MKSAP: Rheumatology

Question 0

How does a pt typically describe the injury that caused their meniscal tear injury?

Answer 0

• twisting injury with the foot in a weight-bearing position
• popping or tearing sensation felt that is followed by severe pain

Question 0

What 2 physical exam tests can be used to dx a meniscal tear?

Answer 0

1. Pain along the joint line –> 76% sensitive

2. McMurray test –> 97% specific

Question 1

Aa

Answer 1

Aa

Question 2

What is the most common cause of knee pain in pts < 45 yrs old?

Answer 2

-patellofemoral pain syndrome

Question 3

Typical pt with patellofemoral pain syndrome?

Answer 3

-young active woman with anterior knee pain that is worsened by going down steps

Question 4

Tx for patellofemoral pain syndrome?

Answer 4

• rest

- NSAIDs

Question 5

Ottawa Knee rules for obtaining an xray in a pt with acute knee pain (4)?

Answer 5

1. Pt > 55 yrs old
2. Tenderness in the head of the fibula or patella
3. Inability to flex to 90*
4. Cant bear weight immediately AND during the exam

Question 6

What is calcifications of cartilage pathognomonic for?

Answer 6

• pseudogout (AKA: calcium pyrophosphate deposition dz)
• esp in fibrocartilage of knee meniscus, symphysis of the pubis, glenoid and acetabular labra, and the triangular cartilage of wrist

Question 7

What are postmetopausal women who use diuretics at an increased risk for?

Answer 7

-tophaceous gout of the DIP joints

Question 8

Aside from “bronze diabetes” what are 4 Ssx of hemachromatosis?

Answer 8

1. Abnormal liver chemistries
2. Arthropathy
3. Fatigue
4. Impotence

Question 9

Best screening test for pts with suspected hemochromatosis?

Answer 9

-transferrin saturation measurement

Question 10

Leukocyte count in synovial fluid of: OA? Gout & pseudogout? Septic arthritis?

Answer 10

• OA = < 2,000
• Gout & pseudogout = 2,000 - 50,000
• Septic arthritis = > 50,000

Question 11

PIP and DIP: OA or RA?

Answer 11

• PIP = RA

- DIP = OA

Question 12

Migratory arthralgias in a sexually active pt: most likely dx? Tx?

Answer 12

• dx: disseminated gonrrhea

- tx: ceftriaxone

Question 13

2 most common cause of nongonococcal septic arthritis in adukts?

Answer 13

• gram-positive bacteria:
  1. Strep
  2. Staph aureus –> most common

Question 14

Tx for pts with infection of a closed space septic arthritis?

Answer 14

1. IV antibiotics

2. Joint drainage

Question 15

Typical presentation of vasculitic neuropathies?

Answer 15

-acute onset of asymmetrical weakness and sensory loss with severe pain

Question 16

3 Ssx of polymyalgia rheumatica?

Answer 16

1. Pain and morning stiffness in axial joints and proximal muscles
2. No evidence of joint inflammation or muscle weakness
3. Elevated sed rate

Question 17

Typical age of onset of polymyalgia rheumatica?

Answer 17

> 50 yrs

Question 18

Tx for polymyalgia rheumatica?

Answer 18

-corticosteroids