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IM-MSK Flashcards

1
Q

The non-specific antibody marker for SLE?

A

ANA

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2
Q

The 2 specific antibody marker for SLE

A

Anti-dsDNA & anti-smith

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3
Q

Chronic malabsorptive diarrhea, wt loss, migratory non-deforming arthritis, lymphadenopathy and a low-grade fever? Dx? and diagnostic test

A

Whipple disease

PAS- + macrophages (Tropheryma whippeli-gram + bacillus)

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4
Q

dry mouth and eye, lymphocytic infiltration of the salivary glands. Dx? Diagnostic test

A
  • Sjogren syndrome

- SSA (Ro) and SSB (La) antibodies

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5
Q 
Morning facial puffiness and bilateral leg swelling. Recurrent pulmonary infection, psoriasis, 4+ proteinuria . 
Dx? 
diagnostic test? 
Tx? 
Prevention?
A

Amyloidosis
Abdominal fat pad aspiration biopsy
Colchicine for tx and prevention

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6
Q

Serology finding for systemic sclerosis (4)

A
  • Antinuclear antibody (ANA)
  • Anti-topoisomerase I (anti-scl-70)antibody
  • Anti-RNA polymerase III
  • Anti-centromere antibody
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7
Q

Med risk for tendon rupture (Achilles)

A

Fluoroquinolone

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8
Q

Associated findings for Anklosing spondylitis (3)

A
  • thoracic wedging
  • hyperkyphosis
  • Aortic regurgitation
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9
Q
  • Groin pain on weight bearing
  • Pain on hip abduction and internal rotation
  • no erythema, swelling, or point tenderness
A

Avascular necrosis of the hip

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10
Q

The 2 carpal tunnel syndrome tests

A
  • Phalen

- Tinel tests

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11
Q

The 3 treatments for Carpal tunnel syndrome

A
  • Wrist splinting
  • Glucocorticoid injection
  • Surgery
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12
Q

What are associated condition with Primary Raynaud’s phenomenon?

A

No underlying cause

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13
Q

What are associated conditions with Secondary Raynaud’s phenomenon (6)?

A
  • Connective tissue disease (Scleroderma)
  • Occlusive vascular conditions (SLE, thromboangiits obliterans)
  • Sympathomimetic drugs
  • Vibrating tools
  • Hyperviscosity syndromes
  • Nicotine
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14
Q

Pt with rheumatoid arthritis, came in with Macrocytic anemia, nausea, stomatitis, rash, hepatotoxicity, interstitial lung disease, alopecia and fever

A

Methotrexate SE

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15
Q

45-54YO. Hx of repetitive or forceful wrist extension, pain in lateral elbow.
Pain with resisted wrist extension or supination
Pain with passive wrist flexion

A

Lateral epicondylitis

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16
Q

Tx of lateral epichondylitis (5)

A
  • Modiefied activity
  • inelastic counterforce brace
  • NSAID
  • Stretching and progressive resistance exercise
  • PT
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17
Q

The two nodes on osteoarthritis hand

A
  • Proximal interphalangeal (Bouchard nodes)

- Distal interphalangeal (Heberden nodes)

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18
Q

common causes of overproduction of uric acid other than gout include (5)

A
  • hematologic malignancies
  • Myeloproliferative/lymphoproliferative sidorders
  • Tumor lysis syndrome
  • Psoriasis
  • Hypoxanthine-guanine phosphoribosyl transferase (HGPT) deficinecy
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19
Q

what nodules locations are presented in Rheumatoid

A

elbows (commonly)

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20
Q

What spinal risk is involved in Rheumatoid?

A

cervical joint- spine subluxation-spinal cord compression

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21
Q

> 3 months of symptoms with widespread pain index or symptom severity score. Normal laboratory studies

A

Fibromyalgia

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22
Q

Proximal muscle weakness (difficulty climbing upstairs), pain mild/absent

A

Polymyositis

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23
Q

diagnostic for Polymyositis (3)

A
  • Elevated muscle enzymes (CK, aldolase, AST)
  • Autoantibodies (ANA, anti-Jo-1)
  • Biopsy- Endomysial infiltrate, patchy necrosis
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24
Q

50yo, stiffness in pain in shoulders, hip girdle, neck. Associated with giant cell (Temporal)arteritis

A

Polymyalgia rheumatica

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25
Q

Diagnostic for Polymyalgia rheumatica (2)

A
  • Elevated ESR, C-reactive protein

- Rapid improvement with glucocorticoids

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26
Q

Purulent monoarthritis &/OR

Triad of Tenosynovitis, dermatitis, asymmetric migratory polyarthralgias

A

Disseminated gonococcal infection

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27
Q

How to diagnose Disseminated gonococcal infection (3)

A
  • Blood culture (maybe neg)
  • Synovial fluid analysis: Inflammatory effusion with neutrophil predominance (gram stain & culture or NAAT)
  • Culture or NAAT of urethra, cervix, pharynx, rectum
28
Q

Tx: Disseminated gonococcal infection

A
  • IV ceftriaxone-> switch to oral (Cefixime) when clinically improved
  • empiric azithromycin OR doxycycline for concomitant chlamydial infection
  • Joint drainage for purulent arthritis
29
Q

progression of tx for RA includes

A
  1. Methotrexate
  2. add TNF inhibitor with parallel therapy - an addition of Sulfasalazine, hydroxychloroquine)
  3. Switch to alternate TNF inhibitor and continue Methotrexate
30
Q

Extrusion of fluid from knee joint space into semimembranosus/gastrocnemius bursa

A

Popliteal (Baker) cyst

31
Q

Joint pain worst in the morning, Morning stiffness >60mins?

32
Q

Joint pain worst in the evening and morning stiffness <30seconds

33
Q

Limited range of motion with crepitus and pain

34
Q

Positive anti-CCP diagnostic test for?

35
Q

X-ray with soft-tissue swelling, joint space narrowing, and bony erosions

36
Q

Why is osteoporosis risk for RA(4)?

A
  • increased level of proinflammatory cytokines
  • corticosteroid therapy
  • lack of activity
  • generalized loss of bone mass in RA
37
Q

Posture-dependent pain-lumbar extension worsens pain and lumbar flexion relieves pain, lower extremity numbness, and tingling, lower-extremity weakness, low back pain
-Normal pulses and frequently normal examination

A

Neurogenic claudication (pseudoclaudication)

38
Q

Diagnosis: Neurogenic claudication (pseudoclaudication)

A

MRI of spine

39
Q

Common reason for lumbar spinal stenosis

A
  • degenerative arthritis (Spondylosis)
  • Degenerative disk disease
  • Thickening of the ligamentum flavum
40
Q 
Exertionally dependent pain
Pain relieved with rest 
LE cramping/tightness
NO LE weakness
Possible buttock, thigh, calf or foot pain
A

Vascular claudication

-Decreased pulses, cold extremities, decreased hair growth, pallor with leg elevation

41
Q

Dx: vascular claudication

42
Q

New mom holding her baby with thumb stretched causing wrist pain

A

De Quervain tenosynovitis

43
Q

De Quervain tenosynovitis:- which two tendons are affected

A
  • Abductor pollicis longus

- Extensor pollicis brevis

44
Q

a non-modifiable risk for osteoarthritis (5)

A
  • Advanced age
  • Female
  • Family Hx
  • Abnormal joint alignment
  • prior joint trauma
45
Q

Modifiable OA risks (4)

A
  • Sedentary lifestyle
  • Obesity
  • Occupational joint loading
  • DM
46
Q 
Arthritis (sacroiliitis)
Reduced chest expansion &amp; spinal mobility
enthesitis 
Dactylitis
Uveitis
A

Ankylosing spondylitis

47
Q

3 risk of Ankylosing spondylitis

A
  • Osteoporosis/vertebral fractures
  • Aortic regurgitation
  • cauda equina
48
Q

Ddx of anterior knee pain in young patients (3)

A
  • Patellofemoral syndrome
  • Patellar tendonitis
  • Osgood-Schlatter disease
49
Q

A young female athlete with subacute to chronic pain that increased with squatting, running, prolonged sitting, using stairs

A

Patellofemoral syndrome

50
Q

Patellofemoral syndrome, diagnostic

A

Patellofemoral compression test

51
Q

Primary athlete (jumper’s knee), with episodic pain and tenderness at the inferior patella

A

Patellar tendonitis

52
Q

Preadolescent/adolescent athletes with a recent growth spurt

with increasing pain with sports, relieved by rest, tenderness and swelling at the tibial tubercle

A

Osgood-Schlatter disease

53
Q

Risk factors for carpal tunnel syndrome (5)

A
  • working on a computer for long hrs
  • Obesity
  • DM
  • Pregnancy
  • Hypothyroidism
54
Q

Medial knee pain and tenderness

A

Pes anserinus pain syndrome (PAPS)

55
Q

Pes ansernus is formed by the conjoint tendons from which 3 muscles

A
  • Gracilis
  • Sartorius
  • Semitendinosus
56
Q

low back pain, increased with standing, walking. lying on back, tenderness at the affected level, negative leg raised test

A

Vertebral compression fracture- risk from Osteoporosis

57
Q

45% of patient have complicated inflammatory bowel disease by

A

arthritis (involve axial or peripheral joints)

58
Q

Skin manifestation of hereditary hemochromatosis

A

Hyperpigmentation (bronze diabetes)

59
Q

MSK manifestation of hereditary hemochromatosis (3)

A

Arthralgia
arthropathy
chondrocalcinosis

60
Q

GI manifestation of hereditary hemochromatosis (3)

A
  • Elevated hepatic enzymes with hepatomegaly (early)
  • Cirrhosis (later)
  • Increased risk of hepatocellular carcinoma
61
Q

The endocrine manifestation of hereditary hemochromatosis (3)

A

DM
secondary hypogonadism
hypothyroidism

62
Q

Cardiac manifestation of hereditary hemochromatosis (2)

A

restrictive or dilated cardiomyopathy

conduction abnormalities

63
Q

Infections manifestation of hereditary hemochromatosis

A

Increased susceptibility to listeria, Vibrio & Yersinia enterocolitica

64
Q

What are the iron studies that are abnormal in hereditary hemochromatosis (3)

A

High serum Iron,

Ferritin and transferrin saturation

65
Q

Rheumatoid arthritis
Low WBC
Large spleen
Often serious and repeated infections

A

Felty’s syndrome

UWORLD-STEP2 (BA) (19 decks)

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