Rheuma Retention Flashcards by Tisha Ayonayon

Arthritis of the cervical spine leads to the most severe limitation of which neck motion?

a. Lateral bending
b. Rotation
c. Extension
d. Flexion

b. Rotation

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Positive urethritis and conjunctivitis is seen in:

a. Felty’s syndrome
b. Reactive arthritis
c. SLE
d. Gout
e. OA

b. Reactive arthritis

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Which of the following is not a characteristic of psoriatic arthritis?

a. HLA B27 is positive
b. RF- positive
c. Asymmetric inflammatory arthritis
d. (+) dactylitis
e. None of these

b. RF- positive

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DIP hyperextension and PIP extension is a characteristic of:

a. Mallet finger
b. Hammer toes
c. Boutonniere
d. Swan neck
e. None of these

e. None of these

PIP flexion dapat

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The first manifestation of ankylosing spondylitis is usually:

a. Kyphosis
b. Sacroiliitis
c. Iritis
d. Carditis

b. Sacroiliitis

Symmetric + morning back pain

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IN confirming a diagnosis of osteoarthritis which labaoratory abnormality will you expect to note:

a. ESR is elevated
b. Rf-positive
c. Leukocytosis
d. Polyarticular involvement
e. None of these

e. None of these

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Most common age of onset for ankylosing spondylitis:

a. 30y/o
b. 40-60y/o
c. 20-40y/o
d. >60y/o
e. None of these

c. 20-40y/o

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Which of the following definition best fits the term enthesitis?

a. Alteration of joint alignment so that the articulating surfaces incompletely approximate each other
b. Inflammation at the site of tendinous or ligamentous insertion into bone
c. Inflammation of the periarticular membrane lining of the joint capsule
d. Inflammation of the sac like cavity near a joint that decreases friction
e. A crackling sensation elicited with joint motion

b. Inflammation at the site of tendinous or ligamentous insertion into bone

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Nerve compression syndromes may occur in rheumatoid arthritis. What is the most common?
a. Ulnar nerve compression at Guyon’s canal
b. Carpal tunnel syndrome
c. Tarsal tunnel syndrome
d. Ulnar nerve compression at the elbow
e. Thoracic outlet syndrome

b. Carpal tunnel syndrome

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An arthritic condition associated with cognitive impairment:

a. OA
b. RA
c. SLE
d. None of these

c. SLE

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A 36-year old female is diagnosed with rheumatoid arthritis, which of the following statements regarding RA is true:

a. There is an association with HLA-B27
b. The earliest lesion is an increase in the number of synovial lining cells with microvascular lesion
c. Females are affected 3x more often than are males, and it is maintained throughout life
d. African – Americans are involved
e. RF- positive is not predictive of the severity of RA and its complications

b. The earliest lesion is an increase in the number of synovial lining cells with microvascular lesion

a: ACPA
d: Caucasians
e: Predictive

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Arthritic joints, renal manifestations and photosensitivity:

a. OA
b. RA
c. Gout
d. SLE
e. None of these

d. SLE

Code: DOPAMINE RASH

Discoid rash
Oral ulcer
Photosensitivity
Anti-Nuclear Antibody
Malar rash
Immunologic SLE
Neurologic SLE

Renal dse
Arthritis
Serosis
Hematologic (Blood)

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Heberden’s nodes are seen in:

a. RA
b. Gout
c. OA
d. SLE
e. None of these

c. OA

HeberDIP

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The following statements describe fibromyalgia except:

a. A non- articular rheumatic disease of unknown origin characterized by tenderness at 11 or more of the 18 tender points sites
b. Cardiovascular training offers no benefits in reducing the symptoms
c. There maybe patient reported joint swelling without objective findings of swelling
d. The tender points are primarily localized to the musculotendinous junctions
e. Generalized fatigue, chronic headache and sleep disturbance may be present

b. Cardiovascular training offers no benefits in reducing the symptoms

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On examination of a female obese patient with knee pain, she complains of years of knee stiffness and pain for about 30 minutes every morning when she wakes up and has recurrent knee aches towards the end of the day. What is the common pathology?

a. Chondromalacia patella
b. Patellar bursitis
c. Patellar tendonitis
d. Knee OA

d. Knee OA

OA: <30 mins
RA: > 30 mins

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A 45-year old aunt complains of pain and swelling in both wrists and knees for three months. There is increased in the hands early in the morning, which last close to 40 minutes. The MCP joints and wrist are warm and tender. There is no alopecia , photosensitivity, kidney disease, or rash. What is the most likely diagnosis of this patient?

a. Gouty arthritis
b. Systemic lupus erythematosus
c. Osteoarthritis
d. Rheumatoid arthritis

d. Rheumatoid arthritis

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Positive subchondral sclerosis, crescent sign and symmetric arthritis can be found in:

a. AS
b. RA
c. OA
d. SLE
e. Gout

d. SLE

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Acute gouty arthritis is characterized by:

a. Attack in big toe
b. Fever
c. Podagra
d. All of these

d. All of these

A and C are the same

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Most common arthritis seen in the elderly:

a. RA
b. OA
c. Gout
d. SLE
e. All of these

b. OA

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An individual with RA that has a functional capacity adequate to perform only a few or none of the duties of occupation or self- care is classified as CLASS:

a. III
b. IV
c. V
d. II
e. I

a. III

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Indicators of poor prognosis in rheumatoid arthritis include the following, except:

a. RF positive
b. Persistently elevated ESR or C- reactive protein accompanied by active synovitis
c. Generalized oligoarthritis involving both small and large joints
d. Radiographic erosions within 2 years of disease onset
e. None of these

c. Generalized oligoarthritis involving both small and large joints

Polyarthritis

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An individual with RA that is largely or wholly incapacitated, bedridden or using a wheelchair, permitting little or no self-care is classified as CLASS:

a. V
b. IV
c. I
d. III
e. II

b. IV

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Tophaceous deposits of gouty arthritis are most commonly seen on the:

a. 1st MTP
b. Ear cartilage
c. Olecranon bursae
d. None of these

c. Olecranon bursae

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Linear, vertical marginal syndesmophytes is seen in which of the following?

a. OA
b. Gout
c. RA
d. AS
e. None of these

d. AS

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25.Involvement of the lumbosacral spine will suggest more of: a. OA b. RA c. SLE d. Gout e. None of these

a. OA Weightbearing

The inflammatory reaction that occurs in early RA involves the: a. Articular cartilage b. Enthesis c. Synovium d. Articular capsule

c. Synovium

Destructive changes in joints of patients with RA: a. Erosion by synovial pannus b. Vasculitis with infarction c. Ligamentous instability d. Osteoporosis with bone cysts

a. Erosion by synovial pannus

Boutonniere deformity is characterized by: a. Flexion of both PIP and DIP of the hands b. Rupture of the central slip of the extensor hood c. Rupture of the lateral slip of the extensor hood d. None of these

b. Rupture of the central slip of the extensor hood Code: Bottons ng damit nasa gitna (central slip) Yung beak ng swan nasa gilid (lateral slip)

HLA B-27 is specific for a. Psoriatic arthritis b. Scleroderma c. Ankylosing Spondylitis d. Systemic Lupus Erythematosus e. Gout

c. Ankylosing Spondylitis MC and has the highest association with HLA B27 a: Psoriasis if no HLA B27

Indicators of a poor prognosis in rheumatoid arthritis include the following, except: a. RF-positive b. Persistently elevated ESR or C-reactive protein accompanied by active synovitis c. Generalized oligoarthritis involving both small and large joints (>10 to 20 total joints) d. Radiographic erosions within 2 years of disease onset e. None of these

c. Generalized oligoarthritis involving both small and large joints (>10 to 20 total joints)

Manual Therapy may also be used for your 69- year-old aunt with severe deg OA of both knees. She has genu Varus and limitation towards full knee flexion and extension. Which of the following are allowed for her? a. Passive ROM, accessory joint motions b. All of the answers c. Massage techniques d. Soft tissue mobilization e. None of these

b. All of the answers

Which hip- repair surgical procedure is indicated for severe hip pain from degenerative joint disease in elderly patients who are poor surgical risks and have little prospect of walking? a. muscle release b. femoral prosthesis c. displacement osteotomy d. double-cup arthroplasty e. arthrodesis

e. arthrodesis uniting 2 bones @ a joint

What hip repair surgical procedure is indicated for pain in early stages of degenerative joint disease before motion has been lost? a. double-cup arthroplasty b. femoral prosthesis c. muscle release d. arthrodesis e. displacement osteotomy

e. displacement osteotomy Changing the alignment of the bone/ alter WB stresses

True hip pain in rheumatoid involvement of the hip produces pain in the? a. lateral aspect of the hip b. groin c. on the acetabular area d. medial aspect of the thigh e. posterior aspect of the thigh

b. groin Felt in the groin > inguinal area > buttocks > knee

If you differentiate dermatomyositis form SLE, the latter is? a. periorbital and oral area spared b. heliotrophe rash around the eyes c. rash around the knuckles d. rash with purple coloration e. proximal girdle muscle weakness

a. periorbital and oral area spared

Scleroderma is a disease due to excessive production of: a. fibrous tissue b. calcium c. collagen d. salts

c. collagen

What is the proper sequence of skin changes in scleroderma, from earliest to latest? a. indurative, atrophic, edematous b. atrophic, indurative, edematous c. edematous, indurative, atrophic d. indurative, edematous, atrophic

c. edematous, indurative, atrophic Edematous: Skin thickening with puffy, swollen fingers Indurative: Skin becomes firm and tightly bound to the underlying subcutaneous tissue Atrophic: Skin thins and ulcerates easily

The best recreational exercise for patients with osteoarthritis of the hip is: a. jogging b. swimming c. hiking d. bicycling

b. swimming

Classification of polymyositis and dermatomyositis according to Bohan and Peter which is associated with malignancy: a. Type 3 b. Type 1 c. Type 2 d. Type 4

a. Type 3

A 4- year old girl presents with a history of bilateral knee swelling and left ankle swelling. She is febrile with irregular pupils. She most likely has: a. Systemic lupus erythematosus b. Pauciarticular Juvenile Rheumatoid Arthritis c. Still’s disease d. Polyarticular Juvenile Rheumatoid Arthritis

b. Pauciarticular Juvenile Rheumatoid Arthritis Code: Pauci KAWT (Knee, Ankle, Wrist, TMJ)

A 65- year old female patient complains of joint stiffness on pain especially to her shoulders and hip. And also sometimes has low grade fatigue and depression rheumatoid condition fever. What might be the condition? a. Polymyalgia Rheumatica b. RA c. OA d. MPS

a. Polymyalgia Rheumatica Key word: Low grade fever

The facet joint most commonly affected by osteoarthritis in the cervical spine is ______. a. C4-C5 b. C1-C2 c. C3-C4 d. C5-C6

d. C5-C6 b: RA

The most disabling problem in osteoarthritis of the hand is the involvement of the: a. 1st metacarpal joint b. carpal joints c. distal interphalangeal joint d. first carpometacarpal joint

d. first carpometacarpal joint 60% of hand fxn

In rheumatoid arthritis, if the glenohumeral joint is affected, this motion is limited early. a. flexion b. extension c. internal rotation d. external rotation

c. internal rotation

The most common deformity in osteoarthritis is: a. hallux valgus b. clubfoot c. hallux rigidus d. pes planus

a. hallux valgus RD of big toe

The following are clinical features of mixed connective tissue disease except: a. tightly swollen fingers b. sclerodermatous changes c. none of these d. raynaud’s phenomenon

c. none of these

Which of the following is not part of CREST syndrome? a. esophageal disease b. calcinosis c. tuberculosis d. sclerodactyly

c. tuberculosis CREST Syndrome Calcinosis Raynaud's Phenomenon Esophageal Disease Sclerodactyly Telangiectasia

The crystals seen in the joint spaces of patients with gouty arthritis are: a. hydroxyapatite b. calcium pyrophosphate c. monosodium urate d. calcium monophosphate

c. monosodium urate

Sjogren’s syndrome is characterized by: a. decreased tear formation b. all of these c. decrease saliva formation d. infection of the conjunctiva

b. all of these a: Xeropthalmia c: Xerostomia + Dyspareunia (Dryness of Vagina)

The gait abnormality typical of patients with RA is termed apropulsive because of: a. Excessive push off b. Absence of push off c. Excessive heel strike d. None of these

b. Absence of push off 1st MTP is affected

The following are symptoms of MPS, EXCEPT: I. Trigger points II. Referred patterns of pain III. Tight band IV. Fatigue complaints A. I, II, III B. I, II, IV C. II , IV D. IV only E. NOTA

D. IV only

This is the drug of choice for refractory reactive arthritis which can also be used in patients with HIV infection a. Intra-muscular gold b. Sulfasalazine c. Sulfamylon d. D-penicillamine e. Anti-malaria

b. Sulfasalazine

Which of the following conditions is a complication of primary polycythemia? a. Ulcerative colitis b. Reactive colitis c. Gouty arthritis d. Progressive systemic scleroderma e. None of these

c. Gouty arthritis

A 41-year-old man was recently in a motor vehicle accident in which he was the driver. He states that he was wearing his seat belt at the time of the accident. A day after the accident, he developed neck pain that has now continued for 10 days. He notices crunching on extension and lateral bending of the neck. Physical examination reveals no neurologic deficits. His neck has no areas of tenderness and there are no areas of spasm. He has no normal lateral bend, extension, and flexion of the neck. Which of the following is the most likely diagnosis? a. Ankylosing spondylitis b. Osteoarthritis c. Reiter’s syndrome d. Whiplash e. Wry neck

d. Whiplash Keywords: MVA, wearing his seat belt

55. The most frequent cause of death in the patient with SLE is: a. Pericarditis b. Stroke c. Myocardial infarction d. Malignancy e. Nephritis

e. Nephritis Kidney inflammation

All of the following are true about the criteria for the classification of acute gouty arthritis, except: a. Maximal inflammation developed within 1 day b. Joint redness observed c. Asymmetric swelling within a joint d. Subcortical cysts with erosions e. None of these

d. Subcortical cysts with erosions

Global functional status in RA: Able to perform usual self-care and vocational activities, but limited in avocational activities a. Class I b. Class II c. Class IV d. Class III e. Class V

b. Class II a: Ok ALL c: Lim voc and avoc d: Lim ALL

ACR Criteria: Able to perform usual self-care activities, but limited in vocational and avocational activities a. Class 1 b. Class 2 c. Class 3 d. Class 4

c. Class 3 a: Ok ALL b: Ok self-care and voc, Lim avoc d: Lim ALL

Kellgren and Lawrence Grading for OA described as definite osteophytes and absent or questionable narrowing of the joint space: a. Grade 1 b. Grade 2 c. Grade 3 d. Grade 4 e. Grade 5

b. Grade 2 0: No radiographical findings 1: Doubtful narrowing, possible osteophyte 2: Possible narrowing, definite osteophyte 3: Mod multiple osteophyte, definite narrowing, small pseudo cystic area 4: Large osteophyte, marked narrowing, severe sclerosis, definite deformity of bone contour

Clinical classification criteria for hip OA include the following: a. Pain present with hip IR >= 15 degrees b. Morning stiffness <= 60 minutes c. Pain on hip IR < 15 degrees and hip flexion < 115 degrees d. All of these e. None of these

d. All of these

Stage II rheumatoid arthritis, except: a. Joint deformity without fibrous or bony ankylosis b. Radiographic evidence of osteoporosis with or without slight subchondral bone destruction c. Adjacent muscle atrophy d. Extra-articular soft tissue lesions may be present

a. Joint deformity without fibrous or bony ankylosis

Criteria for hip osteoarthritis, except: a. Pain on internal rotation b. Hip internal rotation ≥ 15° c. morning stiffness ≥ 60mins d. age > 50years

c. morning stiffness ≥ 60mins <30 mins

Stage III rheumatoid arthritis: a. Radiographic evidence of cartilage and bone destruction without osteoporosis b. Fibrous or bony ankylosis c. Joint deformity without fibrous or bony ankylosis d. No destructive changes on radiographic examination

c. Joint deformity without fibrous or bony ankylosis

Criteria for hand osteoarthritis, except: a. presence of Heberden’s nodes b. age less than 40 years c. family history of nodes d. joint space narrowing in any finger joint

b. age less than 40 years More than

A patient is able to perform usual self-care and vocational activities but cannot do avocational activities. At what classification of functional status in RA does the patient belong to? a. Class I b. Class II c. Class III d. Class IV

b. Class II

What type of hypersensitivity reaction is noted in SLE? a. Anaphylactic Allergic Reaction b. Cytotoxic Allergic reaction c. Immunologic complex Allergic reaction d. Delayed hypersensitivity e. NOTA

c. Immunologic complex Allergic reaction

Rheumatoid Arthritis is associated with which of the following HLA allele? a. HLA- B47 b. HLA- B27 c. HLA- DR4 d. HLA- B72 e. HLA- BR4

c. HLA- DR4 Code: R4 (RA)

Which of the following is not a seronegative arthritis? a. Psoriatic arthritis b. Reiter’s Syndrome c. Marie Strumpell d. Crohn’s Dse e. NOTA

e. NOTA b: Reactive Arthritis c: AS d: IBD

The inflammatory reaction that occurs in early RA involves the: a. Articular cartilage b. Enthesis c. Synovium d. Articular capsule

c. Synovium

OA is characterized by: a. All of these b. Increased synthesis of ground substances c. Destructive bony changes d. Widening of joint space

c. Destructive bony changes

Oligoarticular JRA is defined as synovitis of: a. 6 joints or more b. More than 4 joints c. Polyarticular d. None of these

d. None of these b: Only 1-4 joints

Destructive changes in joints of patients with RA: a. Erosion by synovial pannus b. Vasculitis with infarction c. Ligamentous instabilities d. Osteoporosis with bone cysts

a. Erosion by synovial pannus

This area of the shoulder has the highest incidence of degenerative arthritis: a. Acromioclavicular joint b. Sternocostal joint c. Glenohumeral joint d. Sternoclavicular joint

a. Acromioclavicular joint c: RA

Psoriatic arthritis usually involves the: a. DIP joints b. PIP joints c. Wrist joint d. MCP joints

a. DIP joints Code: DAKO DIP affected Auspitz sign- Bleeding Koebner's Phenomenon- Formation of new lesion Onycholysis- nail changes

Treatment of ankylosing spondylitis should not include: a. Deep breathing exercise b. Back extension exercise c. Stretching d. None of these

d. None of these

Which joint is usually spared form involvement in the pauciarticular form of juvenile rheumatoid arthritis? a. Hip b. Ankle c. Knee d. Wrist

a. Hip Code: KAWT Knee Ankle Wrist TMJ

Photosensitivity and alopecia are frequent signs of: a. OA b. RA c. SLE d. Gout e. None of these

c. SLE

Progressive, symmetric, erosive form of arthritis: a. OA b. Gout c. SLE d. RA e. None of these

d. RA

Koebner phenomenon is a finding in: a. SLE b. Psoriasis c. OA d. RA e. None of these

b. Psoriasis Code: DAKO DIP affected Auspitz sign- Bleeding Koebner's Phenomenon- Formation of new lesion Onycholysis- nail changes

The best orthosis for relief of pain on osteoarthritis of the base of the thumb is: a. 3 point IP orthosis b. Thumb spica c. Cock-up splint d. All of these

b. Thumb spica

Erythematous rashes over the cheeks and fingertips associated with polyarthritis of small joints of the hands is suggestive of: a. RA b. OA c. SLE d. Psoriasis e. None of these

c. SLE

Common pathologic findings in OA includes the following: a. Degradation of articular cartilage b. Thickening of subchondral bone c. Osteophytes formation d. All of these

d. All of these

Which of the following statements is not true about SLE? a. Common in women b. Males are spared c. Common among blacks d. Polyarticular involvement of small joints e. None of these

b. Males are spared Not spared a: 15-45 years old c: + Hispanic, Carribean

The most commonly involved joint in psoriasis is the: a. 1st CMC b. MCP c. 1st MTP d. MTP’s e. NOTA

e. NOTA DIP

Which of the following epidemiology of inflammatory arthritis is true? a. RA is high in whites than blacks b. Gout is common among Caucasians c. SLE is common among Caucasians d. All of these e. None of these

a. RA is high in whites than blacks

In patients with acute RA, immobilization of joints is best accomplished by: a. Static splinting b. Bed rest for 1- 2 weeks c. Traction d. Suspension devices

a. Static splinting

SLE is common among: a. Blacks b. Caucasians c. Asians d. None of these

a. Blacks

To prevent thumb flexion deformity in RA, the position of splinting the thumb should be: a. Extension, apposition b. 10 degrees, IP flexion c. Extension, same plane as thumb d. 20 degrees IP extension

a. Extension, apposition

Which of the following statements is true about gout? a. Asymmetric involvement of joints b. Joints involved presents with agonizing pain and intense inflammation c. Mainly affects peripheral joints of the lower extremities d. Attacks are correlated with rapid increase in serum urate e. All of these

e. All of these

If glenohumeral joint is involved in RA, this motion is limited early: a. Flexion b. Extension c. Internal rotation d. External rotation

c. Internal rotation

Jaccoud’s arthritis is seen in: a. SLE b. RA c. Gout d. Oa e. Psoriasis

a. SLE Code: JaccoLE

Fatigue, severe stiffness of the shoulder and pelvic girdles, depression, and low -grade fever are hallmarks of this disorder: a. Polymyalgia rheumatica b. Polyarteritis c. Metabolic arthropathies d. Systemic lupus erythematosus

a. Polymyalgia rheumatica Keywords: Low grade fever Systemic/ Still's JRA: High grade fever

Tophi of gouty arthritis are usually seen on: a. Ulnar surface of the forearm b. Ears c. All of these d. Achilles tendon

c. All of these

Steroids are routinely used for rheumatic diseases. The rheumatic diseases which does not require routine steroids is________. a. Rheumatoid arthritis b. SLE c. Dermatomyositis-polymyositis d. Gouty arthritis

d. Gouty arthritis Only be given one time (severe cases)

On examination of a patient with severe knee pain, there is note of knee redness, swelling, and warmth. Concomitantly, the patient has febrile episodes. What is this case. a. Knee OA b. Infective arthritis c. Torn ACL d. Knee bursitis

b. Infective arthritis

A 33-year old female named presents with malar rash that is exacerbated by sun exposure. She has experienced episodes of myalgia, pleural effusion, pericarditis and arthralgia without deformity over the course of several years. The best screening test for her would be: a. Rheumatoid factor b. Anti-ds-DNA antibody c. Antinuclear antibody d. HLA-B27 e. None of these

c. Antinuclear antibody Hallmark of SLE 95% of more px with SLE have (+) ANA

Characteristics of Felty’s Syndrome include the following, except: a. Arthritis b. Anemia c. Neutropenia d. Leukopenia e. None of these

e. None of these Code: SLLAANT Splenomegaly Lymphadenopathy Leukopenia Anemia Arthritis Neutropenia Thrombocytopenia

The organism most often found to cause infectious pyogenic arthritis in children is: a. Staphylococcus aureus b. Diplococcus pneumoniae c. Streotococcus pyrogenes d. Neisseria gonorrhoeae e. Hemphilus influenza

a. Staphylococcus aureus Keywords: infectious pyogenic arthritis

A patient presents with chest pain, tenderness, and firm swelling in the area of the left third costochondral junction. No history of trauma can be obtained. Deep breathing increases the pain. A likely diagnosis is: a. Tietze’s syndrome b. Atypical angina c. Pneumonitis d. Rib fracture e. Scheuermann’s disease

a. Tietze’s syndrome Keywords: Chest pain, tenderness, and firm swelling in the area of the left third costochondral junction

A 40-year-old male develops dermatomyositis. He should also be closely evaluated for the presence of: a. Diabetes b. Hyperparathyroidism c. Addison’s disease d. Malignant tumor e. Hypertriglyceridemia

d. Malignant tumor

Rheuma Retention Flashcards

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