders, including:
    • Rheumatoid arthritis

    Relevant exam questions

  • 2002 paper two question 55 Drug treatment in RA


    Tumor Necrosis Factor Inhibitors for Rheumatoid Arthritis Scott D.L., Kingsley G.H. N Engl J Med 2006; 355:704-712, Aug 17, 2006. Clinical Therapeutics

    Drug Therapy: Therapeutic Strategies for Rheumatoid Arthritis
    O'Dell J. R. N Engl J Med 2004; 350:2591-2602, Jun 17, 2004. Review Articles

    Clinical review Treatment of rheumatoid arthritis
    Paul Emery BMJ 2006; 332: 152-155.


    • Infectious arthritis

    exam questions

    2005 paper two question 50 mycobacterial or fungal infection as a differential in a Subacute or chronic monoarthritis with risk factors in this question an oyster farmer

    • Osteoarthritis

    Relevant Exam Questions

    2004 paper one question 60 Glucosamine sulphate has the strongest experimental support in clinical setting of OA as a therapy able to retard cartilage loss

    2004 paper two question 60 Treatment of OA of he knee

    2005 paper two question 40 In chronic OA with new four-week history of severe pain in the right knee on weight bearing a MRI can help diagnose a meniscal tear

    2005 paper two question 99 simple analgesia, weight loss and quad strength improvement are appropriate initial management options for OA of the knee



    Osteoarthritis of the Knee Felson D. T.
    N Engl J Med 2006; 354:841-848, Feb 23, 2006. Clinical Practice

    Clinical review Osteoarthritis
    David J Hunter and David T Felson
    BMJ 2006; 332: 639-642.

    • Ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease

    Exam Questions

    2002 paper one question 32 syndesmophyte formation is most likely to be first seen in the Thoracolumbar spine


    Clinical review Diagnosis and management of ankylosing spondylitis Claire M McVeigh and Andrew P Cairns
    BMJ 2006; 333: 581-585.

    Ankylosing spondylitis Braun J, Sieper J
    The Lancet - Vol. 369, Issue 9570, 21 April 2007 , Pages 1379-1390

    • Systemic lupus erythematosus, Sjogren's syndrome, poly- and dermatomyositis, scleroderma (systemic sclerosis)

    Relevant Exam Question

    2002 paper two question 21 Anti-Sm antibody (Smith) and anti-dsDNA antibody (double stranded) are highly specific (90%) but not very sensitive (Sm: 25% and dsDNA 70%) for SLE

    2002 paper two question 71 Weakness of long finger flexors differentiates inclusion body myositis from polymyositis? Repeat question 2003

    2003 paper two question 11 Diagnosing SLE with autoantibodies

    2003 paper two question 26 antibodies Jo-1 and polymyositis (anti-synthetase syndrome) differential diagnosis of raynauds repeat question 2002 paper two question 50

    2003 paper two question 83 Neonatal lupus syndrome: Anti-Ro/SSA and anti-La/SSB antibodies are Antibodies to extractable nuclear antigens (ENA)

    2003 paper two question 87 Renal involvement in SLE and indications for treatment

2004 paper one question 18 nail changes with systemic sclerosis

2004 paper one question 48 Homozygous deficiencies of early components of complement (C1q,r,s; C2; C4) confer strong predisposition to SLE but each deficiency is rare. However there is a high concordance rate (14 to 57%) of SLE in monozygotic twins.

2004 paper two question 13 Secondary Raynaud’s Phenomenon is associated with Positive anticentromere antibody test

2004 paper two question 86 Sjogrens syndrome diagnosis and its assoications - Glomerulonephritis is rare in Sjogren’, but may occur in setting of cryoglobulins

2004 paper two question 94 Causes of death in SLE 1. Atherosclerotic disease (ie. coronary artery disease); 2.Infection 3. Disease activity in this example pulmonary hypertension

2005 paper one question 38 Most likely cause of death in young women SLE dying of VF arrest is Coronary atherosclerosis.

2005 paper two question 1 - myopathy, myositis

2005 paper two question 22 diagnosing scleroderma with hand xray


Clinical review Systemic lupus erythematosus
David P D'Cruz BMJ 2006; 332: 890-894.

Vasculitis, including temporal arteritis and polymyalgia rheumatica

Relevant Exam Questions

2004 paper one question 31 treatment with Aspirin and low molecular weight heparin to achieve pregnancy in womean with antiphospholipid syndrome

2004 paper two question 41 the use of high dose topical steroids in the treatment of pemphigoid a autoimmune disease characterised by bullous blistering


Inhibiting Inflammation in Rheumatoid Arthritis Firestein G. S.
N Engl J Med 2006; 354:80-82, Jan 5, 2006. Clinical Implications of Basic Research

Mechanisms of Disease: Antiinflammatory Action of Glucocorticoids - New Mechanisms for Old Drugs Rhen T., Cidlowski J. A.
N Engl J Med 2005; 353:1711-1723, Oct 20, 2005. Review Articles

Clinical review Azathioprine-induced pancytopenia in a patient with pompholyx and deficiency of erythrocyte thiopurine methyltransferase
M Konstantopoulou, A Belgi, K D Griffiths, J R C Seale, and A W Macfarlane BMJ 2005; 330: 350-351.

Practice Understanding the NSAID related risk of vascular events
Harald E Vonkeman, Jacobus R B J Brouwers, and Mart A F J van de Laar
BMJ 2006; 332: 895-898.



  • The management of acute rheumatological emergencies, including:
    • The evaluation of an acutely hot joint
    • Acute low back pain
    • Management of vasculitis (in association with a connective tissue disorder)
    • Management of patients with temporal arteritis
    • Development of cervical myelopathy in rheumatoid arthritis
    • Assessment and evaluation of fever in a patient with an underlying connective tissue disease.

    Exam Questions

    2005 paper two question 11 Appropriate initial investigation of back pain without red flags is plain xray


    Polyarticular septic arthritisC Christodoulou, P Gordon, and G Coakley BMJ 2006; 333: 1107-1108.

  • Basic knowledge of the epidemiology and socio-economic impact of musculoskeletal disorders.

2004 paper one question 9 Diagnosing autoimmune disease: Direct evidence of causality implies that autoimmune response can be shown to produce the disease, This can only be done by the transfer of autoantibody from a patient to a healthy recipient (human or animal)

  • Rheumatology should provide a format for the management of chronic progressive disorders, e.g. rheumatoid arthritis, including:
    • Appropriate use of medical therapy (analgesia, anti-inflammatory medication, disease modifying agents), relative role of orthopaedic surgery, the workings of a multidisciplinary team (including physiotherapy, nursing, occupational therapy, social work)
    • Means of evaluating and addressing disability and handicap (including the provision of aids, adaptations, and social support)
    • Providing psychological support.