Rapid Style Questions

Question 2

What is Complex Regional Pain Syndrome

Answer 2

Complex Regional Pain Syndrome

• History of previous extremity injury, fracture, or surgery
• More common in women, mean age of 40yrs
• Pain > 6 months
• Sx and findings: light touch causes extreme pain, allodynia, autonomic changes, alterations in skin appearance, motor symptoms
• Tx options include physical therapy, NSAIDs, amitriptyline, gabapentin, nerve blocks

Question 3

Describe the clinical manifestations of fibromyalgia?

Answer 3

Clinical manifestations include
* diffuse pain that is worse in the morning,
* extreme fatigue
* stiffness
* painful and tender joints
* SLEEP DISTURBANCES

Symptoms often worsened with physical and psychological stress

Question 4

What medication class is typically used to treat fibromyalgia?

Answer 4

Anticonvulsants (pregabalin/gabapentin)

The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica)

Question 5

What is the most commonly affected joint in gout?

Answer 5

The first metatarsophalangeal joint (big toe), also known as podagra

Question 6

Which type of crystals are found in synovial fluid analysis of a gout patient?

Answer 6

Needle-shaped, negatively birefringent monosodium urate crystals

Question 7

What lifestyle modification can help reduce gout attacks?

Answer 7

Reducing intake of purine-rich foods (e.g., red meat, seafood) and alcohol

Question 8

Which medication inhibits xanthine oxidase to reduce uric acid production in gout?

What patient education must be done prior to prescribing?

Answer 8

Allopurinol

It may make gout worse at first. Rash is the m/c side effect.

Question 9

What type of crystals are associated with pseudogout?

Which joint is most commonly affected by pseudogout?

Answer 9

Rhomboid-shaped, positively birefringent calcium pyrophosphate dihydrate (CPPD) crystals

Knee

Question 10

Name a common risk factor for developing pseudogout

Answer 10

Advanced age or metabolic disorders like hyperparathyroidism or hypothyroidism

Question 11

What is the radiographic finding characteristic of pseudogout?

Answer 11

Chondrocalcinosis (cartilage calcification)

Question 12

What is the initial treatment for an acute pseudogout flare?

Answer 12

NSAIDs

Question 13

What is the most commonly affected joint pattern in rheumatoid arthritis?

Answer 13

Symmetrical involvement of small joints (wrist, MCP, PIP, MTP).

Spares the DIP

Question 14

What is the hallmark laboratory test for diagnosing rheumatoid arthritis?

What imaging finding is characteristic of long standing RA?

Answer 14

Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies

**Anti-CCP most specific **

Symmetric joint space narrowing and erosions

Question 15

What is the first-line disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis?

What is the MOA? And what supplement needs to be initiated with its use?

Answer 15

Methotrexate

Folic antagonist - must initiate supplementation of folic acid

Question 16

What type of blood vessels are primarily affected in polyarteritis nodosa?

Answer 16

Medium-sized arteries

Question 17

What is a common infectious association with polyarteritis nodosa?

Which organ systems are most commonly involved?

Answer 17

Hepatitis B virus (HBV) infection

The kidney’s, skin, peripheral nerves and GI system

Question 18

What is the gold standard diagnostic tool for confirming polyarteritis nodosa?

Answer 18

Tissue biopsy or angiography

Question 19

What are the typical symptoms of polymyalgia rheumatica?

What age group is most commonly affected?

Answer 19

Bilateral pain and stiffness in the shoulders, neck, and hips, especially in the morning.

Adults over 50

Question 20

Which laboratory marker is typically elevated in polymyalgia rheumatica?

Answer 20

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)

Question 21

What is the primary clinical feature of polymyositis?

Which laboratory marker is usually elevated in polymyositis?

Answer 21

Symmetrical proximal muscle weakness

Creatine Kinase (CK)

Question 22

What diagnostic test is definitive for confirming polymyositis?

Which autoantibody is often associated with polymyositis?

Answer 22

Muscle Biopsy

Anti-Jo-1 Antibody

Question 23

What is the first line treatment for polymyositis?

Answer 23

Corticosteroids (prednisone)

Question 24

What is the classic triad of symptoms in reactive arthritis?

Answer 24

• Arthritis
• Urethritis
• Conjunctivitis

Question 25

What infections are commonly associated with triggering reactive arthritis? | What genetic marker is often associated with reactive arthritis?

Answer 25

* Gastrointestinal (Shigella, Salmonella, Campylocator) * Genitourinary (Chlamydia) | HLA-B27

Question 26

What is the first line treatment for arthritis in reactive arthritis?

Answer 26

NSAIDs

Question 27

What is the typical joint involvement pattern in reactive arthritis?

Answer 27

Asymmetric involvement of large joints, especially the lower extremities (knee's, ankles)

Question 28

What is the most common joint pattern affected by rheumatoid arthritis?

Answer 28

Symmetrical involvement of small joints, especially the hands (metacarpophalangeal and proximal interphalangeal joints).

Question 29

What is the hallmark lab test for diagnosing rheumatoid arthritis?

Answer 29

Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP)

Question 30

What are the two most common clinical symptoms of Sjögren's syndrome?

Answer 30

* Dry Eyes (xerophthalmia) * Dry Mouth (xerostomia)

Question 31

Which autoantibodies are commonly associated with Sjogren's Syndrome?

Answer 31

Anti-Ro/SSA and Anti-La/SSB antibodies

Question 32

What test is commonly used to evaluate tear production in suspected Sjogren's syndrome?

Answer 32

Schirmer's Test

Question 33

What is a common extra-glandular manifestation of Sjögren's syndrome?

Answer 33

* Arthralgias * Interstitial Lung Disease * Vasculitis

Question 34

What is the first-line treatment for dry eyes and dry mouth in Sjogren's Syndrome?

Answer 34

Artificial Tears and Saliva Substitutes

Question 35

What is the most common cause of acute compartment syndrome?

Answer 35

Fractures, particularly of the tibia or forearm ## Footnote Acute compartment syndrome commonly results from trauma, with fractures being the leading cause due to increased pressure from bleeding or swelling.

Question 36

What is the critical threshold of intracompartmental pressure that typically suggests the need for surgical intervention?

Answer 36

Greater than 30 mmHg ## Footnote Compartment pressures above this level can compromise perfusion and tissue viability, necessitating fasciotomy.

Question 37

What is the most reliable clinical finding for diagnosing acute compartment syndrome?

Answer 37

Pain out of proportion to the injury

Question 38

What is the definitive treatment for acute compartment syndrome?

Answer 38

Fasciotomy

Question 39

Which nerve is most commonly affected in anterior compartment syndrome of the lower leg?

Answer 39

Deep peroneal nerve ## Footnote This nerve runs through the anterior compartment and can be affected, leading to sensory and motor deficits