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Flashcards in Rheumatology Deck (331)
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1
Q

Positive straight leg test

A

disk herniation

2
Q

Rx of acute back pain with no neurologic deficit(4)

A

NSAIDS
Early mobilisation
Mx relaxants
rx dure 4 a 6 semaines

3
Q

Clue for whipple disease (3)

A

Joint pain
Malabsorption
PAS

4
Q

Dx of Whipple(2)

A

Biopsy small intestine

PCR

5
Q

quid of tropherima whippeli

A

Gram positive bacteria

6
Q

xray in osteoarthritis(3)

A

subchondral sclerosis
joint space narrowing
ostophytes

7
Q

joint hand involved in osteoarthritis

A

DIP

8
Q

joint hand involved in RA(2)

A

MCP

PIP

9
Q

Marker of systemic sclerosis

A

antitopoisomerase-I

10
Q

digestive complication of systemic sclerosis(2)

A

GERD

esophageal dismotility

11
Q

Most common cause of death in past from systemic sclerosis and why(2)

A

renal failure

because no ACE inbitor at this time

12
Q

why people with multiple sclerosis can develop right failure

A

because of increase pulmonary artery pressure

13
Q

risk of patient taking chemo in rhumatology

A

gout

14
Q

prophylactic measure to prevent gout in patient taking chemo(2)

A

allopurinol
and
probenicid

15
Q

most common presentation of goutty attack

A

podagra

16
Q

quid of podagra

A

first metatarsophalangeal gouty arthritis

17
Q

characteristic of urate crystals in gout induced by chemo(2)

A

negative birefringent

needled shaped

18
Q

Wbc count in gout arthrocentesis

A

2000-50000

19
Q

what’s allopurinol

A

xanthine oxydase inhibitor

20
Q

Meds used to treat acute attack of gout(3)

A

colchicine
NSAIDS
Steroids

21
Q

Triad of Bechet(3)

A

reccurent painful ulcers
erythema nodosum
ant uveitis

22
Q

localisation of reccurrent ulcers in behcet(2)

A

mouth

penis

23
Q

population touched by Behcet(3)

A

turkish
asian
Middle eastern population

24
Q

clue for compression vertebral fractures

A

local tenderness upon percussion of vertebrae

25
Q

cause of compression fractures(2)

A

Bone demineralisation

low bone densitiy

26
Q

cause of osteomalacia(3)

A

low calcium
low vit D
low phosphore

27
Q

clue for viral arthritis

A

Multiple joint pain in patient working in day care center

28
Q

cause of viral arthritis

A

parvovirus B19

29
Q

localisation of pain in hand(3)

A

like RA
PIP
MCP

30
Q

how long pain last in viral arthritis

A

2 months

31
Q

patient at risk of vertebral osteomyelitis(3)

A

IV drugs user
sickle cell diseas
immunodepression

32
Q

Paraclinique of vertebral osteomyelitis

A

MRI

33
Q

bugs causing vertebral osteomyelitis

A

staph aureus

34
Q

clue in physical exam in vertebral osteomyelitis

A

tenderness to gentle percussion of spinous process

35
Q

young patient with low back pain

A

ankylosing spondylitis

36
Q

Most common extra articular manif of ankylosing spondylitis

A

Ant uveitis

37
Q

clue for Ankylosing spondylitis(3)

A

Morning stiffness
improve with exercice
link HLA-B27

38
Q

bone involved in in Ankylosing spondylitis(2)

A

sacroillitis

then the spine

39
Q

clue for lumbar stenosis(2)

A

elder patient

sitting relieves pain

40
Q

why pain is relieved in lumbar stenosis while sitting

A

spine flexion open intervertebral space

41
Q

quid of neural claudication

A

joint disease

42
Q

what could be a complication of RA(2)

A

cervical subluxation spine

cervical spinal cord compression

43
Q

clue for RA and pain

A

morning stiffness improving with activity

44
Q

Marker of RA

A

anti-CCP

45
Q

which immunoglobulin in RA

A

IGM

46
Q

first drug used to treat RA

A

methotrexate

47
Q

second line regimen if failure if no improvement after 6 months of treatment of RA

A

TNF inhibitor

48
Q

what other drug can be used in adjunction to metotrexate(2)

A

hydroxychloroquine
or
sulfasalasine

49
Q

quid of non biologic agent in RA(DMARD)(4)

A

methotrexate
hydroxychloroquine
sulfasalazine
azathioprine

50
Q

quid of biologic effect(3)

A

ethanercept
infliximab
rituximab

51
Q

mechanism of action of biologic agent in RA

A

TNF inhibitor

52
Q

before beginning DMARD what to check first(2)

A

Hep B et C

TB

53
Q

diasease causing erythema nodosum(7)

A
sarcoidosis
behcet
cocciodomycosis
TB
histoplasmosis
IBD
strep infection
54
Q

what to do in presence of erythema nodosum(2)

A

chest x ray

search hilar adenopathy

55
Q

erythema nodosum plus hilar adenopathy

A

sarcoidosis

56
Q

oligoarthritis plus uretritis plus conjunctivitis

A

reactive arthritis

57
Q

clue for reactive arthritis(3)

A

oligoarthritis
uretritis
conjunctivitis

58
Q

oligo arthritis plus uretritis plus mouth ulcers

A

reactive arthritis

59
Q

first line rx of reactive arthritis

A

NSAIDS

60
Q

quid of enthesitis

A

Pain in tendon

61
Q

tendon most frequently involved in enthesitis

A

achilles

62
Q

most commonly involved joint in reactive arthritis(2)

A

Knee

sacroilliac

63
Q

fluid synovial examination in gonococcal arthritis

A

negative or sterile

64
Q

side effects of methotrexate(6)

A
oral ulcers
increase transaminase
pulmonary toxicity
BM suppression
alopecia
anemia
65
Q

what the mechanism responsible of side effect in methotrexate

A

antimetabolite agent

66
Q

patient taking prednisone develops hip pain Dx

A

avascular necrosis of femoral head

67
Q

the best test to Dx avascular necrosi of femoral head

A

MRI
or
scintigraphy

68
Q

shoulder pain in tennis player

A

subacromial bursitis

69
Q

Physical exam finding of subacromial bursitis

A

pain during rotation and flexion of the shoulder

70
Q

Neer impingement sign? meaning(2)

A

pain during rotation and flexion of the shoulder

subacromial bursitis

71
Q

quid of sausage digit or dactylitis

A

diffusely swollen digit

72
Q

disease causing dactilytis or sausage digit

A

psoriatic arthritis

73
Q

rx of psoriatic arthritis(3)

A

NSAIDS
methotrexate

anti TNF agents

74
Q

arthrocentesis finding in pseudogout

A

rhomboid shaped

positively birefringent crystals

75
Q

Quid of CPPD

A

calcium pyrophosphate dihydrate

76
Q

disease with CPPD

A

chondrocalcinosis in Pseudogout

77
Q

clue for rotator cuff tear

A

pain not relieved by lidocaine shooting

78
Q

clue for rotator cuff tendinitis

A

pain relieved by lidocaine shooting

79
Q

best test to DX rotator cuff tear

A

MRI of shoulder

80
Q

causes of rotator cuff tear(2)

A

rotator cuff tendinitis

trauma

81
Q

physical exam clue of rotator cuff tear(2)

A

lifting the arm above the head causes pain

no possibility of abduction and external rotation

82
Q

site of lesion in Myasthenia gravis

A

post synaptic acetylcholine receptor

83
Q

site of lesion in lambert eaton syndrome

A

presynaptic voltage gated calcium channel

84
Q

site of lesion in dermato myositis or polymyositis

A

MX fibers

85
Q

clue for dermatomyositis(2)

A

gottron papules

heliotrop rash

86
Q

quid of gottron papules

A

violaceus papules involving dorsum of fingers

87
Q

In Lambert eaton how are reflexes

A

absent

88
Q

patient of unilateral leg edema and fever(3)

A

DVT
cellulitis
lymphadenitis

89
Q

clue for cellulitis in unilateral edema(2)

A

fissured web toe

macerated

90
Q

clue of anserine bursitis(2)

A

pain in medial side of the tibia

just below the knee

91
Q

meaning of valgus test

A

medial collateral ligament is touched

92
Q

rx of anserine bursitis(2)

A

ice

rest

93
Q

cause of anserine bursitis(3)

A

trauma
overuse
abnormal gait

94
Q

clue of the arthritis in SLE

A

non deforming arthritis

95
Q

quid of HLA-B27 arthropathy(4)

A

IBD
Ankylosing spondylitis
Reactive arthritis
psoriatic arthritis

96
Q

point common of any disease with HLA b27

A

enthesitis

97
Q

most common lieu for enthesitis

A

heel

98
Q

finding of ankylosing spondylitis

A

spine limited mobility

99
Q

other sites of enthesitis(2)

A

illiac crest

tibial tuberosities

100
Q

clue for fibromyalgia

A

female with diffuse Mx pain

101
Q

first rx for fibromyalgia

A

amitryptiline

102
Q

alternative rx for fibromyalgia(3)

A

duloxetin
pregabalin
milnacipran

103
Q

quid of negative birefringent needle(2)

A

yellow needle like crystal
when parallel to polarizing axis
blue needle like crystals when perpendicular to polarizing axis

104
Q

crystals causing negative birefringent needle

A

monosodium urate crustal deposition

105
Q

wbc in osteo arthritis

A

200-2000

106
Q

arthrocenthesis result in inflammatory arthritis wbc

A

2000-100000

107
Q

arthrocenthesis result in septic arthritis wbc

A

> 50000

108
Q

how to differentiate septic arthritis from inflammatory arthritis(2)

A

PMN>50% inflammatory arthritis

PMN> 80% septic arthritis

109
Q

risk factor for gout(3)

A

high meat consumption
excessive alcohol intake
drugs (diuretic)

110
Q

drug causing gout

A

diuretic thiazide

111
Q

short term rx of gout(3)

A

NSAIDS
colchicine
corticosteroids

112
Q

long term rx of gout

A

allopurinol

113
Q

clue for polymyositis et dermatomyositis(3)

A

elevated CPK
ESR high
proximal mx weakness

114
Q

cause of proximal weakness(4)

A

drug induced myositis
hypothyroid myopathy
Mx dystrophy
Myathenia gravis

115
Q

Confirmatory dx of polymyositis

A

Mx Biopsy

116
Q

Drugs causing Myopathy(3)

A

statin
alcohol
antipsychotics

117
Q

first line of polymyositis

A

corticosteroids

118
Q

first line rx of fibromyalgia(2)

A

aerobic exercice

good sleep hygiene

119
Q

second step of fibromyalgia

A

amitryptiline

120
Q

lumbar pain during lifting heavy object

A

lumbar strain

121
Q

what should be done to prevent further back pain

A

keep the back straight when lifting object

122
Q

patient with back pain worse at night

A

metastasis cancer

123
Q

first tumor to metastase in bone(5)

A
lung
breast
prostate
thyroid
kidney
124
Q

rx for symptomatic sarcoidosis

A

glucocorticoid

125
Q

workup for sarcoidosis and meaning (3)

A

chest xray
biopsy
ACE increases

126
Q

chest xray for sarcoidosis

A

hilar adenopathy

127
Q

biopsy finding for sarcoidosis

A

non caseiting granuloma

128
Q

xray finding in paget

A

mosaic pattern of lameller bone

129
Q

physiopatho of paget

A

bone remodelling

130
Q

why can you have hearing loss in paget

A

cranial nerve entrapment

131
Q

main cause of paget

A

osteoclast dysfunction

132
Q

bone reached in paget

A

femoral bowing

133
Q

clue for inflammatory arthritis(2)

A

pain worst with rest

improves with movement

134
Q

first bone touched in ankylosing spondylitis

A

apophyse joint of axial skeleton

135
Q

triad of gonococcemia(3)

A

thenosinovitis
polyarthritis
painless vesiculo pustular lesions

136
Q

quid of thenosinovitis

A

pain along the tendon sheath

137
Q

quid CREST(5)

A
calcinosis
raynaud phenomenon
esophageal dysmotility
sclerodactily
teleangiactasia
138
Q

what’s the most important guide in the treatment SLE

A

the grade of lupus nephtitis

139
Q

in front of lupus dx what’s the first step

A

kidney biopsy

140
Q

clue for compression fractures

A

pain in back without trauma

141
Q

patient with risk for Compression fractures

A

osteroporosis

142
Q

quid of babinski sign

A

upper motor neuron problem

143
Q

absent ankle reflex in elderly meaning?

A

It’s normal

144
Q

finding xray in ankylosing spondylitis(2)

A

fusion of sacroiliac joint

bamboo spine

145
Q

gender in Ankylosing spondylitis

A

Male>female

146
Q

why respiratory problem in Ankylosing spondylitis(2)

A

chest wall motion restriction

restrictive disease

147
Q

why chest wall motion restriction in ankylosing spondylitis

A

fusion of costovertebral joints

148
Q

clue of secondary amyloidosis

A

nephrotic syndrome in the setting of chronic and reccurrent infection

149
Q

cause of secondary amyloidosis

A

any chronic inflammation

150
Q

other name of secondary amyloidosis

A

AA

151
Q

causes of secondary amyloidosis(5)

A
infection chronique
inflammatory arthritis
IBD
malignancy(lymphoma)
vasculitis
152
Q

dx of AA and finding(2)

A

fad pad aspiration biopsy

Amyloid A

153
Q

rx and prevention of AA

A

colchicine

154
Q

target organs for amyloidosis(4)

A

rein
foie
coeur
system nerveux autonome

155
Q

two presentation of gonococcal arthritis(2)

A

polyarthritis with skin rash and thenosinovitis

monoarthritis

156
Q

cause of CPPD(3)

A

hyperparathyroidism
hemochromatosis
hypomagnesemia

157
Q

high calcemia plus arthritis

A

CPPD

158
Q

complication of Paget(2)

A

osteosarcoma

pathologic fractures

159
Q

work up for paget(4)

A

high ALP
High urine hydroxyproline
Normal calcium and
phosphate

160
Q

urinary marker of bone resorption(4)

A

N telopeptide
C telopeptide
hydroxyproline
deoxypiridinoline

161
Q

Long ter complication of AS

A

decrease bone density

162
Q

consequence of reduced bone density

A

fracture for minimal trauma

163
Q

IBD et P anca positif plus arthritis

A

UC

164
Q

P anca positif plus arthritis

A

UC

165
Q

extracolonic manif of UC(5)

A
cholangitis
episcleritis
erythema nodosum
pyoderma gangrenosum
arthritis
166
Q

disease with P-ANCA positive without vasculitis(2)

A

UC

AS

167
Q

why sjogren causes difficulty swallowing

A

throat dryness because of lack of saliva

168
Q

consequence of lack of saliva in sjogren(3)

A

high incidence of caries
submandibular swelling
dysphagia

169
Q

cause of lack of saliva in sjogren

A

lymphocytic infiltration of salivary glands

170
Q

quid of keratoconjonctivitis sicca in sjogren

A

dry eyes

171
Q

glands problem in sjogren(2)

A

infiltration of salivary glands

and lacrymal glands

172
Q

autoantibodies in sjogren

A

antiRO/SSA

anti LA/SSB

173
Q

dermatomyositis antibody

A

anti mi 2

174
Q

what is often associated with Dermatomyositis

A

malignancy

175
Q

Most common malignancy associated with dermatomyositis(3)

A

ovarian # 1
breast lung
female urogenital

176
Q

when you dx dermatomyositis what to do?

A

screen for Cancer

177
Q

the most important surveillance approach in patient taking hydroxychloroquine

A

eye examination

178
Q

risk with hydroxychloroquine

A

retinopathy

179
Q

quid of phallen sign

A

flexion of wrist worsens paresthesia in carpal tunnel syndrome

180
Q

cause of carpal tunnel syndrome

A

hypothyroidism

181
Q

physiopatho of carpal tunnel syndrome in hypothyroidism

A

accumulation of matrix substances in the endneurium and perineurium of median nerve

182
Q

quid of matrix substances

A

it’s mucopolysaccharides

183
Q

indication of cyclophosphamide in SLE(2)

A

severe renal impairement

CNS impairement

184
Q

side effects of cyclophosphamide(4)

A

bladder carcinoma
hemorragic cystitis
sterility
myelosuppression

185
Q

cause of bladder carcinoma and hemorragic cystitis in cyclophosphamide

A

bladder toxicity causes by accumulation of acrolein

186
Q

quid of acrolein

A

metabolite of cyclophosphamide

187
Q

how to avoid bladder toxicity in cyclophosphamide(2)

A

lot of fluids

Mesna

188
Q

patient with history of gout seen with knee swollen ,what test should be done first?(2)

A

synovial fluid analysis

189
Q

cause of neuropathic joints(6)

A
diabetes
B12
tabes dorsalis
syringomyelie
peripheral nerve damage
spinal cord injury
190
Q

consequence of neuropathic joints in diabetes

A

charcot joint

191
Q

quid of charcot joints

A

deformed foot

192
Q

cause of baker cyst

A

inflamed synovium

193
Q

cause of baker cyst(3)

A

rhumatoid arthritis
osteoarthritis
cartilage tears

194
Q

the most readily modifiable risk factor for OA

A

obesity

195
Q

study of choice for spiunal stenosis

A

MRI

196
Q

pain variation in spinal stenosis

A

worst in standing

relieved by seating

197
Q

neuropathic claudication /vascular claudication

A

pain persisting during rest

198
Q

most common extra articular manif of AS

A

anterior uveitis

199
Q

whtas the most common cause of back pain

A

lumbar strain

200
Q

straight leg raise test in lumbar strain

A

Normal

201
Q

neurologic exam in lumbar strain

A

normal

202
Q

rx of lumbar strain(2)

A

NSaid
and
early mobilisation

203
Q

mechanism of corticoid related osteonecrosis

A

disruption of bone vasculature

204
Q

arthritis with no pain after 2 months

A

viral arthritis

205
Q

cause of positive Rheumatoid factor(4)

A

viral arthritis
bact arthritis
malignancy
rheumatoid arthritis

206
Q

ANA positive cause(4)

A

SLE
HIV
Hepatitis
rheumatoid arthritis

207
Q

does a normal individual can have ANA positive

A

yes

208
Q

other name of rotator cuff impingement

A

same rotator cuff tendinitis

209
Q

mechanism of kidney damage in SLE(2)

A

immune complex mediated

complex antigen antibody activates complement

210
Q

why C3 is decreased in immune complex mediated reaction

A

activation of complement system

211
Q

cause of low C3

A

any disease caused by immune complex reaction

212
Q

disease causing low C3(2)

A

lupus

GNA

213
Q

articulation touche dans SLE(3)

A

MCP
PIP
it’s like Rheumatoid arthritis

214
Q

blood problem in SLE(3)

A

anemia
low platelet
low wbc

215
Q

first initial treatment in OA

A

acetaminophen

216
Q

what the two more common site of atherobolism event secondary to cardiac catheterisation(2)

A

pedal arteries

renal arteries

217
Q

consequence of renal arterythrombo embolism post cardiac catheterisation

A

high creatinine

218
Q

consequence of pedal artery thrombo embolism post cardiac catheterisation

A

blue toe syndrome

219
Q

what’s the cause of thromboembolism in post cardiac catheterisation

A

cholesterol embolism

220
Q

why chemo causes gout

A

massive release of acid uric from DNA of destroyed cells

221
Q

quid of acid uric

A

by product of DNA

222
Q

back pain in OA cause(2)

A

osteophytes

hypertrophy of ligamentum flavum

223
Q

dx of degenerative central canal stenosis

A

MRI

224
Q

cause of Dequervain

A

inflammation of two muscles

225
Q

Mx inflammed in Dequervain(3)

A

abductor pollicis longus
extensor pollicis brevis
when passing through fibrous sheath at the radial styloid process

226
Q

quid of finkelstein sign

A

flexion of thumb into the palm elicit pain

227
Q

Meaning of finkelstein sign

A

Dequervain

228
Q

person at risk of Dequervain

A

mother who holds the baby with their thumb outstretched

abducted et extended

229
Q

rx of polymyalgia rhumatica(PMR)

A

low dose of prednisone

230
Q

dx criteria for PMR

A

age >50
Mx ache
ESR> 40

231
Q

localisation of Mx ache in PMR(3)

A

pelvic girdle
shoulder
neck

232
Q

association of PMR

A

giant cell arteritis

233
Q

clue for OA

A

difficulty moving after a period of rest

234
Q

predisposing factor for OA(2)

A

obesity

age

235
Q

the most common cause of joint disease

A

OA

236
Q

greatest risk for patient with rhumatoid arthritis

A

osteoporosis

237
Q

how does last the morning stiffness in RA

A

> 1 hour

238
Q

prevention of osteoporosis in rheumatoid arthritis(4)

A

calcium
vit D
biphosphonate
low glucorticoid use

239
Q

spinal problem in degenerative joint disease

A

cervical spondylysis

240
Q

clue for cervical spondylisis(2)

A

neck pain

sensory problem in forearm

241
Q

xray in cervical spondylisis

A

bone spur over cervical vertebrae

242
Q

the most common finding in cervical spondylisis

A

bone spur

243
Q

quid of tennis elbow

A

lateral epicondylitis

244
Q

cause of tennis elbow

A

degeneration of extensor carpi radialis brevis tendon

245
Q

Localisation of pain in lumbar strain

A

perispinal

246
Q

Localisation of pain in compression fracture

A

directly on vertebrae

247
Q

quid of pain during direct palpation of vertebrae(3)

A

infection
compression fracture
lytic bone lesion

248
Q

quid of straight leg raise test

A

herniated disc

249
Q

3 cancer metastasis in the spine

A

lung
breast
prostate

250
Q

spine involvement in rhumatoid arthritis

A

cervical spine

251
Q

monoarticular arthritis in elderly with normal lab

A

OA

252
Q

monoarticular arthritis in elderly with high acid uric and high ESR

A

gout

253
Q

physical findings in OA

A

bony crepitus

254
Q

criteria to dx OA(5)

at least 3 to DX OA

A
bony crepitus
bone enlargement
bone tenderness
lack of warmth
lack of morning stiffness
ahe >50
255
Q

why myeloproliferative disorder can cause gout(3)

A

high turnover
high catabolism of purine
so over production of acid uric

256
Q

example of myeloproliferative disorder causing gout

A

polycythemia vera

257
Q

why Polycythemia vera produces gout(2)

A

because of high number of circulating basophiles

histamine release

258
Q

scleroderma antibody

A

topoisomerase -I

259
Q

Monoarthritis pain(3)

A

crystal induced arthritis
septic arthritis
OA

260
Q

predisposing factor for septic arthritis

A

cartilage destruction(rhumatoid arthritis)

261
Q

Rx of septic arthritis(2)

A

drainage

IV antibio

262
Q

patient with AS ,back pain after minimal trauma

A

rule out vertebal fracture

263
Q

risk of patient with AS

A

vertebal fracture with minimal trauma

264
Q

red flag for back pain(7)

A
age > 50
pain during night or sleep
neurologic symptom
pain > 1 month
history of previous ca
weight loss
no response to previous rx
265
Q

rx of temporal arteritis

A

high dose of prednisone

266
Q

new headache in patient female > 50 ans

A

temporal arteritis

267
Q

vessels involved in giant cell arteritis

A

aorta and its cranial branches

268
Q

know to differentiate gonococcemia from toxic shock syndrome

A

pustules on extensor surfaces even in woman using tampon=gonococcemia

269
Q

anterior knee pain in young patient(3)

A

patello femoral syndrome
patellar tendonitis
osgood schlatter

270
Q

who’s at risk for patellar femoral syndrome

A

female

271
Q

who’s at risk for patellar tendonitis

A

athletes

272
Q

who’s at risk for osgood schlatter

A

adolescent

273
Q

clue for patello femoral syndrome

A

pain during climbing stairs

274
Q

physical exam in patello femoral syndrome(2)

A

extend the knee while compressing the patella

patello femoral compressing test

275
Q

rx of patellofemoral syndrome

A

exercice to stretch and strenghten the mx

276
Q

pain location in patellar tendonitis

A

inferior patella

277
Q

pain location in osgood schlatter

A

tibial tubercle

278
Q

cause of lumbar spinal stenosis

A

spinal canal narrowing

279
Q

cause of neurogenic claudication

A

spinal canal narrowing

280
Q

mx pain with normal ESR

A

fibromyalgia

281
Q

mx pain with high ESR

A

PMR

282
Q

most common complication of giant cell arteritis

A

aortic aneurism

283
Q

after dx giant cells arteritis next step

A

serial chest xray

284
Q

specificity of neurogenic claudication

A

pain when standing

285
Q

difference between anserine bursitis and patellar tendonitis

A

X?

286
Q

quid of tophi

A

urate deposition in soft tissue forming tumor

287
Q

HCTZ and gout(2)

A

hyperuricemia

can worsen gout

288
Q

biopsy in whipple(2)

A

PAS positive macrophages in lamina propia

nonacd fast gram positive bacilli

289
Q

action allopurinol

A

decrease acid uric production

290
Q

Parvovirus in children

A

slapped cheek fever

291
Q

risk factor for vertebral osteomyelitis

A

distant infection

292
Q

Median for AS

A

20’s-30’s

293
Q

palinfilm in AS

A

bilateral sacroilitis

294
Q

quid of trigger finger

A

thenosinovitis of the palms

295
Q

disease with trigger finger

A

RA

296
Q

quid of rhumatoid nodules

A

nontender nodulesnear the elbows over the back the forearm

297
Q

spinal complication of RA(2)

A

cervical spine subluxation—->

spinal cord compression

298
Q

limitation of glucocorticoid in rx of RA

A

doesn’t prevent cartilage destruction

299
Q

when can you use glucocorticoid in RA

A

to provide short term in awaiting response of DMARD

300
Q

quid erythema nodosum

A

painful reddish multiple on ant surface of legs

301
Q

most common casue of recent infection

A

recent strep infection

302
Q

patient on rx for RA develops cytopenia and high transminases,what drug he is on

A

leflunomide

303
Q

quid of leflunomine

A

pyrimidine synthesis inhibitor

304
Q

action of hydroxychloroquine and sulfasalasine

A

TNF

IL-1 suppresor

305
Q

patient on rx for RA develops hemolytic anemia and high transminases and stomatitis,what drug he is on

A

sulfasalazin

306
Q

TNF inhibitor(6)

A
adalimumab
certolizumab
ethanercept
infliximab
golumumab
307
Q

DMARDS

A
adalimumab
certolizumab
ethanercept
infliximab
golumumab
methotrexate
leflunomide
hydroxychloroquine
sulfasalazine
308
Q

how to reduce toxicity of metotrexate

A

folic acid

309
Q

cause of avascular necrosis(3)

A

corticosteroids
alcoholism
hemoglobinopathies

310
Q

articulation involved in psoriasis

A

DIP

311
Q

when can occur pseudogout

A

after recent surgery

medical illness

312
Q

what about deformity in SLE

A

deformity is uncommon

313
Q

young patient with articular pain

A

AS

314
Q

quid of PAget disease

A

osteoclast hyperfunction

315
Q

hearing loss in paget why

A

entrapment of 8

316
Q

syndrome nephrotic in a context of hepatomegaly,palpable kidneys,fourth heart sound

A

amyloidosis

317
Q

quid of 4 heart sound

A

ventricular hypertrophy

318
Q

tender articulation and fever in young adult sexually active

A

Neisseria gonorrhea

319
Q

constipation plus hypercalcemia with arthritis

A

pseudo gout

320
Q

what disease to rule out after dx pseudogout

A

hyperparathyroidism

321
Q

CPPD

A

calcium pyrophosphate dihydrate

322
Q

most commonly affected bone in paget

A

skull

323
Q

cause of charcot joint(2)

A

complication of neuropathy

repeated joint trauma in diabetic

324
Q

when baker cyst can be confused with DVT

A

when rupture

325
Q

profession with risk of lateral epicondylitis

A

tennis player

screwdriver

326
Q

initial work up in back pain

A

xray plain film

327
Q

patient with RA develops swollen knee chills and fever

A

septic arthritis

328
Q

cause of charcot joint

A

nerve damage

329
Q

greatest risk of complication in RA

A

osteoporosis

330
Q

pain during squatting in woman

A

patellofemoral syndrome

331
Q

quid of Anti CCP

A

anti cyclic citrulinated peptide