Musc step 3

Question 1

medications that predispose to gout

Answer 1

diuretics, low dose aspirin, immune suppressants

Question 2

treatment of gout

Answer 2

Nsaid –> if contra –> Colchicine (Like high cR) –> if contra –> systemic steroids in more than 2 joints, systemic or intaarticular steroids if 1 or 2 joints

Question 3

most accurate test to diagnose Achilles tendon

Answer 3

Thompson test: sqeezing of the calf and observe plantar flexion (patient lying prone) –> absence of flexion

Question 4

hemochromatosis arhtropathy

Answer 4

2nd and 3rd metacarpophalangeal joints, knees ankles and shoulders

• calcium pyrophosphate dihydrate crystals in 50%
• not improved by phlebotomy

Question 5

disease modifying antirhematic drugs

Answer 5

1. methotrexate
2. leflunamide
3. hydroxyckoroquine
4. sulfasalazine
5. TNF inhibitors

Question 6

Reactive arthritis treatment

Answer 6

antibiotics and nsaid

Question 7

how to decrease chances of lung complication in surgery

Answer 7

stop smoking 4 weeks before

Question 8

scleradeorma renal crisis - treatment

Answer 8

ACEi inh (captopril)
\+ nitropr if papilledema

Question 9

myotonic dystrophy - presentation

Answer 9

classic (adult): myotonia and weakness (face, hands, ankles)

childhood: cognitive and behavioral
infants: hypotonia, resp failure, inverted V shapped upper lip

Question 10

myotonic dystrophy: non muscle symptos

Answer 10

DM, hypogonadism, catarhact, frontal balding, daytime sleeping

Question 11

common causes of shoulder pain

Answer 11

1. rotator cuff impingement or tendinopathy
2. rotator cuff tear
3. adhensive capsulitis (frozen shoulder)
4. biceps tendinopathy or rupture
5. glenohumeral osteoarthritis

Question 12

rotator cuff impingement or tendinopathy

Answer 12

1. pain with abd and ext rotation
2. subacromial tenderness
3. normal motion with positive tests

Question 13

rotator cuff tear

Answer 13

similar to rotator cuff impingement

Question 14

adhensive capsulitis (frozen shoulder)

Answer 14

decreased passive and active motion

stiffness +/- pain

Question 15

biceps tendinopathy or rupture

Answer 15

anterior shoulder pain

pain with lifting or carring

Question 16

glenohumeral osteoarthritis

Answer 16

uncommon, trauma
gradual anterior and deep pain
decreased active and passive motions

Question 17

adhensive capsulitis (frozen shoulder) - treatment

Answer 17

range of motion exercises

steroid injections if severe

Question 18

raynold + systemic symptoms

Answer 18

ANA, RF, CBC, complement, urinalysis

Question 19

when to start osteoporosis screening

Answer 19

65 if no RFs

Question 20

chronic stroid use: osteoporosis?

Answer 20

baseline and annual test

calcium and vit d

Question 21

3 criteria of ankylosing spondylitis

Answer 21

1. low back pain and stiffness for mor than 3 months diration that improves with exerecise
2. limit range of motion
3. limit chest expansion

Question 22

monitor ankylosing spondylitis - f/u

Answer 22

1. anteroposterior and lateral views of the lumbar spine
2. lateral view of the cervical spine
3. pelvic radiograph including sacroiliac joint

Question 23

Dupuyrten contracture

Answer 23

progressive fibrosis of the palmar fascia. Thickening and nodule formation along flexor tendons distal palmar crease, (decreased extension

Question 24

Dupuyrten - associated with

Answer 24

DM

Question 25

correlates with SLE activity

Answer 25

anti-DS

Question 26

sle initial treatment

Answer 26

low prednisone and hydroxychloroquine

Question 27

Complex regional pain syndrome

Answer 27

recent joint injury presented with local burning pain, edema, skin changes and decreased range of motion

Question 28

sjogren - cancer

Answer 28

B cell lymph

Question 29

giant cell arteritis - diagnosis

Answer 29

3/5 1. more than 50 2. new onset of headache with fever and visual stiurb 3. esr more than 50 4. tenderness or decrease pulse of temporal artery 5. temporal artery biopsy with necrotizing arteritis