Rheumatology

Question 1

Complication of RA
Painful, photophobia, diffuse redness of sclera

Management

Complication

Answer 1

Scleritis

Steroids. Treat underlying disease.

Rupture of globe

Question 2

Treatment for RA

Answer 2

Methotrexate
Then steroids
Then PPD for monoclonal Ab

Question 3

Adverse effect of infliximab

Answer 3

Psoriasis

Question 4

Adverse effect of tocilizumab

Answer 4

Diverticular rupture
OCP failure
HLD

Question 5

Adverse effect of rituximab

Answer 5

Can deactivate Hep B

Question 6

Methotrexate monitoring

Answer 6

CBC, AST, Cr q 3 mo

Question 7

Positive Homan sign

Negative DVT US

Answer 7

Ruptured popliteal (Baker) cyst

Question 8

RA
Splenomegaly
Neutropenia

Answer 8

Felty syndrome

Question 9

Polyarthritis
Fever
Evanescent salmon colored/faint pink rash

Answer 9

Juvenile idiopathic rheumatoid arthritis (Still’s disease)

Question 10

Diseases correlated with Sjogrens

Answer 10

Increased risk of lymphoma and celiac disease

Question 11

Diagnosing Sjogren

Answer 11

Schirmer (blotting paper) test
- positive if < 5’m wetting in tearing of eyes in 5 min (normal is 15mm in 5min)

If Ab negative, Lip biopsy

Question 12

Management of Sjogren

Answer 12

Hydration
Pilocarpine
Cevimeline

Question 13

Bamboo spine
Uveitis
Aortitis
HLA B27+

Answer 13

Ankylosis spondylitis

Question 14

Management of anklyosing spondylitis

Answer 14

NSAIDs

Then anti-TNF

Question 15

Keratoderma blenborrhagicum

Answer 15

Reactive arthritis

Question 16

Management of reactive arthritis

Answer 16

NSAIDs

Question 17

Arthritis
Pitting nails

Management

Answer 17

Psoriatic arthritis

NSAIDs (mild)
Methotrexate (skin/nail changes)

Question 18

Oral and genital ulcers
Erythema nodosum
Pathergy+
Aneurysm

Management

Answer 18

Bechet’s disease

Colchicine (mucocutaneous)
Steroids, TNF inhibitors (moderate to severe)

Question 19

Caribbean
Fever
Arthritis

Answer 19

Chikungunya

Question 20

Flowing ossification if anterior longitudinal ligament

Answer 20

Diffuse idiopathic skeletal hyperostosis (DISH)

Question 21

Most important risk factor for osteoarthritis

Answer 21

Obesity

Question 22

Osteophytes formation

Answer 22

Osteoarthritis

Question 23

Anterior hip pain on external and internal rotation

Answer 23

Osteoarthritis

Question 24

Potential reason for Tscore discrepancy (Lumbar spine -1.0, iliac spine -2.6)

Answer 24

Osteophytes in lumbar vertebrae

Question 25

Lateral hip pain

Answer 25

Greater trochanter pain syndrome

Question 26

Gouty attack | On chlorthalidone

Answer 26

Switch to losartan

Question 27

Rhomboid crystals Weakly + birefringence Chondrocalcinosis

Answer 27

Pseudogout | Calcium pyrophosphate dihydrate disease

Question 28

Diseased associated with calcium pyrophosphate dihydrate disease

Answer 28

Hemochromatosis | Hyperparathyroidism

Question 29

Shoulder pain Washing back while showering Lateral shoulder pain while lying down

Answer 29

Rotator cuff tendinopathy

Question 30

Fall on outstretched hand Shoulder pain Cannot abduct arm and keep up to 90 deg

Answer 30

Rotator cuff tear

Question 31

Affected muscle in lateral epicondylitis

Answer 31

Extensor carpi radialis brevis

Question 32

Affect muscle in carpal tunnel syndrome

Answer 32

Abductor pollicis brevis

Question 33

Unable to hold paper between fingers

Answer 33

Ulnar nerve entrapment

Question 34

Affected muscles in De Quervains tenosynovitis

Answer 34

Abductor pollicis longus | Extensor pollicis brevis

Question 35

Saturday night palsy

Answer 35

Compression of radial nerve at spiral groove in middle of arm

Question 36

Management for dupuytrens contracture

Answer 36

Collagenase injections

Question 37

DM | Inability to completely extend fingers

Answer 37

Diabetic cheiropathy

Question 38

Diabetic hand syndrome

Answer 38

Diabetic cheiropathy + Dupuytrens contracture

Question 39

DM Pelvic and thigh pain Atrophy and weakness of thigh muscle

Answer 39

Diabetic amyotrophy

Question 40

Knee pain Medial aspect 2in below join line

Answer 40

Pes anserine pain syndrome

Question 41

Heel spur Tender at base of calcaneus Tender with squeezing heel

Answer 41

Plantar fasciitis

Question 42

Management for fibromyalgia

Answer 42

Amitryptyline

Question 43

Episodic swelling of ears | Cartilaginous portion of ear swollen

Answer 43

Relapsing polychondritis

Question 44

Abdominal pain Renal insufficiency Hep B sAg positive

Answer 44

PAN

Question 45

Italian. Jewish. Arab. High fever. Swollen knee Father with similar symptoms

Answer 45

Familial Mediterranean fever

Question 46

Clinical findings that suggest secondary Raynaud

Answer 46

Age > 40 Abnormal nail fold capillaries Digital ulcerations

Question 47

Swelling of arms and legs sparing hands and feet Orange peel like quality of skin Eos+

Answer 47

Eosinophilic fasciitis

Question 48

Dermatomyositis Mechanic hands ILD Raynaud

Answer 48

Anti-synthetase syndrome

Question 49

Distal weakness > proximal Endomysial inflammation Basophilic rimmed vacuoles

Answer 49

Inclusion body myositis No treatment

Question 50

LE proximal muscle weakness | Vacuoles. No inflammation

Answer 50

Colchicine myopathy

Question 51

RTA 1 | CaPhos stones

Answer 51

Sjogren