IM Essentials

Question 1

Articular v/s Periarticular Joint pain.

Answer 1

Articular: pain increases with both active and passive movement. ROM is reduced.

Periarticular: pain increases with active movement only. ROM is preserved.

Question 2

Morning stiffness in inflammatory v/s non-inflammatory joint pain.

Answer 2

Inflammatory: > 1 hour.

Non-inflammatory:

Question 3

Extra articular manifestations of Rheumatoid Arthritis?

Answer 3

Rheumatoid nodules
Pulmonary system: pleuritis, interstitial lung disease, pulmonary nodules.
Cardiac: pericarditis, carditis.
Ocular: scleritis, episcleritis.

Question 4

Indications for Arthrocentesis.

Answer 4

1. Unexplained:
   - ———-monoarthritis
   - ———-joint effusion.
2. Suspected:
   - ———-crystal induced arthritis
   - ———-joint infection
   - ———-hemarthrosis.

Question 5

Ottawa knee rules to obtain a radiograph following trauma if:

Answer 5

1. Patient age > 55
2. Tenderness at head of fibula
3. Isolated tenderness at patella
4. Cant flex knee more than 90 degrees
5. Cant bear weight immediately after injury.

Question 6

Why women don’t develop gout often?

Answer 6

Estrogen promotes uric acid secretion. So you won’t see gout in women typically unless they are postmenopausal.

Question 7

Tumor lysis syndrome causes:

Answer 7

1. Hyper
   - ——-phosphatemia
   - ——-kalemia
   - ——-uricemia
2. Hypocalcemia.

Question 8

Classification of protein in urine.

Answer 8

Normally: albumin < 30 and total protein < 150 in urine.
Abnormal: albumin > 30 and total protein > 150 in urine.

The values above are with respect to creatinine. For albumin its called albumin creatinine ratio (ACR) and for total protein its called protein creatinine ratio (PCR).

Question 9

Albuminuria terminology:

Answer 9

Normal ACR < 30.
Moderately increased albuminuria/ microalbuminuria is 30-300.
Severely increased albuminuria/ macroalbuminuria > 300.

Question 10

Diseases associated with Nephrotic syndrome.

Answer 10

HIV = FSGN

Hepatitis B = Membranous glomerulopathy.