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ABIM > MKSAP STOCK5 > Flashcards

MKSAP STOCK5 Flashcards

1
Q

What are the two most common peripheral nerve manifestations of polyarteritis nodosa?

A

Mononeuropathy, Mononeuritis multiplex

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2
Q

What is the expected physiologic changes in plasma osmolality and serum sodium during pregnancy?

A

Decrease in BOTH osmolality and sodium with normalization after delivery

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3
Q

What is the most common mechanism of cardiac involvement in patients with systemic sclerosis and cardiomyopathy?

A

Microvascular disease (leads to patchy myocardial fibrosis)

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4
Q

What kidney disease is associated with mesalamine therapy?

A

Interstitial nephritis

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5
Q

What are four indications to start urate-lowering therapy for gout?

A

Two or more attacks within 1 year period; one attack in the setting of CKD (at least stage II), one attack and the presence of tophi, one attack and a Hx of nephrolithiasis

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6
Q

What is the definitive diagnostic intervention for primary angiitis of the central nervous system?

A

Intracerebral angiography with brain biopsy

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7
Q

What is a long term complication of meniscectomy?

A

Early onset knee OA

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8
Q

What is the diagnostic imaging test for knee osteoarthritis?

A

STANDING plain radiograph of the knee

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9
Q

What is the treatment of rheumatoid arthritis that is inadequately controlled with methotrexate?

A

Addition of tumor necrosis factor alpha inhibitior (adalimumab, golimumab, certolizumab, infliximab, or etanercept)

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10
Q

Cause of persistent urogenital infection associated with reactive arthritis

A

Chlamydia trachomatis

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11
Q

What is the management of methotrexate therapy before conception?

A

Must be discontinued

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12
Q

What nonpharmacologic therapy is indicated for all patients with fibromyalgia?

A

Regular aerobic exercise

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13
Q

What are two common causes of hypersensitivity vasculitis

A

Drugs and Infection

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14
Q

What is the most likely cause of progressive weight loss, abdominal cramping, and loose stools in a patient with diffuse cutaneous systemic sclerosis?

A

Bacterial Overgrowth Syndrome

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15
Q

What is the treatment of polymyalgia rheumatica?

A

Low-Dose Prednisone i.e. 10-20 mg –expect rapid improvement

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16
Q

What is the recommended pharmacologic therapy for knee osteoarthritis in patients with inadequate response to acetaminophen

A

NSAIDs systemic or topical

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17
Q

What is the diagnosis for insidiously progressive shoulder pain, stiffness, and swelling following either trauma or overuse in older women?

A

Basic Calcium Phosphate Deposition (Milwaukee Shoulder Syndrome)

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18
Q

What are two antihypertensive medications that lower the risk of an acute flare in patients with gout?

A

Losartan (but NOT other ARBs) and CCBs

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19
Q

What is the urine study useful for determining the cause of a metabolic alkalosis?

A

Urine chloride levels

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20
Q

What is the confirmation for a diagnosis of drug-induced lupus?

A

Aside from the anti-histone Ab, cessation of sx when drug is stopped

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21
Q

What agents are recommended by JNC 8 for initial tx of stage I HTN in blacks?

A

Thiazide or CCB

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22
Q

What imaging is required for patients with clinically diagnosed hand osteoarthritis?

A

NONE- woooh tricked ya!

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23
Q

What is the recommended initial pharmacologic therapy for knee osteoarthritis

A

Acetaminophen

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24
Q

What is the initial treatment of new-onset, rapidly progressive, or erosive rheumatoid arthritis?

A

Methotrexate (some form of DMARD)

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25
Q

What are the complement levels in cyroglobulinemic vasculitis?

A

Low C4, normal C3

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26
Q

What are three findings predictive of diffuse alveolar hemorrhage in a patient with systemic lupus erythematosis?

A

Hypoxemia, New pulmonary infiltrates on chest radiograph, decreasing hematocrit

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27
Q

Cultures of these two body fluids should be obtained before initiating empiric antibiotics for suspected prosthetic joint infection

A

Blood and synovial fluid

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28
Q

What is the formula for estimating the maximal expected ESR based on age?

A

(Age in years + 10) /2

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29
Q

What are four clinical findings highly suggestive of cryoglobulinemic vasculitis?

A

Multisystem vasculitis, Low C4, normal C3, and a positive rheumatoid factor

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30
Q

What is the preferred type of vascular access in patients with ESRD requiring HD

A

AV fistula

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31
Q

What endocrine disorder is associated with acquired hypokalemic periodic paralysis?

A

Thyrotoxicosis

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32
Q

What is the diagnosis for erosive arthritis involving the distal interphalangeal and carpometacarpal joints NOT associated with elevation of inflammatory markers?

A

Erosive Osteoarthritis

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33
Q

This is a disease characterized by eosinophilia, migratory pulmonary infiltrates, purpuric skin rash, and mononeuritis multiplex

A

Eosinophilic Granulomatosis with polyangiitis

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34
Q

What is the indicated therapy for the treatment of a scleroderma renal crisis?

A

Captopril

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35
Q

What ist he recommended manipulation of NSAID therapy in older patients to decrease the risk of gastrointestinal toxicity?

A

Switch from oral to topical

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36
Q

What serum antibody levels correlate with disease activity in SLE (esp. kidney involvement)

A

Anti-Double Stranded DNA ab

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37
Q

What is the initial treatment of polymyositis or dermatomyositis with muscle involvement?

A

Glucocorticoids (high dose)

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38
Q

What routine lab monitoring is required q8-12 weeks in patients treated with leflunomide?

A

Liver enzymes

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39
Q

Reactive arthritis and psoriatic arthritis are more common and more severe in patients with this systemic infection

A

HIV infection

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40
Q

What antibody is often associated with mixted connective tissue disease?

A

Anti-U1 ribonucleoprotein

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41
Q

What is the initial treatment of mild systemic lupus erythematosis

A

Hydroxychloroquine

42
Q

What is the most overrepresented cancer in women with dermatomyositis compared with women without it

A

Ovarian CA

43
Q

What is the recommended mgmt of secondary hyperparathyroidism in patients with CKD?

A

Normalization of calcium, phosphorus, and vitamin D levels with active vitamin D (i.e. Calcitriol)

44
Q

What is the diagnosis associated with distal skin thickening and features of CREST syndrome?

A

Limited Cutaneous Systemic Sclerosis

45
Q

What is pegloticase?

A

Infusional uric acid specific drug used for gout refractory to xanthine oxidase inhibitors

46
Q

What is the name of the neuropathy characterized by abnormal findings in the territory of two or more nerves in separate parts of the body?

A

Mononeuritis multiplex

47
Q

Testing for this infection is indicated before initiating treatment with a biologic agent

A

Mycobacterium tuberculosis

48
Q

What is the form of osteoarthritis affecting non weight bearing joints such as the shoulders or wrists?

A

Osteoarthritis with calcium pyrophosphate deposition

49
Q

What is the primary therapy for parvovirus B19 associated arthritis?

A

NSAIDs

50
Q

What are the four clinical findings of which TWO are required to make a diagnosis of Behcet syndrome in addtion to recurrent painful oral ulcers?

A

Recurrent painful genital ulcers, eye involvment, skin involvement, and pathergy

51
Q

What is the recommended initial therapy for minimal change disease in adults?

A

High dose steroids

52
Q

What rheumatologic disorder is characterized by high spiking fevers, arthritis, rash, high neutrophil counts, and markedly elevated serum ferritin?

A

Adult Onset Still Disease

53
Q

What are two clinical criteria to diagnose preeclampsia in a patient without proteinuria?

A

New onset HTN after 20 weeks of pregnancy or evidence of end-organ damage i.e. thrombocytopenia, kidney dysfxn, liver dysfxn, pulm edema etc)

54
Q

What are three indications for kidney biopsy in patients with suspected lupus nephritis?

A

Increasing serum creatinine without explanation, proteinuria >1 g / 24h; and proteinuria with cellular casts or hematuria

55
Q

What are four synovial fluid studies indicated when evaluating probable crystal related arthritis?

A

Leukocyte count, crystal analysis, gram stain, and culture

56
Q

What are the three cardinal findings of Lofgren syndrome?

A

Acute arthritis, Bilateral Hilar lymphadenopathy, and erythema nodosum

57
Q

What is the clinical diagnosis in a patient with findings consistent with rheumatoid arthritis but negative rheumatoid factor of anti-cyclic citrullinated peptides?

A

Seronegative Rheumatoid Arthritis

58
Q

What is the diagnosis of a lymphoplasmacytic infiltration and enlargement of pancreas, lymph nodes, salivary glands, kidneys, or skin?

A

IgG4-Related Disease

59
Q

Name four autoimmune diseases associated with scleritis?

A

Rheumatoid Arthritis, Relapsing Polychondritis, Inflammatory Bowel Disease, and Vasculitis

60
Q

What is the most common inherited kidney disorder?

A

Autosomal Dominant Polycystic Kidney Disorder

61
Q

What is the kidney disease causing marked proteinuria without apparent systemic disease that may occur in extremely obese patients?

A

Secondary focal segmental glomerulosclerosis (FSGS)

62
Q

What is the serum bicarbonate level for which oral alkali therapy is indicated in patients with CKD?

A

If it is <23

63
Q

What are two coexisting conditions that may present as acute monoarthritis?

A

Gout and Septic Arthritis

64
Q

What is an indication for gouty flare prophylaxis when treating tophaceous gout?

A

Any sign of active disease including flares of acute gout or tophi

65
Q

What is the diagnostic criteria for preeclampsia

A

New onset hypertension after 20 weeks of pregnancy with proteinuria (>300 mg or urine prot/cr ratio >300)

66
Q

What is the recommended method to monitor ankylosing spondylitis disease activity in patients responding to Tx?

A

A good physical exam

67
Q

What are four factors associated with a worse clinical outcome in patients with IgA nephropathy?

A

HTN, Kidney dysfunction, Persistent proteinuria >1g, and tubulointerstitial damage seen on kidney bx

68
Q

What are the two most common causes of pseudohyponatremia?

A

Hyperglycemia, significantly elevated serum lipid levels, and abnormal serum paraproteins

69
Q

What is a cause of acute kidney injury associated with peripheral eosinophilia, hypocomplementemia, and eosinophiluria?

A

Cholesterol embolization

70
Q

What is the likely diagnosis in a patient younger than 40 with signs and symptoms of large vessel stenosis and evidence of systemic inflammation?

A

Takayasu arteritis

71
Q

What is the imaging study indicated for all patients with Marfan syndrome?

A

Transthoracic Echocardiography

72
Q

Patients who are treated with cyclophosphamide are at increased risk for developing what malignancy?

A

Bladder CA

73
Q

What are three culture sites for suspected disseminated gonococcal infection?

A

Blood, GU tract, or pharynx

74
Q

What is the potential rheumatologic prodrome of acute hepatitis B infection?

A

Rapid Onset Symmetric Polyarthritis

75
Q

What is the diagnosis for the syndrome that includes features of systemic lupus erythematosis, systemic sclerosis, and/or polymyositis and positive anti-U1 Ribonucleoprotein antibodies?

A

Mixed Connective Tissue Disease

76
Q

What is the immunosuppressant treatment for dry eyes associated with Sjogren syndrome?

A

Topical Cyclosporine

77
Q

What is the imaging study for suspected osteonecrosis if plain radiographs are normal?

A

MRI

78
Q

What are four clinical features characteristic of reactive arthritis?

A

Asymmetric monoarthritis or oligoarthritis of the lower extremities, enthesopathy, dactylitis, and sacroiliitis

79
Q

What condition is defined by flowing osteophytes involving contiguous vertebrae in the thoracic spine with preservation of disk space in the absence of inflammatory change?

A

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

80
Q

What are the two most common causes of death in patients with ESRD?

A

Cardiovascular disease and infection

81
Q

What is an inflammatory myopathy characterized by insidious onset, slow progression, and weakness of both distal and proximal muscles?

A

Inclusion Body Myositis

82
Q

What are four clinical features in patients with Raynaud phenomenon indicating and increased risk for developing an associated connective tissue disease?

A

Severe and prolonged episodes of vasospasm, asymmetric involvement of digits, abnormal nailfold capillary exam, and digital pitting

83
Q

What is the recommended tx for patients with CKD and hyperphosphatemia after following low phosphate (renal) diet?

A

Oral Phosphate Binders

84
Q

What acid-base disorder is associated with anxiety disorder and panic episodes

A

Respiratory alkalosis

85
Q

What is the recommended treatment of acute ethylene glycol poisoning?

A

IV hydration, fomepizole (competes for EtOH dehydrogenase) and HD

86
Q

What is the initial diagnostic study for evaluating possible diabetes insipidus?

A

Water Restriction test

87
Q

What are three drugs that may be safely continued during pregnancy in women with SLE requiring immunosuppression?

A

Azathioprine, hydroxychloroquine, and prednisone

88
Q

What is the most common cause of hyporesponsiveness to EPO in patients with CKD related anemia?

A

Iron deficiency

89
Q

What is the recommended BP goal by JNC8 for pt aged 60 and over

A

Less than 150/90

90
Q

What is the sequence of the two serologic tests for a diagnosis of Lyme arthritis?

A

ELISA followed by B. borgdurferii Western Blot

91
Q

Increasing the dietary intake of this type of food may help decrease risk of gout flares?

A

Low-Fat dairy products

92
Q

What is the diagnostic laboratory study for suspected granulomatosis with polyangiitis?

A

Antiproteinase 3 antibodies (C-ANCA)

93
Q

What is the first line treatment of ankylosing spondylitis when NSAIDs are inadequate?

A

tumor necrosis factor alpha inhibitor therapy

94
Q

What medication is indicated to lower serum urate levels in pt with gout who do not respond to xanthine oxidase inhibitors?

A

Pegloticase (this is infusional therapy)

95
Q

What is the most common cardiac manifestation of rheumatoid arthritis?

A

Pericarditis

96
Q

What are four potential causes of secondary membranous glomerulopathy?

A

Malginancies (solid organ), Autoimmune diseases (lupus or MCTD), HBV/HCV, and medications like Gold, NSAIDs and penicillamine

97
Q

What urate-lowering agent is contraindicated in patients being treated with azathioprine?

A

Febuxostat (allpurinol requires dose reduction)

98
Q

What is the agent used in tumor lysis syndrome to rapidly decrease serum urate levels?

A

Rasburicase (urate oxidase)

99
Q

What is the initial therapy to rapidly lower serum potassium levels in severe hyperkalemia?

A

IV insulin and glucose

100
Q

Three classes of antihypertensive medication that is ABSOLUTELY contraindicated in pregnancy

A

ACE, ARBs, and direct renin inhibitors (aliskerin)

ABIM (9 decks)

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