Study Fast Facts
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:
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
Clinical review Treatment of rheumatoid arthritis
O'Dell J. R.
N Engl J Med 2004; 350:2591-2602, Jun 17, 2004. Review Articles
BMJ 2006; 332: 152-155.
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
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
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.
Braun J, Sieper J
- 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
2002 paper two question 15 Treatment of polymyalgia rheumatica
2002 paper two question 64 arteries involved in Takayasu’s arteritis
2002 paper two question 91 Recurrent oral ulceration is the most common manifestation of Behcet’s disease?
2005 paper one question 8 the common pathophysiologic mechanism of end-organ ischaemia in Giant Cell Arteritis is Luminal occlusion secondary to concentric intimal hyperplasia
2005 paper two question 56 Urticarial vasculitis can be distinguished by Duration of individual lesions greater than 72 hours.
Treatment of Antineutrophil Cytoplasmic Antibody–Associated VasculitisA Systematic Review
Xavier Bosch, MD, PhD; Antonio Guilabert, MD; Gerard Espinosa, MD, PhD; Eduard Mirapeix, MD, PhD
- Gout, pseudogout, and chondrocalcinosis
2002 paper two question 83 treatment of gout repeat question 2001
2004 paper two question 64 diagnosing gout on an xray of hand
2005 paper one question 68 Beer consumption is the dietary factor which most increases the likelihood of gout
2005 paper two question 39 Treatment for acute exaccerbation of gout is NSAIDs or colchicine, in renal impairment prednisolone is an appropriate alternative to NSAIDS
Clinical review Colchicine in acute gout Ian Morris, George Varughese, and Peter Mattingly
BMJ 2003; 327: 1275-1276.
Clinical review Diagnosis and management of gout
BMJ 2006; 332: 1315-1319.
- Rheumatic manifestations of diseases in other medical specialties, e.g. cancer, diabetes, viral infections (including AIDS)
2002 paper two question 28 xray findings in haemachromatosis
2002 paper two question 69 Respiratory presentation and diagnosis of Wegener’s Granulomatosis
2003 paper two question 41 extra hepatic manifestations of hep c - raynauds/rheum
- Osteoporosis, osteomalacia, and Paget's disease
Relevant Exam questions
2002 paper one question 68 Risk factors for osteoporosis
2004 paper two question 30 Stress fracture of the sacrum or pelvis in elderly woman with sudden onset pain and normal bone scan
2005 paper two question 24Management of persistant pain despite analgesia and NSAIDS of pagets disease of the pelvis next step alendronate
Paget's Disease of BoneWhyte M. P.
N Engl J Med 2006; 355:593-600, Aug 10, 2006. Clinical Practice
Osteoporosis and its management Kenneth E S Poole and Juliet E Compston
BMJ 2006; 333: 1251-1256.
Mechanisms of Disease: Bone Quality - The Material and Structural Basis of Bone Strength and Fragility
Seeman E., Delmas P. D. N Engl J Med 2006; 354:2250-2261, May 25, 2006. Review Articles
Screening for Osteoporosis
Raisz L. G. N Engl J Med 2005; 353:164-171, Jul 14, 2005. Clinical Practice
- Low back pain and soft tissue rheumatism.
Relevant Exam questions
2003 paper one question 15: Rotator cuff tear
2004 paper one question 5 Knee pain walking downstairs assoicated with Retropatellar compartment pathology
Persistent Low Back Pain
Carragee E. J.
N Engl J Med 2005; 352:1891-1898, May 5, 2005. Clinical Practice
Clinical review Diagnosis and treatment of low back pain
B W Koes, M W van Tulder, and S Thomas
BMJ 2006; 332: 1430-1434.
- Use of anti-inflammatory, disease modifying and immunosuppressive drugs: their adverse effects and safety monitoring procedures.
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.
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.