Misc

Question 1

Psoriatic arthritis - treatment of:
mild disease?
skin and nail changes?
recalcitrant psoriatic arthritis?

Answer 1

mild disease - NSAIDs
skin and nail changes - Methotrexate
NO hydroxychloroquine (BAD for psoriatic arthritis)
recalcitrant psoriatic arthritis - Methotrexate + anti-TNF alpha (infliximab)

Question 2

Behcet’s disease - treatment of:
mucocutaneous disease?
moderate to severe disease?

Answer 2

TREATMENT of oral and genital ulcers –> topical steroids
PREVENTION of recurrent mucocutaneous disease - colchicine
moderate to severe disease - steroids –> azathioprine –> TNF-alpha inhibitors

Question 3

in lateral epicondylitis AKA tennis elbow, what muscle is most commonly affected?

Answer 3

extensor carpi radialis BREVIS

Question 4

in carpal tunnel syndrome, what muscle is most commonly affected?

Answer 4

abductor pollicis brevis

Question 5

treatment for polymyalgia rheumatica

Answer 5

low dose prednisone

Question 6

Polyarteritis nodosa
best way to Dx?
Tx?

Answer 6

best way to Dx - abdominal angiogram

Tx - steroids –> + cyclophosphamide

Question 7

Familial Mediterranean Fever
best tx?
complications of FMF?

Answer 7

best tx - colchicine

complications of FMF - AA amyloidosis

Question 8

causes of amyloidosis (4)

Answer 8

Familial Mediterranean Fever
Rh arthritis
TB
Multiple myeloma

Question 9

treatment of SLE: arthritis

Answer 9

ASA, NSAID –> Hydroxychloroquine (Plaquenil) –> Belimumab

Question 10

treatment of SLE: photosensitivity/rash

Answer 10

avoid sun/use sunscreen –> steroid –> Hydroxychloroquine –> +/- quinacrine

Question 11

treatment of SLE: thrombocytopenia

Answer 11

steroids –> IVIG

Question 12

treatment of SLE: hemolytic anemia

Answer 12

steroids

Question 13

treatment of SLE: nephritis

Answer 13

steroids –> add cyclophosphamide (do not give to Hispanics) –> mycophenolate mofetil (use first if no kidney dysfunction)–> cyclosporine

Question 14

treatment of SLE: in AA and Hispanics nephritis

Answer 14

steroids –> mycophenolate mofetil

Question 15

gold standard to diagnose Sjogrens syndrome

Answer 15

lip biopsy of minor salivary glands

Question 16

Treatment of Fibromyalgia

Answer 16

pregabalin, duloxetine, and milnacipran

Question 17

Tx of SLE with mild to moderate active disease when standard therapy fails

Answer 17

belimumab (inhibits B lymphocyte stimulator protein)

Question 18

what are the 4 disorders of spondyloarthritis?

Answer 18

"PAIR"
Psoriatic arthritis
Ankylosing spondylitis
IBD-associated arthritis
Reactive arthritis

Question 19

Treatment of extensive psoriasis?

Answer 19

Narrowband ultraviolet B (UVB)

Question 20

what is the treatment of relapsed granulomatosis with polyangiitis?

Answer 20

Rituximab

Question 21

what conveys the greatest risk for long-term cardiovascular events in survivors of childhood Kawasaki disease?

Answer 21

Persistent coronary artery aneurysm

Question 22

common comorbidity of chronic silicosis?

Answer 22

TB

Question 23

Felty syndrome is a triad of?

Answer 23

rheumatoid arthritis, splenomegaly, and neutropenia

Question 24

A diagnosis of ankylosing spondylitis can be made in a patient younger than age 45 years with symptoms of?

Answer 24

• inflammatory back pain for 3 + months and
• bilateral sacroiliitis on imaging
  NO SEROLOGY NEEDED (e.g., HLA-B27)

Question 25

Acute calcium pyrophosphate crystal arthritis (pseudogout) is characterized by the sudden onset of pain, warmth, tenderness, and swelling of the affected joint, usually at which sites?

Answer 25

a knee or wrist; attacks are typically longer than those of gout

Question 26

Adult-onset Still disease is characterized by? | - what lab abnormality is characteristic?

Answer 26

- spiking fever, an evanescent salmon-colored rash on the trunk and extremities that occurs in conjunction with fever, arthritis, lymphadenopathy, and leukocytosis - an extremely high serum ferritin level (1000)

Question 27

Evidence of acute calcium pyrophosphate crystal arthritis (pseudogout) in a young person should always prompt an investigation for?

Answer 27

secondary causes such as hyperparathyroidism, hypothyroidism, hypophosphatasia, hypomagnesemia, and hemochromatosis - look for signs of hypercalcemia ( abdominal discomfort, constipation, and weakness) and check serum calcium

Question 28

what medication may be considered for patients with severe recurrent and/or tophaceous gout that is intolerant or resistant to standard therapies?

Answer 28

Pegloticase | - stop febuxostat

Question 29

An uncommon side effect of leflunomide (tx for rheumatoid arthritis) is?

Answer 29

peripheral neuropathy, and definitive treatment is discontinuation of the medication

Question 30

The classic triad for IgA vasculitis | - Dx?

Answer 30

(Henoch-Schönlein purpura) - purpura, abdominal pain, and arthralgia; - diagnosis is established with biopsy of the affected organ.