Formative assesment

Question 1

alternating buttock pain=

Answer 1

spondyloarthritis

Question 2

how long is early morning stiffness in osteoarthritis?

Answer 2

none or 10-30 mins, no longer

Question 3

pain in first carpo-metacarpal joint =

Answer 3

osteoarthritis

Question 4

extra-articular manifestations of rheumatoid arthritis:

Answer 4

subcutaneous nodules, episcleritis, peripheral sensory neuropathy, pericardial effusion (seropositive, high protein content)

Question 5

where are subcutaneous nodules most most commonly found?

Answer 5

elbow

Question 6

what is episcleritis?

Answer 6

inflammation of the white of the eye

Question 7

what is an example of peripheral sensory neuropathy?

Answer 7

carpal tunnel syndrome

Question 8

classical rheumatoid arthritis sign on x-ray?

Answer 8

peri-articular erosions

Question 9

new bone formation on x-ray?

Answer 9

ankalosing spondylistis

Question 10

3 days ago, spontaneous back pain no other symptoms, 53 years old, pain at work as a builder. what is the most appropriate follow up?

Answer 10

reassured and told to take simple analgesics and return to work when feeling better.
no worrying features or neurological concerns, short history

Question 11

lytic tumour visible on x-ray, must have lost what percent of bone density?

Answer 11

> 60%

Question 12

gout dietary changes:

Answer 12

cut out alcohol, cut down red meat, less fizzy drinks (fructose), less sugary foods, eat more dairy
less purines in diet = less uric acid in blood

Question 13

painful 1st MTP, red and swollen, male, 53 yrs old?

Answer 13

gout

Question 14

autoimmune connective tissue disorders?

Answer 14

SLE, primary sjogren’s syndrome, systemic sclerosis, dermatomyositis

Question 15

what is ehler danlos?

Answer 15

connect tissue, inherited, stretchy skin

Question 16

associated symptoms of lupus?

Answer 16

photosensitive rash, deforming arthritis (non-erosive), pulmonary embolism (antiphospholipid syndrome, can come together), seizures, low WBC, low platelet count

Question 17

raynaud’s, positive ANA, high ESR< normal CRP, low WBC, female, 23 mouth ulcers, fever?

Answer 17

SLE

Question 18

treatment of SLE?

Answer 18

anti-malarial, hydroxcchrolquine

Question 19

treatnent of gout?

Answer 19

allopurinol

Question 20

what us sulfasalzine used to treat?

Answer 20

rheumatoid arthritis, DON’T USE IN LUPUS

Question 21

what is ustekinuab used to treat?

Answer 21

psoriatic arthritis

Question 22

what is anti-TNF used in?

Answer 22

rheumatoid, psoriatic, DON’T USE IN LUPUS

Question 23

right sided headache, early morning stiffness, pain in jaw, high CRP ESR, sight loss

Answer 23

giant cell arteritis, treat sight loss with steroid ASAP

Question 24

how do you treat GCA?

Answer 24

steroids

Question 25

rarely causes joint infection in infants?

Answer 25

haemophilus influenzae (due to vaccines)

Question 26

most common cause of joint infection?

Answer 26

staph (then strep)

Question 27

female, 64, DMT2, cellulitis of right foot, IV flucloxacilin no response, CRP lower but not gone?

Answer 27

osteomyelitis

Question 28

no response to oral and IV antibiotics with osteomyelitis after 4 weeks - next most appropriate investigation?

Answer 28

X-ray
as infected for over 2 weeks, changes will show up on x-ray
no point in blood cultures as no response to antibiotics, correct answer if no antibiotics had been given
do MRI if symptoms has been less than 2 weeks

Question 29

most frequent infective organism for hip replcemet?

Answer 29

coagulase staph

Question 30

history of back pain, ibuprofen helping a lot, morning stiffness, radiating pain to buttock and leg?

Answer 30

Ankalosing spondylitis

Question 31

inflammatory back pain associated symptom?

Answer 31

pain across costochondral joints (rib cage), worse at rest, better with movement