Rheum

Question 1

Common extra spinal findings in ankylosing spondylitis

Answer 1

Enthesitis

Inflammation and pain at sites of tendon and ligament attachment

Question 2

What test can confirm CTS?

Answer 2

Nerve conduction studies

Question 3

Pt has dry eye but negative ANA

Answer 3

Age related sicca

d/t age related exocrine gland atrophy

Question 4

adult with new onset symmetric, small joint arthralgias, mild joint swelling x 1 wk. Works at a day care

Answer 4

Viral arthritis

d/t parvo B19

Question 5

What other chronic dz is associated with dermatomositis?

Answer 5

Malignancy

15% of dermatomyositis pts

Question 6

Diclofenac is a?

Answer 6

NSAID

Question 7

Young adult
recurrent oral/genital ulcers
Skin, ocular involvement common

Answer 7

Behcet syndrome
multisystem inflammatory condition
Asian descent
Thrombosis main cause of morbidity
clinical dx

Question 8

Initial step for dx of sciatica?

Answer 8

Trial of NSAIDs

Question 9

Young adult
anterior knee pain
Worse with climbing stairs

Answer 9

Patellofemoral syndrome
dx - extension of the knee while compressing the patella
tx - stretch, strengthen the thigh muscle and avoid activities that worsen the pain

Question 10

Tx for polymalgia rheumatica

Answer 10

Low dose prednisone

pt >50, pain and stiffness in the neck, shoulders, pelvic girdle, elevated ESR

Question 11

Guy gets seronegative arthritis after tx for G/C.

Answer 11

Reactive arthritis

Tx - NSAIDs

Question 12

electrolyte changes in paget dz

Answer 12

disorder of bone resorption
CA, Phos - WNL
Alk Phos, urine hydroxyproline - high

Question 13

you suspect bone malignancy. Order a?

Answer 13

lumbar Xray

Question 14

When do you start DEXA scans?

Answer 14

> 65, or younger women with an increased risk for osteoporotic fx

Question 15

Dermatomyositis affects the?

Answer 15

Muscle fibers
Dx with bx
findings - weakness, gottron papules (hands), heliotope rash

Question 16

Pt <40 y/o with lumbar back pain at night
Improves with rest worse with activity
Dx?

Answer 16

Low back pain d/t inflammatory cause (mechanical)

Inflammation at ligamentous insertions

Question 17

Which part of the spine is most commonly affected by RA?

Answer 17

cervical

Can cause spinal subluxation and spinal cord compression

Question 18

Pt on glucocorticoids develops hip pain w/ decreased ROM but NL Xray. Why?

Answer 18

Osteonecrosis

Best seen on MRI

Question 19

Inflammatory arthritis
Splenomegaly
Neutropenia

Answer 19

Felty syndrome

Question 20

Polyarthralgia
Tenosynovitis
Vesiculopustular skin lesions

Answer 20

Disseminated gonorrhea