Treatment

Question 1

Fibromyalgia

Answer 1

TCA (amitriptyline)

SSRIs

Lyrica

Lifestyle modification (exercise, sleep, therapy)

Question 2

SLE

Answer 2

(NSAIDs)

hydroxychloroquine (fatigue/skin)

HD cortocosteroids (renal)

cyclophosphamide (immunosuppressant)

Can also rx methotrexate, azathioprine

Question 3

Scleroderma

Answer 3

NO CURE - SYMPTOMATIC

ACE inhibitors (renal)

Calcium channel blockers (Raynauds)

Cyclophosphamide (lung)

Promotility drugs (GI)

Question 4

Polymyositis

Answer 4

HD steroids

methotrexate/azathiaprine

IVig (severe)

Question 5

Sjogren’s

Answer 5

Pilocarpine

Restasis

Artifical tears and saliva

Question 6

PMR

Answer 6

LD Steroids 1-2 years

Question 7

GCA

Answer 7

HD steroids

Question 8

GWP (granulomatosis)

Answer 8

HD steroids

cyclophosphamide

methotrexate/azathiaprine

Rituxan

Question 9

PAN

Answer 9

HD steroids

cyclophosphamide

methotrexate/azathiaprine

antivirals (for Hep B)

Question 10

OA general

Answer 10

Lifestyle: dec weight, exercise

Acetaminophen, topical NSAIDs

Injections

Then total joint replacement

Question 11

RA

Answer 11

10mg prednisone, NSAIDs, methotrexate

Progress thru DMARDs

Question 12

Osteoporosis

Answer 12

Lifestyle: exercise, take Ca, etc.

Biphosphonates

HRT

SERMs

Question 13

Septic Arthritis

Answer 13

Surgical debridement (I & D)

Staph: IV vanco or ceftriaxone 6 weeks

Niesseria: IM or IV ceftriaxone daily for 2 weeks

Question 14

Osteomyelitis

Answer 14

6 week abx therapy

surgical debridement

Question 15

Gout

Answer 15

Acute: NSAIDs, ice, elevation

Steroid injections

Colchicine

Chronic: XOI (allopurinol or probenecid)

Surgical excision

Question 16

Pseudogout

Answer 16

Same as gout

Question 17

Hip OA

Answer 17

Conservative (rest, NSAIDs/acetamin, PT, cortisone injection, dec weight)

Surgical: THA*, debridement, fem head resurfacing

Question 18

AVN

Answer 18

Conservative + NSAIDs, anticoags, statins, biphosphonates

Surgical: hip resurface, core decompression, fibular grafting, THA

Question 19

Greater Trochanteric Bursitis

Answer 19

Conservative

Surgical: excision

Question 20

Quad/Hamstring strain

Answer 20

Conservative (RICE!)

Surgery: repair, evacuate hematoma, fasciotomy

Question 21

Extensor mechanism rupture

Answer 21

Surgery: repair with sutures, may brace then PT

Conservative if too sick: cast for 6-8 weeks then PT

Question 22

OA of knee

Answer 22

Conservative 1st

Surgery: knee arthroscopy, tibial/femoral osteotomy, TKA

Question 23

Patellofemoral pain syndrome

Answer 23

Conservative + brace, foot orthotics

Surgery: MPF ligament reconstruction, lateral release, tibial tubercle osteotomy

Question 24

MCL/LCL/ACL/PCL Injury

Answer 24

Conservative (grades 1, 2, maybe 3) + brace

Surgery: ligament reconstruction

Question 25

Meniscus tear

Answer 25

Conservative (improves ONLY sx) **Surgical**: repair, menisectomy

Question 26

Pre-patella bursitis

Answer 26

Conservative + knee pad, cortisone (CAREFUL), and aspiration

Question 27

Shin splints/tibial stress fx

Answer 27

**Conservative** + orthotics, crutches maybe Surgery: Fasciotomy (RARE)

Question 28

Achilles tendon rupture

Answer 28

**Surg** then cast 8 weeks Cons: cast 12 weeks

Question 29

Ankle sprain

Answer 29

Conservative + splint Surgical reconstruc of ligaments

Question 30

plantar fasciitis

Answer 30

**Conservative** + orthotics, night splints Surgical release as last resort

Question 31

metatarsalgia/stress fx

Answer 31

Conserv + metatarsal pad, orthotics, cast if bad if stress fx, cast 4 weeks

Question 32

Charcot foot

Answer 32

**Total contact cast**: 6-9 months to be stable

Question 33

Carpal Tunnel

Answer 33

**Surgery -** release transverse carpal ligament (Conserv + NSAIDs, night splints)

Question 34

Scaphoid fx

Answer 34

thumb spica splint for 2 weeks even if no fx seen re-XR every 2 weeks

Question 35

Mallet finger

Answer 35

splint in full extension for 8 weeks

Question 36

Jersey finger

Answer 36

splint in flexion & refer ## Footnote **must be surgically repaired**

Question 37

Boutonniere deformity

Answer 37

splint PIP in extension for 6 weeks leave DIP joint free

Question 38

ankylosing spondy

Answer 38

NSAIDs 1st DMARDs (methotrexate) Etanercept

Question 39

Reactive arthritis

Answer 39

NSAIDs (sx) sulfasalazine, methotrexate, or etanercept

Question 40

psoriatic arthritis

Answer 40

NSAIDs (mild) corticosteroid injections DMARDs

Question 41

Spinal stenosis

Answer 41

Acetaminophen/NSAIDs/tramadol Decompressive surgery