Rheuma

Question 1

RA + pulmo nodules

Answer 1

Caplans syndrome

Question 2

Orange peel skin

Answer 2

Nephrogenic fibrosing dermopathy

Eosinophilic fasciitis

Question 3

Fastest acting dmard

Answer 3

MTX

Question 4

Dmard w/c decreases mortality in ra

Answer 4

Mtx

Question 5

What to monitor w/ mtx tx?

Answer 5

Cbc, crea, alt q2-4wks x 3, q8-12wks x 3 then yearly

Question 6

How to treat mtx induced renal failure

Answer 6

Glucarpidase

Question 7

Predictor of cvs mortality in ra

Answer 7

Inc homocysteine

Question 8

Tx for atlanto-odontoid subluxation

Answer 8

8mm asymptomatic- surgery

Symptomatic- surgery

Question 9

Hydrochloroquine side effect

Answer 9

Macular degeneration

Question 10

Felty’s syndrome

Answer 10

Leukopenia and splenomegaly

Question 11

Still’s dse

Answer 11

Leukocytosis, fever, salmon colored rash

Question 12

Sweet’s syndrome

Answer 12

Leukocytosis, painful red nodules

Question 13

Tx of ankylosing spondylitis

Answer 13

Exercise, PT
If with pain, Nsaids
If unresponsive, anti-TNF alpha agents

Question 14

How to follow up px with ankylosing spondylitis

Answer 14

Xray q3months

ESR for dse activity

Question 15

Skin manifestation common in Reiter’s

Answer 15

Keratoderma blenorrhagica

Question 16

Tx of psoriasis w/ skin and nail involvement

Answer 16

MTX

Question 17

Never drugs in psoriasis

Answer 17

Hydroxychloroquine
Beta blocker
Sunlight (UVB)

Question 18

Pathergy test positive

Answer 18

Behcet’s dse

Mouth/genital ulcers, EN, uveitis

Question 19

Tx of mucocutaneous sx of behcet’s

Answer 19

Colchicine

Question 20

Tx of moderate to severe behcet’s

Answer 20

Steroids

Question 21

Caribbean with high fever and joint pains

Answer 21

Chikungunya

Question 22

Positive titers for ana

Answer 22

> 1:160

Question 23

Positive titers for rf

Answer 23

1:80

Question 24

Diff bet Oa and Ra erosions

Answer 24

OA: central erosions
RA: periarticular erosions

Question 25

Double line sign in T2 MRI

Answer 25

Avascular necrosis

Question 26

Pain on lat aspect of hip, cant sleep on that side

Answer 26

Trochanteric bursitis

Question 27

Negatively birefringent crystals

Answer 27

Gout

Question 28

Positively birefringent crystals

Answer 28

Pseudogout

Question 29

Tx of gout with CI to NSAIDs or colchicine

Answer 29

Steroids

Question 30

Allopurinol increases level of

Answer 30

Azathioprine

Question 31

In pseudogout, what is the crystal involved

Answer 31

ca pyrophosphate

Question 32

Most commonly affected joint in pseudogout

Answer 32

Knee

Question 33

Variable bifringence

Answer 33

Ca oxalate

Question 34

Pain on abduction, tenderness on bicipital groove

Answer 34

Bicipital tendinitis

Question 35

Pain on abd beyond 40 deg and int rot

Answer 35

Rotator cuff tendinopathy

Question 36

Drop arm test +

Answer 36

Rotator cuff tear

Question 37

No pain on extremes of movement but px complains of pain on abd

Answer 37

Subacromial bursitis

Question 38

Pain beyond abduction to 120 deg

Answer 38

Acromioclavicular joint arthritis

Question 39

Shoulder pain with recurrent swelling; tap reveals rbcs, ca phosphate and hydroxyapatite crystals

Answer 39

Milwaukee shoulder

Question 40

What to do if there is thenar muscle wasting in carpal tunnel

Answer 40

NCV studies

Question 41

Sat night palsy

Answer 41

Compression of radial nerve in spiral groove

Question 42

Tx for dupuytren's contracture

Answer 42

Collagenase injections

Question 43

Pain in the anatomical snuff box after fall

Answer 43

Scaphoid fracture Spica splint then do mri or bone scan

Question 44

Meralgia paresthetica

Answer 44

Compression of femoral cutaneous nerve

Question 45

Pain on medial aspect of knee 5cm below joint line

Answer 45

Pes anserine bursitis

Question 46

Tenderness in the lateral aspect of the knee above joint line, snap on flexion

Answer 46

Iliotibial band syndrome

Question 47

Movie goers sign

Answer 47

Chondromalacia patella/ patellofemoral syndrome

Question 48

Point tenderness just below the knee while extending knee against resistance

Answer 48

Osgood schlatter's syndrome

Question 49

Ant drawer sign and lachman test +

Answer 49

Acl tear

Question 50

Mcmurray sign +

Answer 50

Meniscal tear

Question 51

Valgus test +

Answer 51

Mcl tear

Question 52

Pain on percussion posterior and inferior to medial malleolus

Answer 52

Tarsal tunnel syndrome

Question 53

Tx for fibromyalgia

Answer 53

Amitriptyline

Question 54

Tx for polymyalgia rheumatica

Answer 54

Steroids

Question 55

Recurrent pain in the neck, xray shows calcification of ligaments in neck

Answer 55

Crown dens syndrome

Question 56

Sle

Answer 56

Anti dsDNA, anti smith

Question 57

Drug induced lupus

Answer 57

Anti-histone

Question 58

Subacute cutaneous lupus

Answer 58

Anti-Ro (ssa)

Question 59

Scleroderma

Answer 59

Anti-scl 70 | Anti-topoisomerase

Question 60

Crest

Answer 60

Anti-centromere

Question 61

MCTD

Answer 61

Anti-RNP

Question 62

Polymyositis

Answer 62

Anti-jo

Question 63

Dermatomyositis

Answer 63

Anti-MI2

Question 64

Which sign is specific for dermatomyositis

Answer 64

Gottron's papules

Question 65

Sjogren's

Answer 65

Anti-ro, anti-la

Question 66

Schirmer test positive result

Question 67

Wegener's

Answer 67

P anca (myeloperoxidase)

Question 68

Vacuoles + inflammation

Answer 68

Inclusion body myositis

Question 69

Vacuoles with no inflammation

Answer 69

Colchicine myopathy

Question 70

Poor prognosis for dermatomyositis

Answer 70

Dysphagia

Question 71

Steroid psychosis

Answer 71

Greater than pred 20mg/d with auditory hallucinations

Question 72

Sle psychosis

Answer 72

On steroids

Question 73

What marker to follow for sle dse progression

Answer 73

Anti-dsdna

Question 74

Tx for wegeners

Answer 74

Non-severe: steroid + mycophenolate Severe: steroid + cyclophosphamide In remission: MTX In relapse: rituximab

Question 75

Appears like ICH but BP normal

Answer 75

Amyloid angiopathy of the brain

Question 76

Recurrent Serositis + arthritis

Answer 76

Familial mediterranean fever

Question 77

Tx for Familial mediterranean fever

Answer 77

Colchicine