Wk 5 Rheumatology

Question 1

Osteoarthritis pathophys

Answer 1

progressive cartilage loss

Question 2

Osteoarthritis progression

Answer 2

gradual progressive joint pain

Question 3

New bone formation term

Answer 3

sclerosis

Question 4

Sclerosis in joints

Answer 4

osteophyte

Question 5

Radiologic findings of osteoarthritis

Answer 5

osteophytes
bone spurs at joints
unilateral cartilage degeneration

Question 6

Physical exam findings of osteoarthritis

Answer 6

hard joints (bone spurs)

Question 7

Hx findings osteoarthritis

Answer 7

morning stiffness < 30 min

Question 8

Tx osteoarthritis

Answer 8

NSAIDs
analgesics
intra-articular steroid/hyaluronic acid injections

Question 9

RA pathophys

Answer 9

chronic progressive autoimmune inflammatory arthritis

Question 10

RA extra-articular manifestations

Answer 10

• sub-Q nodules
• pericarditis
• lung nodules
• interstitial fiborosis
• inflammatory eye disease
• vasculitis

Question 11

Hx RA

Answer 11

morning stiffness > 1 hr

Question 12

Physical exam findings RA

Answer 12

symmetrical swollen glossy joints

Question 13

RA small joints

Answer 13

wrist
MCP
MTP
PIP

Question 14

Osteoarthritis joints

Answer 14

DIP
PIP
knee
hip

Question 15

RA large joints

Answer 15

ankle
elbow
knee
shoulder

Question 16

RA severe physical findings

Answer 16

subluxation

ulnar deviation

Question 17

RA severe radiological findings

Answer 17

bone degeneration

Question 18

RA Tx

Answer 18

DMARDs (disease-modifying anti-rheumatic drugs)

Question 19

Juvenile Idiopathic Arthritis (JIA) age group

Answer 19

≤ 16 y/o (be definition)

Question 20

JIA Systemic Onset Sx

Answer 20

daily spiking fevers
evanescent salmon-colored rash
hepatosplenomegaly
lymphadenopathy
pericardial/pleural effusions
leukocytosis

Question 21

DDx in systemic onset JIA

Answer 21

LEUKEMIA
IT’S A CHILD ALWAYS THINK LEUKEMIA
okay not “always”

Question 22

JIA polyarticular onset

Answer 22

5+ joints

RF+ subtype most severe, resembles RA

Question 23

JIA oligoarticular onset

Answer 23

≤ 4 joints
most common
1-5 y/o

Question 24

Test 95% sensitive for lupus

Answer 24

ANA (but nonspecific)

Question 25

Tx for drug-induced lupus

Answer 25

DC drug

Question 26

2 types of crystal induced arthritis

Answer 26

gout (monosodium urate) | pseudogout (calcium pyrophosphate dihydrate)

Question 27

What is the most common cause of uric acid concentration elevation

Answer 27

decreased excretion

Question 28

What is the second most common general cause of elevated serum uric acid

Answer 28

increased synthesis

Question 29

What type of drug is usually associated with gout

Answer 29

thiazide diuretics

Question 30

Definitive diagnosis of gout/pseudgout

Answer 30

joint aspiration/crystals

Question 31

Tofi are present in what disease

Answer 31

gout

Question 32

What makes up tofi

Answer 32

uric acid crystals

Question 33

T/F uric acid levels may be normal during acute gout episode

Answer 33

T

Question 34

First-line gout therapy

Answer 34

NSAIDs

Question 35

What Rx is definitely NOT an appropriate first-line gout therapy but is appropriate for long-term gout uric acid level management?

Answer 35

allopurinal (PRPP pathway, xanthine oxidase inhibitor)

Question 36

Chonrocalcinosis of the knee is most common in which condition

Answer 36

pseudogout

Question 37

Pseudogout is often associated with which disease

Answer 37

hyperthyroidism (15%)

Question 38

Ankylosing spondylitis

Answer 38

boney fusion of lumbar vertebrae

Question 39

Ankylosing spondylitis, increase or decrease of pain w/ exercise

Answer 39

decrease

Question 40

Psoriatic arthritis

Answer 40

DIP joints most affected dactylitis/sausage toe sacroiliitis

Question 41

Reactive arthritis

Answer 41

GI bacterial infiltration, chlamydia, or gonnorhea