Rheumatology and Immunology

Question 1

MC type of Arthritis

Answer 1

OA - MCC of chronic knee pain in persons >45 y/o

Question 2

pathologic sine qua non of OA

Answer 2

hyaline articular cartilage loss

Question 3

usually SPARED joints in OA

Answer 3

AWE
ankle
wrist
elbow

Question 4

1st line treatment in OA

Answer 4

NSAIDs and COX 2 inhibitor

Question 5

Laboratory seen in OA and RA

Answer 5

OA: WBC <2000
RA: 5000-50,000; overwhelming neutrophil

Question 6

Radiographic seen in OA and RA

Answer 6

OA: joint space loss or narrowing, osteophytes
RA: periarticular osteopenia (early) soft tissue swelling, joint space loss, subchondral erosion

Question 7

This is a flexion of the PIP joint with hyperextension of the DIP joint

Answer 7

Boutonniere deformity

Question 8

Hyperextension of the PIP joint with a flexion of DIP joint

Answer 8

Swan-neck deformity

Question 9

Subluxation of the 1st MCP joint with hyperextension of 1st IP joint

Answer 9

Z line deformity

Question 10

hallmark of the RA

Answer 10

Flexor tenosynovitis (trigger fingers)

Question 11

MC pulmonary manifestation of RA

Answer 11

Pleuirits

Question 12

MC valvular abnormality in RA

Answer 12

MR

Question 13

Conditions with positive RF

Answer 13

SLE
Sjogren syndrome
subacute bacterial endocarditis
Hepatitis B and C

Question 14

first choice for the early treatment of RA

Answer 14

MTX with Folic Acid
— MTX is a folate antagonist

Question 14

DMARD given to Pregnant

Answer 14

Hydrochloroquine
Sulfasalazine

Question 15

Conventional DMARD

Answer 15

Hydroxychloroquine
Sulfasalazine
MTX
Leflunomide

Question 16

no adequate response to MTX

Answer 16

within 6mos, step up –> triple therapy:
MTX, Sulfasalazine, Hydroxychloroquine

Question 17

Diuretic drugs that decrease renal excretion of the uric acid

Answer 17

Thiazides

Question 18

Clinical features seen in OA

Answer 18

Bouchard (PIP) and Heberden (DIP) Nodes

Question 19

Triad of Felty syndrome

Answer 19

nodular RA
neutropenia
Splenomegaly

Question 20

MC used HYPOURECEMIC agent

Answer 20

Allopurinol

Question 21

DIP of pencil-in-cup deformity

Answer 21

Psoriatic arthritis

Question 22

MC CHRONIC DERMATITIS in lupus

Answer 22

Discoid Lupus erythematous

Question 23

MC acute SLE rash

Answer 23

Butterfly rash

Question 24

Labtest should be monitored every 12 weeks

Answer 24

Creatinine CBC - myelosuppresion

Question 25

Antibodies specific for SLE

Answer 25

anti- dsDNA -- correlate with Disease activity: nephritis, vasculitits anti-Smith

Question 26

Drug induced lupus

Answer 26

Lupus Makes My HIPS Extremely Painful Methyldopa Minocycline Hydralazine Isoniazid Phenytoin Sulfa drugs Etanercept Procainamide

Question 27

antibodies seen in Drug-induced lupus

Answer 27

Anti-histone

Question 28

mainstay treatment in SLE

Answer 28

Systemic Glucocorticoids

Question 29

Most serious cardiac manifestation in SLE

Answer 29

Myocarditis Libman-Sacks endocarditis

Question 30

best screening test for SLE

Answer 30

ANA antibody

Question 31

most accurate test in Sjogren syndrom

Answer 31

Labial biopsy

Question 32

MC site of urticaria

Answer 32

extremities and face

Question 33

MC site for angioedema

Answer 33

periorbital and lips

Question 34

most potent drug for the treatment of rhinitis

Answer 34

intranasal glucocorticoid (high dose)

Question 35

DOC for the 1st prevention of ARF

Answer 35

benzathine Pen G 1.2M Penicillin/Amoxicillin Po for 10 days

Question 36

Drugs for secondary prevention

Answer 36

Benzathine Pen G 1.2M every 4 weeks Oral Pen V 250mg BID Erythromycin (penicillin allergy) 25mg BID

Question 37

DUration of Prophylaxis in patient with RF without carditis

Answer 37

5 yrs last attack until 21 y/o

Question 38

Duration of Prophylaxis in patient with RF with carditis without valvular dse

Answer 38

10 yrs last attack until 21 y/o

Question 39

DUration of Prophylaxis in patient with RF with carditis and persistent valvular disease

Answer 39

10 yrs last attack until 40 y/o or sometimes lifetime

Question 40

Diagnosis of the RECURRENT ARF

Answer 40

2 major 1 major and 2 minor 3 minor

Question 41

Diagnosis of the INITAL ARF

Answer 41

2 major 1 major + 2 minor

Question 42

TOC for Anaphylaxis

Answer 42

Epinephrine 0.3-0.5mL of 1:1000 (1mg/ml) IM with repeated dose at 5-20mins interval for severe reaction