Rheumatology & Haematology — Flashcards

Flashcard 601: Haemochromatosis can cause arthropathy, especially in _____ joints with "hook-like" osteophytes

Answer: metacarpophalangeal (MCP)

Flashcard 602: When should you refer osteoarthritis for a joint replacement? _____

Answer: Substantial impact on QOL or non-surgical mx is ineffective/unsuitable

Flashcard 603: A red flag symptom in rheumatoid arthritis is _____ stiffness/pain because it can lead to atlantoaxial subluxation

Answer: neck

Flashcard 604: _____ BMI is a modifiable risk factor for osteoarthritis **bonus: why?

Answer: High

Extra: High BMI increases risk via two main mechanisms: 1. **Mechanical:** Increased loading and stress on weight-bearing joints (knees, hips). 2. **Metabolic:** Pro-inflammatory cytokines and **adipokines** (e.g., leptin) secreted by adipose tissue contribute to cartilage degradation.

Flashcard 605: What investigation is needed to confirm hereditary haemochromatosis alongside iron studies? _____

Answer: Genetic testing for HFE mutation

Extra: Hereditary haemochromatosis (HH) is most commonly caused by a mutation in the HFE gene (C282Y homozygosity is the most common genotype). Genetic testing has largely replaced liver biopsy for the primary diagnosis of HH.

Flashcard 606: Rheumatoid arthritis most commonly affects _____ & feet (which joints?)

Answer: hands

Flashcard 607: On examination for rheumatoid arthritis, there is pain on _____ test of the MCP joints.

Answer: Gaenslen/Squeeze

Extra: Gaenslen's sign (not to be confused with Gaenslen's test for the sacroiliac joint) is positive in Rheumatoid Arthritis when there is tenderness on gripping the MCP joints. It is a sensitive clinical marker for synovitis.

Flashcard 608: What is the first-line imaging for osteoarthritis? _____

Answer: X-ray of joint

Flashcard 609: Rheumatoid arthritis is _____ with activity

Answer: improved

Flashcard 610: Osteoarthritis has a _____ onset

Answer: gradual