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Part I Boards Question Bank > Arthritis I & II > Flashcards

Arthritis I & II Flashcards

1
Q

Fusiform soft tissue swelling and erosion of the ulnar styloid process are early signs of

a. gout.
b. dermatomyositis.
c. jaccoud’s arthropathy.
d. psoriatic arthritis. e. rheumatoid arthritis.

Yochum and Rowe, pg. 2005

A

e. rheumatoid arthritis.

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2
Q

Active or acute erosive margins are

a. indistinct.
b. sclerotic.
c. sharp.
d. non-marginal.
e. overhanging.

Manaster, M. 2013, pg. 288. The Requisites, 3rd edition

A

a. indistinct.

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3
Q

Fusiform soft tissue swelling is the characteristic response of inflammatory pannus formation. This represents an associated feature of rheumatoid arthritis or

a. ankylosing spondylitis.
b. diffuse skeletal hyperostosis.
c. intervertebral osteochondrosis.
d. osteoarthritis.
e. septic arthritis.

Manaster, M. 2013, pg. 288. The Requisites, 3rd edition

A

e. septic arthritis.

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4
Q

What is the chronological cranial obliteration distribution pattern of the sutures described by Resnick and Korsakoff (2005)?

a. Coronal → Sagittal → Bregma → Lambdoid
b. Sagittal→ Bregma → Coronal → Lambdoid
c. Bregma → Coronal → Sagittal → Lambdoid
d. Lambdoid → Sagittal → Coronal → Bregma
e. Bregma → Sagittal → Coronal → Lambdoid

Resnick & Korsakoff, 2005

A

e. Bregma → Sagittal → Coronal → Lambdoid

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5
Q

MRI imaging of the spine has proven to be clinically useful in the evaluation of complications of systemic arthropathies. The craniocervical junction complications associated with rheumatoid arthritis include cord impingement secondary to pannus formation, atlantoaxial subluxation and

a. ankylosis.
b. cranial settling
c. cranial synostosis
d. ossiculum terminale of bergmann
e. pseudoarthrosis

Brower, A. (2000). Arthritis in Black & White pg. 20)

A

b. cranial settling

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6
Q

Widening is a progressive feature of sacroiliac joint erosions. The usual radiographic response to this change is a. cranial settling. b. demineralization. c. effusion. d. sclerosis. e. synostosis. Brower, A. (2000). Arthritis in Black and White pg. 140)

A

d. sclerosis.

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7
Q

Sacroiliitis is characterized by a triad of

a. erosion, sclerosis, and bony bridging
b. demineralization, cyst formation, and synostosis
c. pelvic settling, hypoplastic vertebrae, and posterior element fusion
d. posterior element fusion, pseduofracture, and cyst formation.
e. pseduofracture, cyst formation, and bony proliferation Pope, 691

A

a. erosion, sclerosis, and bony bridging

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8
Q

An angulated lumbosacral spot view of the SI joints reveals an intact white cortical line on the sacral side on the right. It is ill-defined on the iliac side. This is most suggestive of a(n)

a. non-inflammatory arthropathy.
b. connective tissue disorder.
c. inflammatory arthropathy.
d. congenital anomaly.
e. crystalline arthropathy.

Brower, A. (2000). Arthritis in Black & White pg. 141)

A

c. inflammatory arthropathy.

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9
Q

The most common cause of unilateral sacroiliac ankylosis is

a. infection.
b. ligament ossification.
c. inflammatory bowel disease.
d. enteropathic arthritis.
e. duverney compression.

Brower (2000). Arthritis in Black and White pg. 147)

A

a. infection. (septic arthritis)

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10
Q

What is the most common arthropathy involving the apophyseal joints that produces narrowing of the joint spaces, reparative bone formation and osteophytes?

a. Pyruvate arthropathy
b. Septic arthropathy
c. Osteoarthritis
d. Tophi formation
e. Pannus formation

Brower (2000). Arthritis in Black and White pg. 155)

A

c. Osteoarthritis

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11
Q

A lateral view of the cervical spine demonstrates relative preservation of the intervertebral disc spaces and the apophyseal joints. There is excessive contiguous bone formation seen anteriorly from C3-C7. What is the most likely diagnosis?

a. Ankylosing Spondylitis
b. Congenital Synostosis
c. Diffuse Idiopathic Skeletal Hyperostosis
d. Neuropathic Arthropathy
e. Ochronosis

Brower. (2000) Arthritis in Black and White pg. 155)

A

c. Diffuse Idiopathic Skeletal Hyperostosis

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12
Q

As one observes the normal spine, the intervertebral disc spaces should increase as one descends the spine except at the level of

a. C7-T1.
b. L4-5.
c. T12-L1.
d. C1-2.
e. C6-7.

A

a. C7-T1.

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13
Q

What is the most common radiographic sign of degenerative disc disease?

a. Ankylosis
b. Basilar invagination
c. Chondrocalcinosis
d. Disc space narrowing
e. Fusiform soft tissue swelling Resnick

A

d. Disc space narrowing

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14
Q

A non-marginal osteophyte also known as a traction osteophyte is a strong indication for

a. early degenerative joint disease.
b. canal stenosis.
c. hypertrophy.
d. instability.
e. surgical intervention. Resnick

A

d. instability

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15
Q

DISH is most commonly observed in the

a. apophyseal articulations.
b. cervical spine.
c. patella.
d. lumbar spine.
e. thoracic spine.

Brower

A

e. thoracic spine.

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16
Q

DISH is a common disorder, affecting the elderly population. What percentage of the populace are affected by this bone forming diathesis?

a. 10 percent
b. 12 percent
c. 15 percent
d. 30 percent
e. 5 percent

Brower, pg. 275

A

b. 12 percent

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17
Q

Observation of degenerative disc disease at multiple levels without structural abnormality and calcification of adjacent soft tissue structures near the disc space is most likely due to an underlying arthropathy such as

a. Acromegaly
b. Calcium pyrophosphate deposition disease
c. Chondrocalcinosis
d. Hemochromatosis
e. Wilson’s disease

Brower, pg.

A

b. Calcium pyrophosphate deposition disease

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18
Q

Diagnosis of DISH is made when thick flowing ossification involves four or more contiguous vertebral bodies with their intervening disc spaces. In the cervical spine, this ossification may become extensive as to cause

a. esophageal spasm.
b. diverticulosis.
c. dysphagia.
d. increased range of motion.
e. spondylolisthesis

Brower, pg. 281

A

c. dysphagia

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19
Q

One hundred percent of patients with extraspinal DISH have ________ involvement ?

a. appendicular
b. calcaneal
c. cervical spine
d. pelvic
e. synovial joint

Brower, pg. 103

A

d. pelvic

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20
Q

Pathological and radiological aberrations of thoracic spine involvement in DISH are demonstrated by linear paravertebral bone, paradiscal bone, proliferative enthesopathy, and

a. apophyseal ankylosis.
b. chondrocalcinosis.
c. ligamentous ossification.
d. periarticular osteopenia.
e. ulnar variance.

(Resnick & Kransdorf, 2005, pg. 429)

A

c. ligamentous ossification.

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21
Q

An AP bilateral view of the sacroiliac joints demonstrates unilateral degenerative change with sclerosis dominantly on the iliac side. The opposing articular surface is intact. Inferiorly the right sacroiliac joint shows large erosive changes with a sclerotic rim and sharp overhanging edges. This characteristic finding is suggestive of which metabolic disorder?

a. Calcium pyrophosphate deposition disease
b. Gout
c. Septic arthropathy
d. Pannus formation
e. Pyruvate arthropathy

(Brower, 2012, pg. 148)

A

Gout

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22
Q

Synovial chondrometaplasia is most commonly seen in the

a. acromioclavicular joint.
b. glenohumeral joint.
c. knee.
d. pelvis.
e. sternum.

(Yochum & Rowe, 2005, pg. 1006)

A

knee

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23
Q

The most common age range for the onset of PVNS is

a. 10 to 15
b. 15 to 20
c. 15 to 25
d. 20 to 40
e. 40 to 60

(Brower, 2012, pg. 383)

A

20 to 40

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24
Q

Dissolution of the odontoid in CPPD can lead to agenesis.

os odontoideum.

os terminalis bergman.

pathological fracture.

pseudofracture.

(Brower, 2012, pg. 322)

A

pathological fracture.

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25
Q

Ossification around the knee occurs in what percentage of patients with extraspinal DISH ?

5 %

15 %

25 %

29%

35%

(Brower, 2012, pg. 289)

A

29%

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26
Q

Bony ankylosis distal to the wrist is most often seen with cases involving trauma, infection, or

a. seropositive arthropathy.
b. seronegative arthropathy.
c. jaccoud’s arthritis.
d. rheumatoid arthritis.
e. multireticular histiocytosis.

(Manaster, May, and Disler, 2007, pg. 288)

A

seronegative arthropathy.

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27
Q

One of the most characteristic features of spinal involvement in Ankylosing Spondylitis involves

facet hypertrophy.

fibrous ankylosis.

osteophytes.

spondylophytes.

syndesmophytes.

(Pope, et al., 2015, pg. 693)

A

syndesmophytes.

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28
Q

In what location is the atrophic type of neuropathic osteoarthropathy the most common presentation?

A. Knee

B. Spine

C. Shoulder

D. Ankle

A

C. Shoulder

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29
Q

Which one of the following statements is false regarding neuropathic osteoarthropathy?

A. Primarily caused by alteration in sympathetic control of bone blood flow.

B. Most (90%) of patients suffering from neuropathic osteoarthropathy have pain as the initial complaint.

C. There is a rapid destruction of the involved joint(s)

D. May appear radiographically similar to septic arthritis

A

B. Most (90%) of patients suffering from neuropathic osteoarthropathy have pain as the initial complaint.

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30
Q

Which one of the following arthritides does NOT have soft tissue calcification associated with it?

A. Septic (Pyogenic) arthritis

B. Scleroderma

C. SLE

D. Dermatomyositis E. Gout

A

A. Septic (Pyogenic) arthritis

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31
Q

What is the most frequent soft tissue lesion in rheumatoid arthritis?

A. Sinus tract rheumatism

B. Rheumatoid Nodules

C. Baker cysts

D. Retrocalcaneal bursitis

A

B. Rheumatoid Nodules

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32
Q

What is the etiology of saturnine gout?

A. Glycogen storage disease

B. Complete deficiency of hypoxanthine-guanine phosphoribosyltransferace activity

C. Lead nephropathy

D. Chronic myelogenous leukemia

A

C. Lead nephropathy

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33
Q

What clinical abnormality seen in patients with psoriasis has the strongest correlation with articular manifestations?

A. Cutaneous lesions

B. Pustular skin lesions

C. Nail changes

D. Eye changes

A

C. Nail changes

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34
Q

The hallmark of chronic gout is what?

A. Hyperuricemia

B. Tophi

C. Longer recovery time between acute attacks

D. Painful swelling of a joint

A

B. Tophi

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35
Q

In AS, which one of the following is not a mechanism by which localized central lesions seen at the discovertebral junction forming cartilaginous nodes are formed?

A. Osteoporosis

B. Instability due to apophyseal joint disease

C. Increased intradiscal pressure by hyperkyphosis

D. Intraosseous inflammatory changes

A

C. Increased intradiscal pressure by hyperkyphosis

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36
Q

What joints are commonly involved in scleroderma?

A. Knee and hip

B. Hip and elbow

C. Cervical spine and shoulders

D. Fingers and wrists

A

D. Fingers and wrists

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37
Q

The most characteristic site of abnormality seen in gouty arthritis of the foot is where?

A. DIPs

B. 1st metatarsophalangeal joint

C. Hind foot (talocalcaneal)

D. Fore foot (talonavicular)

A

1st metatarsophalangeal joint

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38
Q

Which one of the following arthritides does NOT have destruction of the distal tuft as a possible finding?

A. Scleroderma

B. Psoriatic

C. Raynaud’s

D. Leprosy

E. AS

A

E. AS

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39
Q

The association of rheumatoid arthritis, splenomegaly, and leukopenia is called what?

A. Sjogren’s Syndrome

B. Felty’s Syndrome

C. Jaccoud’s

D. Meigs Disease

A

B. Felty’s Syndrome

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40
Q

What radiographic view of the hands shows erosions on the metacarpal heads, triquetrum, and pisiform to an advantage?

A. Ball Catchers view

B. Ball busters view

C. Dave and busters view

D. Carpal tunnel view

A

A. Ball Catchers view

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41
Q

Which one of the following skin disorders simulates psoriasis clinically and / or radiographically?

A. Acne fulminans

B. Pyoderma gangrenosum

C. Sweet’s syndrome

D. All the above may simulate psoriasis

A

D. All the above may simulate psoriasis

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42
Q

Which one of the following is false regarding the characteristics of psoriatic arthritis?

A. Has bony erosions with adjacent proliferation

B. Asymmetric distribution more common than symmetric

distribution

C. Intra-articular bony ankylosis

D. Osteoporosis is a prominent feature

A

D. Osteoporosis is a prominent feature

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43
Q

Which of the following best characterizes the erosions occurring in Reiter’s syndrome?

A. Initially appearing at the center of the joint and later

associated with osteophytes

B. Initially appearing at the joint margin later progressing to the

center of the joint

C. Initially appearing at the subchrondral bone progressing to

ankylosis

D. Both A and C are correct

A

B. Initially appearing at the joint margin later progressing to the center of the joint

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44
Q

What blood test(s) are frequently abnormal in patients with active ankylosing spondylitis?

Select all correct answers.

A. Sedimentation rate

B. Western blot

C. HLA-B27

D. Kveim test

A

A. Sedimentation rate

C. HLA-B27

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45
Q

Which one of the findings seen in DJD is most strongly linked to hereditary factors?

A. Nonuniform loss in joint space

B. Subchondral cysts

C. Heberden’s nodes

D. Eggar’s cysts

A

C. Heberden’s nodes

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46
Q

The joint deformity seen in severe osteoarthritis of the knee is most commonly of what form?

A. Varus

B. Valgus

C. Impaction

D. All the above

A

A. Varus

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47
Q

Which one of the following is not a systemic factor in the development of degenerative disease of extraspinal locations?

A. Genetics

B. Geography and environment

C. Age and sex

D. Omega fatty acids in the blood

A

D. Omega fatty acids in the blood

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48
Q

Which one of the following terms is not associated with the bony and joint changes seen in psoriatic arthritis?

A. Beak-like bony proliferation

B. Tumoral enthesopathy

C. Pencil-and-a-cup deformity

D. Whiskering

A

A. Beak-like bony proliferation

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49
Q

What is the initial manifestation of Reiter’s syndrome?

A. Urethritis

B. Arthritis

C. Conjunctivitis

D. Epidermolysis bullosa

A

A. Urethritis

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50
Q

Ankylosis as a complication of DJD is most commonly seen in which of the following joints?

A. Knee

B. Shoulder

C. Sacroiliac

D. Wrist

A

C. Sacroiliac

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51
Q

The most common location for amorphous soft tissue calcification in patients with scleroderma is where?

A. Dominate hand

B. Dominate foot

C. Mandible

D. Paretic limbs

A

A. Dominate hand

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52
Q

Which one of the following is not a feature of Reiter’s syndrome?

A. Urethritis

B. Arthritis

C. Conjunctivitis

D. Epidermolysis buitosa

A

D. Epidermolysis buitosa

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53
Q

Which one of the following diseases is not associated with superior displacement of the disc (Schmorls nodes)?

A. IVOC

B. Scheuermann’s

C. Spondylosis deformans

D. Osteoporosis

A

C. Spondylosis deformans

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54
Q

Which one of the following is NOT a common feature of gouty arthritis?

A. Eccentric nodular soft tissue prominence

B. Relatively well maintained joint spaces

C. Bony erosions

D. Regional osteoporosis

A

D. Regional osteoporosis

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55
Q

The patella “tooth” sign does not represent which of the following?

A. Osteoarthritis

B. D.I.S.H.

C. Peritendinitis

D. Both A and C

A

C. Peritendinitis

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56
Q

Which one of the following is not a characteristic manifestation of SLE?

A. Skin manifestations

B. Reversible deformities

C. Hook erosions

D. Positive HLA-B27 laboratory test

A

D. Positive HLA-B27 laboratory test

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57
Q

According to Resnick, what is the frequency in which patients with psoriatic skin lesions develop articular manifestations?

A. 100%

B. 50%

C. 25%

D. 5%

A

D. 5%

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58
Q

Which condition classically has a bilateral and asymmetrical sacroilitis associated with it?

A. Whipples disease

B. AS

C. Osteitis condensans ilii

D. Rheumatoid arthritis

E. Crohn’s disease

A

D. Rheumatoid arthritis

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59
Q

What is the pathogenesis of uncovertebral joint arthrosis?

A. Disc degeneration

B. Facet degeneration leading to abnormal cervical motion

C. Congenital hyperplasia of the uncinates

D. is always post-traumatic

A

A. Disc degeneration

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60
Q

Which one of the following is NOT a differential diagnosis for Milwaukee shoulder?

A. Rheumatoid arthritis

B. PVNS

C. Neuropathic arthritis

D. Both A and B are not

A

B. PVNS

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61
Q

Neuropathic osteoarthropathy of the foot is most frequently associated with which systemic disorder?

A. Hemophilia

B. Diabetes

C. Riley-Day syndrome

D. Spinal cord trauma

A

B. Diabetes

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62
Q

Which of the following is NOT a radiographic characteristic of Intervertebral (Osteo) Chondrosis?

A. Disc space narrowing

B. Vacuum phenomena

C. Well-defined sclerotic vertebral margins

D. Large spondylophytes

A

D. Large spondylophytes

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63
Q

What is the pathogenesis of IVOC?

A. Infection

B. Dehydration and loss of tissue resiliency of the nucleus

pulposus

C. A.L.L. degeneration leading to a “sloppy” inter-body

articulation

D. Abnormalities in the peripheral fibers of the annulus fibrosis

A

Dehydration and loss of tissue resiliency of the nucleus pulposus

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64
Q

What type of Juvenile chronic arthritis frequently involves the cervical spine?

A. Polyarticular

B. Pauciarticular

C. Monoarticular

D. All the above

A

A. Polyarticular

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65
Q

Increased density, joint distention, bony debris, joint disorganization, and dislocation describe the classic radiographic manifestations of what type of neuropathic osteoarthropathy?

A. Hypertrophic

B. Atrophic

C. Mixed

D. Swirled

A

A. Hypertrophic

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66
Q

What is the best-accepted pathogenesis of sponylosis deformans?

A. Infection

B. Dehydration and loss of tissue resiliency of the nucleus

pulposus.

C. A.L.L. degeneration leading to a “sloppy” inter-body

articulation.

D. Abnormalities in the peripheral fibers of the annulus fibrosis

A

D. Abnormalities in the peripheral fibers of the annulus fibrosis

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67
Q

Taken individually, which one of the following is NOT a way to differentiate erosive osteoarthritis from rheumatoid arthritis on radiographs?

A. Erosions

B. Location of involved joints (pattern of involvement)

C. Bony poliferative changes

D. Intra-articular bony ankylosis

A

D. Intra-articular bony ankylosis

68
Q

Degenerative enthesopathy is most commonly seen at which one of the following locations?

A. Pelvis

B. Hand

C. Shoulder

D. Medial compartment of the knee

A

A. Pelvis

69
Q

Systemic Lupus Erythematosus is most commonly found in what population?

A. White females of childbearing age

B. Middle aged white males

C. Black females of child bearing age

D. Middle aged black males

A

C. Black females of child bearing age

70
Q

The atrophic form of neuropathic osteoarthropathy closely resembles what other disease?

A. Osteosarcoma

B. Severe osteoarthropathy

C. Septic arthritis

D. Rheumatoid arthritis

A

C. Septic arthritis

71
Q

In AS, focal destructive areas along the anterior margin of the discovertebral junction at the superior and inferior portions of the vertebral body, called “Romanus lesions” may be present. What is the pathological mechanism for this?

A. Osteitis

B. Syndesmophytes

C. Anderson erosions

D. Burned out AS

A

A. Osteitis

72
Q

The initial joint changes seen in AS are seen in what location?

A. Upper cervical region (C1/C2)

B. Upper thoracic disco vertebral junctions

C. Mid lumbar Facet joints

D. Sacroiliac joints

A

D. Sacroiliac joints

73
Q

In RA of the heel, what is the most frequent abnormality?

A. Plantar fasciitis

B. Achilles tendinitis

C. Retrocalcaneal bursitis

D. Achilles tendon rupture

A

C. Retrocalcaneal bursitis

74
Q

“Hoarseness” in patients suffering from RA may be a result of what?

A. Involvement of the TMJ

B. Invovement of the cricoarytenoid joint

C. Rheumatoid nodules occurring on the vocal cords

D. Pannus formation within the peri-epiglotic region

A

B. Invovement of the cricoarytenoid joint

75
Q

Which one of the following is NOT an arthritis associated with osteoporosis?

A. RA

B. JCA

C. Hemophilia

D. Gout

A

D. Gout

76
Q

What type of calcium is seen within the soft tissues in patients with scleroderma?

A. Calcium pyrophosphate dihydrate

B. Hydroxyapatite

C. Calcitonin

D. Calcium Oxalate

A

B. Hydroxyapatite

77
Q

Syringomyelia frequently causes neuropathic osteoarthropathy of what joint?

A. Hip

B. Ankle

C. Wrist

D. Shoulder

A

D. Shoulder

78
Q

A 45-year-old man presents with fever, weight loss, brown pigmentation of the skin, and knee and ankle joint arthralgia. A previous visit to his internist revealed accumulation of periodic acid-Schiff (PAS) positive inclusions in the macrophages of the lamina propria of his small intestine. What is the most likely diagnosis is what?

A. Wilson’s disease

B. Hemophilia

C. Whipple’s disease

D. Ochronosis

A

C. Whipple’s disease

79
Q

Early manifestation of RA in the wrist includes which one(s) of the following?

A. Erosions of the triquetrum and pisiform bones

B. Erosion and swelling around the distal end of the ulnar

styloid process

C. Sinus tract rheumatism

D. Both A and B are early manifestations

A

D. Both A and B are early manifestations

80
Q

What are the articular deformities seen in SLE related to?

A. Capsular and ligament laxity

B. Pannus formation

C. Hapten complexes

D. Cartilage degeneration

A

A. Capsular and ligament laxity

81
Q

In AS, what is the term applied in which three vertical radiopaque lines are seen on frontal radiographs related to ossification of the supraspinous and interspinous ligaments and apophyseal joint capsules?

A. Bamboo spine

B. Shiny coroner sign

C. Trolley-track sign

D. Dagger sign

A

C. Trolley-track sign

82
Q

Which one of the following is NOT a theory of why hydroxyapatite crystals deposit within the supraspinatus tendon?

A. Degeneration of the tendon fibers

B. Necrosis of the tendon fibers

C. Hypervascularity

D. Trauma

A

C. Hypervascularity

83
Q

Which one of the following processes leads to the appearance of a bamboo spine in AS?

A. Disc calcification

B. Osteitis

C. Syndesmophytes

D. Kyphosis

A

C. Syndesmophytes

84
Q

Which one of the following connective tissue disorders does NOT cause erosions on the superior surface of the ribs?

A. Psoriatic

B. RA

C. SLE

D. Scleroderma

A

A. Psoriatic

85
Q

Which one of the following does NOT cause chondrocalcinosis?

A. CPPD

B. Alkaptonuria

C. Hemochromatosis

D. Gout

E. Lymes disease

A

E. Lymes disease

86
Q

The most common location for a degenerative spondylolisthesis in the lumbar spine is which of the following levels?

A. L2/L3

B. L3/L4

C. L4/L5

D. L5/S1

A

C. L4/L5

87
Q

What portion of the sacroiliac joint is predominately affected in AS?

A. llium

B. Sacrum

C. Sacroiliac ligament

D. Lumbosacral ligament

A

A. llium

88
Q

On an external rotational view of the shoulder, a small calcific density is seen projected over the lateral aspect of the humeral head. On internal rotation of the shoulder, the calcification, (clearly within the soft tissues) is projected just lateral to the humeral head. In what tendon does this collection of calcium reside?

A. Supraspinatus

B. Infraspinatus

C. Teres minor

D. Subscapularis

A

B. Infraspinatus

89
Q

Which one of the following is not associated with scleroderma?

A. Overlap syndrome

B. Acro-osteolysis

C. Erosive joint changes

D. Osteonecrosis

A

D. Osteonecrosis

90
Q

Swan Neck deformities represent what?

A. Hyperextension at the proximal interphalangeal joints and flexion at the distal interphalangeal joints.

B. Flexion at the distal interphalangeal joints and hyperextension at distal interphalangeal joints.

C. Ulnar devuiation of the metacarpals with radial deviation of the phalanges.

D. Dislocation of the first metacarpal phalangeal joint with axial rotation of the digit.

A

A. Hyperextension at the proximal interphalangeal joints and flexion at the distal interphalangeal joints.

91
Q

Which one of the following is NOT a type of bony erosion seen in the hand in Rheumatoid Arthritis?

A. Marginal erosion

B. Compressive erosion

C. Surface resorption

D. Subperiosteal erosion

A

D. Subperiosteal erosion

92
Q

The radiographic abnormalities seen in AS involving the hands may be classified as which one of the following?

A. Asymmetrically distributed

B. Unilateral, Polyarticular

C. Monoarticular

D. Symmetrically distributed

A

A. Asymmetrically distributed

93
Q

Which of one of the following is a pathogenesis of subchondral cyst formation seen in DJD?

A. Subchondral ganglion cyst rupture

B. Bony contusion

C. Increased intra-articular joint pressure from a central osteophyte

D. Hypertrophied synovium

A

B. Bony contusion

94
Q

What radiographic sign is strongly suggestive of gouty arthritis?

A. Erosions

B. Non uniform loss in joint space

C. Overhanging edge

D. Hook erosions

A

C. Overhanging edge

95
Q

What is the name given to the situation in which fraying of the extensor tendons of the wrist occurs by an eroded head of the uina that abnormally projects into the dorsal compartments of the wrist.

A. Radiocarpal Malaignment

B. Zig Zag deformity

C. Caput Ulnae syndrome

D. Ulnar impaction syndrome

A

C. Caput Ulnae syndrome

96
Q

Patients with rheumatoid arthritis have increased intra-articular pressure. Which one of the following is not a mechanism of synovial joint “decompression”?

A. Marginal erosions

B. Subchondral cyst formation

C. Synovial cyst formation

D. Sinus tract formation

A

A. Marginal erosions

97
Q

What portion of the foot is commonly involved in psoriatic arthritis?

A. Forefoot

B. Midfoot

C. Hindfoot

D. Both B and C are correct

A

D. Both B and C are correct

98
Q

What type of juvenile chronic arthritis may mimic leukemia or lymphoma?

A. Still’s disease

B. Juvenile onset adult RA

C. Rheumatoid nodularis

D. Adult onset juvenile RA

A

A. Still’s disease

99
Q

What is the frequency of radiographically detectable peripheral manifestations in AS if all peripheral joints are considered?

A. 75%

B. 50%

C. 25%

D. 5%

A

B. 50%

100
Q

When present, what radiographic finding helps differentiate neuropathic osteoarthropathy caused by leprosy from other causes?

A. Leprosy always presents in a hypertrophic presentation

B. Lisfranc fractures are frequent in leprosy neuropathic

osteoarthropathy

C. Leprosy causes a large soft tissue mass

D. Calcified nerves may be seen in leprosy

A

D. Calcified nerves may be seen in leprosy

101
Q

What type of juvenile chronic arthritis has systemic or articular (or both) symptoms and signs in the absence of positive serologic test results for rheumatoid factor?

A. Still’s Disease

B. Juvenile onset adult RA

C. Rheumatoid nodularis

D. Adult onset juvenile RA

A

A. Still’s Disease

102
Q

Which one of the following is not a frequent site of the articular manifestations in Reiter’s syndrome?

A. Small articulations of the foot

B. Sacroiliac joints

C. Symphysis pubis

D. Hip

A

D. Hip

103
Q

Which one of the following does NOT have a plantar calcaneal spur associated with it?

A. D.I.S.H.

B. Reiter’s syndrome

C. Psoriatic

D. Hemophilia

E. Ankylosing spondylitis

A

D. Hemophilia

104
Q

Syndesmophytes represent ossification of what?

A. Paravertebral tissues

B. Anulus fibrosis

C. Nucleus pulposus

D. Anterior longitudinal ligament

A

B. Anulus fibrosis

105
Q

Which one of the following does NOT progress to

main-en-lorgnette? (Arthritis mutilans or opera glass hand)

A. RA

B. Psoriatic

C. Osteoarthrosis

D. JCA

A

C. Osteoarthrosis

106
Q

Which of the following is the least encountered type of osteophyte seen in DJD?

A. Marginal

B. Central

C. Periosteal

D. Capsular

A

B. Central

107
Q

What type of lumbosacral transitional segment has the highest prevalence of discal herniation above the transition and at the level of the transition?

A. Type I or dysplastic transverse processes

B. Type II or incomplete lumbarization or sacralization

C. Type III or complete lumbarization or sacralization

D. Type IV or mixed

E. Foshang’s pustular postulate

A

B. Type II or incomplete lumbarization or sacralization

(Type 2A specifically)

108
Q

Pauciarticular or mono articular juvenile chronic arthritis most frequently involves which of the following joints?

A. Cervical spine

B. Lumbar spine

C. Shoulder

D. Knee

A

D. Knee

109
Q

Extensive central and peripheral discovertebral lesions seen in AS are related to what?

A. Osteoporosis

B. Hyperkyphosis

C. Improper fracture healing

D. Discal herniation

A

C. Improper fracture healing

110
Q

Involvement of the axial skeleton in ulcerative colitis closely resembles what other inflammatory arthritis?

A. Ankylosing spondylitis

B. Psoriatic spondylitis

C. Idiopathic gouty spondylitis

D. Ochronotic arthropathy

A

A. Ankylosing spondylitis

111
Q

A significant association exists between osteoarthritis of the glenohumeral joint and what?

A. Genetics

B. Obesity

C. Anteverted glenoid fossa

D. Rotator cuff degeneration

A

D. Rotator cuff degeneration

112
Q

Which one of the following does NOT cause enlargement of the intercondylar notch of the distal femur?

A. JCA

B. Hemophilia

C. CPPD

D. Psoriatic

E. Tuberculous arthritis

A

C. CPPD

113
Q

Which one of the following joints is not commonly involved in DJD?

A. Ankle

B. Hip

C. Knee

D. Hand

A

A. Ankle

114
Q

Which one of the following best helps to differentiate psoriatic arthritis from Reiter’s syndrome?

A. Both upper and lower extremity joints are affected in psoriatic arthritis.

B. Psoriatic arthritis has para-vertebral soft tissue calcification

C. Erosion and proliferation of the posterior or inferior surface of the calcareous only occurs in Reiter’s syndrome

D. Psoriatic arthritis is seronegitive

A

A. Both upper and lower extremity joints are affected in psoriatic arthritis.

115
Q

Disc degeneration as seen on a T2-weighted MRI reveals what?

A. High signal intensity

B. Low signal intensity

C. Decreased disc height

D. Both B and C

A

D. Both B and C

116
Q

The term “Pseudogout” refers to what?

A. Calcium pyrophosphate dihydrate crystal-induced acute synovitis

B. Cartilage calcification

C. Structural joint abnormalities attributed to calcium pyrophosphate dihydrate crystals

D. Radiographically evident calcification in and around articulations Reference

A

A. Calcium pyrophosphate dihydrate crystal-induced acute synovitis

117
Q

Which one(s) of the following represent differential diagnoses of degeneration occurring at the knee with prominent subchrondral cysts?

A. Pyrophosphate arthropathy

B. PVNS

C. Gout

D. Both A and B

A

D. Both A and B

118
Q

Which one of the following statements is false regarding neuropathic osteoarthropathy?

A. Primarily caused by alteration in sympathetic control of bone blood flow

B. Most (90%) of patients suffering from neuropathic osteoarthropathy have pain as the initial complaint.

C. There is a rapid destruction of the involved joint(s)

D. May appear radiographically similar to septic arthritis

A

B. Most (90%) of patients suffering from neuropathic osteoarthropathy have pain as the initial complaint.

119
Q

The primary etiologic agent that “licks the joints but bites the heart” that precipitates Jaccoud’s arthropathy is what?

A. Mycoplasm

B. Staph. Aureus

C. Pseudomonas

D. Beta-hemolytic strep.

A

D. Beta-hemolytic strep.

120
Q

Calcification of the medial collateral ligament of the knee associated with trauma is called what?

A. Haglund’s syndrome

B. Pellegrini-Stieda disease

C. Wee-knee disease

D. Crystal lite

A

B. Pellegrini-Stieda disease

121
Q

When present, what radiographic finding helps differentiate neuropathic osteoarthropathy caused by leprosy from other causes?

A. Leprosy always presents in a hypertrophic presentation

B. Lisfranc fractures are frequent in leprosy neuropathic osteoarthropathy

C. Leprosy causes a large soft tissue mass

D. Calcified nerves may be seen in leprosy

A

D. Calcified nerves may be seen in leprosy

122
Q

Which one of the following is NOT a type of bony erosion seen in the hand in Rheumatoid Arthritis?

A. Marginal erosion

B. Compressive erosion

C. Surface resorption

D. Subperiosteal erosion

A

D. Subperiosteal erosion

123
Q

Which one of the following arthritides does NOT have soft tissue calcification associated with it?

A. Septic (Pyogenic) arthritis

B. Scleroderma

C. SLE

D. Dermatomyositis

E. Gout

A

A. Septic (Pyogenic) arthritis

124
Q

Which one of the following radiographic findings characterizes Ochronotic arthropathy of the spine?

A. Large spondylophytes

B. Bamboo spine

C. Calcification and ossification of the intervertebral discs

D. Negative HLA-B27 serologic test

A

C. Calcification and ossification of the intervertebral discs

125
Q

Which one of the following does NOT cause enlargement of the intercondylar notch of the distal femur?

A. JCA

B. Hemophilia

C. CPPD

D. Psoriatic

E. Tuberculous arthritis

A

C. CPPD

126
Q

Which one of the following skin disorders simulates psoriasis clinically and / or radiographically?

A. Acne fulminans

B. Pyoderma gangrenosum

C. Sweet’s syndrome

D. All the above may simulate psoriasis

A

D. All the above may simulate psoriasis

127
Q

The best description of bone sarcoidosis involving the distal phalanges is what?

A. Lace-like or reticulated bone destruction

B. Moth eaten appearance

C. Peristeal deformans

D. Running greyhound appearance

A

A. Lace-like or reticulated bone destruction

128
Q

Widening of the intercondylar notch of the femur seen in hemophilia is related to what?

A. Osteonecrosis

B. Ligament laxity

C. Intraosseous hemorrhage

D. Hemorrhage about the cruciate ligaments

A

D. Hemorrhage about the cruciate ligaments

129
Q

Which of the following is the least encountered type of osteophyte seen in DJD?

A. Marginal

B. Central

C. Periosteal

D. Capsular

A

B. Central

130
Q

Increased density, joint distention, bony debris, joint disorganization, and dislocation describe the classic radiographic manifestations of what type of neuropathic osteoarthropathy?

A. Hypertrophic

B. Atrophic

C. Mixed

D. Swirled

A

A. Hypertrophic

131
Q

The hallmark of chronic gout is what?

A. Hyperuricemia

B. Tophi

C. Longer recovery time between acute attacks

D. Painful swelling of a joint

A

B. Tophi

132
Q

Which one of the following is NOT a “lumpy bumpy” arthritis? (arthritis with soft tissue nodules)

A. Gout

B. Multicentric reticulohistocytosis

C. Xanthamatosis

D. Behcet’s

A

D. Behcet’s

133
Q

What percentage of patients suffering from Henoch-Schonlein purpura develops articular manifestations consisting of pain, tenderness, and swelling?

A. 90%

B. 60%

C. 30%

D. 5%

A

B. 60%

134
Q

Which of the following degenerative diseases is related to nutrition?

A. Bull man’s hands

B. Drillers disease

C. Kashin-becks’ disease

D. Kasaback-merrit syndrome

A

C. Kashin-becks’ disease

135
Q

The main differential diagnosis for the articular manifestations of SLE is which one of the following?

A. Psoriatic arthritis

B. Rheumatoid arthritis

C. Jaccoud’s arthritis

D. Hemochromatosis

A

C. Jaccoud’s arthritis

136
Q

What crystal deposition disorder features bronze pigmentation of the skin, cirrhosis, and diabetes?

A. HADD

B. CPPD

C. Wilson’s

D. Hemochromatosis

A

D. Hemochromatosis

137
Q

Systemic Lupus Erythematosus is most commonly found in what population?

A. White females of childbearing age

B. Middle aged white males

C. Black females of child bearing age

D. Middle aged black male

A

C. Black females of child bearing age

138
Q

Radial subluxation or dislocation at the interphalangeal joint of the thumb in paitents with dermatomyositis / polymyositis is called what?

A. Hitchhikers thumb

B. Caput digitalis

C. Floppy thumb

D. Broken Tom thumb

A

C. Floppy thumb

139
Q

Early manifestation of RA in the wrist includes which one(s) of the following?

A. Erosions of the triquetrum and pisiform bones

B. Erosion and swelling around the distal end of the ulnar

styloid process

C. Sinus tract rheumatism

D. Both A and B are early manifestations

A

D. Both A and B are early manifestations

140
Q

Joint involvement seen in Sarcoidosis is best described as which one of the following?

A. Chronic arthropathy with marked erosive changes

B. Acute arthropathy with marked bony poliferative changes

C. Transient, symmetrical arthropathy without radiographic findings

D. Recurrent arthropathy without erosive changes, but with deformities

A

C. Transient, symmetrical arthropathy without radiographic findings

141
Q

Of the following articulations, which one is most frequently involved in hemophilia?

A. Knee

B. Cervical spine

C. Hip

D. Wrist

A

A. Knee

142
Q

What is the pathogenesis of IVOC?

A. Infection

B. Dehydration and loss of tissue resiliency of the nucleus pulposus

C. A.L.L. degeneration leading to a “sloppy” inter-body articulation

D. Abnormalities in the peripheral fibers of the annulus fibrosis

A

B. Dehydration and loss of tissue resiliency of the nucleus pulposus

143
Q

What type of juvenile chronic arthritis has systemic or articular (or both) symptoms and signs in the absence of positive serologic test results for rheumatoid factor?

A. Still’s Disease

B. Juvenile onset adult RA

C. Rheumatoid nodularis

D. Adult onset juvenile RA

A

A. Still’s Disease

144
Q

Which one of the following has (or may have) a bilateral and asymmetrical sacroilitis associated with it?

A. Whipples disease

B. AS

C. Osteitis condensans ilii

D. Rheumatoid arthritis

E. Crohn’s disease

A

D. Rheumatoid arthritis

145
Q

Which one of the following joint disorders does NOT have a periosteal reaction associated with it?

A. Hemochromatosis

B. JCA

C. Psoriatic

D. Reiter’s

A

A. Hemochromatosis

146
Q

What disorder features episodic inflammation of cartilaginous tissue and organs of special sense?

A. Tietze’s syndrome

B. Bechet’s disease

C. Relapsing polychondritis

D. SAPHO

A

C. Relapsing polychondritis

147
Q

What is the name given to the situation in which fraying of the extensor tendons of the wrist occurs by an eroded head of the ulna that abnormally projects into the dorsal compartments of the wrist.

A. Radiocarpal Malaignment

B. Zig Zag deformity

C. Caput Ulnae syndrome

D. Ulnar impaction syndrome

A

C. Caput Ulnae syndrome

148
Q

What is the etiology of saturnine gout?

A. Glycogen storage disease

B. Complete deficiency of hypoxanthine-guanine phosphoribosyltransferace activity

C. Lead nephropathy

D. Chronic myelogenous leukemia

A

C. Lead nephropathy

149
Q

Disc degeneration as seen on a T2-weighted MRI reveals what?

A. High signal intensity

B. Low signal intensity

C. Decreased disc height

D. Both B and C

A

D. Both B and C

150
Q

Which one of the following is NOT a DDX for hemochromatosis of the hand?

A. CPPD

B. Kashin-Beck’s disease

C. Ochronosis

D. Both A and B are NOT a DDX for hemochromatosis

A

C. Ochronosis

151
Q

Which one of the following statements about polymyositis / dermatomyositis is false?

A. Raynaud’s phenomena may be seen as a clinical sign

B. Radiographic abnormalities seen in joints is common

C. May be associated with malignancy

D. Periarticular osteopenia is a frequent finding

A

B. Radiographic abnormalities seen in joints is common

152
Q

What portion of the foot is commonly involved in psoriatic arthritis?

A. Forefoot

B. Midfoot

C. Hindfoot

D. Both B and C are correct

A

A. Forefoot

153
Q

Which one of the following arthritides does NOT have destruction of the distal tuft as a possible finding?

A. Scleroderma

B. Psoriatic

C. Raynaud’s

D. Leprosy

E. AS

A

E. AS

154
Q

The pathologic condition of the synovial lining in hemophilia is best described as what?

A. Non-inflammatory hypertrophy

B. Non-inflammatory atrophy

C. Inflammatory hypertrophy

D. Inflammatory atrophy

A

C. Inflammatory hypertrophy

155
Q

The most characteristic site of abnormality seen in gouty arthritis of the foot is where?

A. DIPs

B. 1st metatarsophalangeal joint

C. Hind foot (talocalcaneal)

D. Fore foot (talonavicular)

A

B. 1st metatarsophalangeal joint

156
Q

Which arthritis does NOT have diffuse terminal phalangeal sclerosis as an associated finding?

A. Kashin-Beck’s disease

B. RA

C. Scleroderma

D. SLE E. Sarcoidosis

A

A. Kashin-Beck’s disease

157
Q

What is the vector in Lymes disease?

A. Reduvid beetle

B. Mosquito

C. Flea

D. Tick

A

D. Tick

158
Q

On an external rotational view of the shoulder, a small calcific density is seen projected over the lateral aspect of the humeral head. On internal rotation of the shoulder, the calcification, (clearly within the soft tissues) is projected just lateral to the humeral head. In what tendon does this collection of calcium reside?

A. Supraspinatus

B. Infraspinatus

C. Teres minor

D. Subscapularis

A

B. Infraspinatus

159
Q

Which one of the following joints is not commonly involved in DJD?

A. Ankle

B. Hip

C. Knee

D. Hand

A

A. Ankle

160
Q

A 56 year old female presents with a small, pliable soft tissue mass seen on the dorsal aspect of the 2nd distal interphalangeal joint. This mass is moveable upon palpation. Radiographs of the hand reveal non-uniform loss in joint space, osteophytosis, and subchrondral sclerosis in all the DIPs and the 2-4 digit?s PIPs. This soft tissue mass most likely represents what?

A. Heberden’s node

B. Mucous cyst

C. Rheumatoid nodule

D. Lipoma

A

B. Mucous cyst

161
Q

What joint is most commonly involved in Lymes disease?

A. Knee

B. Cervical spine

C. Sacroiliac joints

D. Hand

E. All the above have the same frequency of occurrence

A

A. Knee

162
Q

Which one of the following terms is not associated with the bony and joint changes seen in psoriatic arthritis?

A. Beak-like bony proliferation

B. Tumoral enthesopathy

C. Pencil-and-a-cup deformity

D. Whiskering

A

A. Beak-like bony proliferation

163
Q

Jaccoud’s arthropathy simulates what other disorder(s)?

A. SLE

B. Scleroderma

C. Ehler’s Danlos

D. Both A and C

A

D. Both A and C

164
Q

The association of rheumatoid arthritis, splenomegaly, and leukopenia is called what?

A. Sjogren’s Syndrome

B. Felty’s Syndrome

C. Jaccoud’s

D. Meigs Disease

A

B. Felty’s Syndrome

165
Q

Which one of the following is false regarding the characteristics of psoriatic arthritis?

A. Has bony erosions with adjacent proliferation

B. Asymmetric distribution more common than symmetric distribution

C. Intra-articular bony ankylosis

D. Osteoporosis is a prominent feature

A

D. Osteoporosis is a prominent feature

Part I Boards Question Bank (20 decks)

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