IMMUNOLOGIC/MISC

Question 1

Your patient needs to start treatment with a DMARD for RA. Which is the least expensive?

Answer 1

methotrexate

Question 2

Where are Bouchards Nodes located

Answer 2

PIPs

Question 3

Which of the following is NOT an early sign of HIV/AIDS?

Answer 3

Fatigue/vague abdominal pain

Question 4

Which of the following patients is most likely to get HIV?

Answer 4

Intravenous Drug User

Question 5

Which of the following demonstrates the appearance of normal veins on a funduscopic examination?

Answer 5

Wider than arteries (arteries are brighter red and narrower than veins)

Question 6

Your HIV patient has CMV. What is the appropriate treatment?

Answer 6

Gemcyclovir (pick the ‘vir’)

Question 7

Your patient has RA and her corticosteroids are not working. What is your next step?

Answer 7

Methotrexate

Question 8

Your patient stepped on a nail and does not know his tetanus status. Do you give Td or Tdap?

Answer 8

Tdap

Question 9

In which pt would sarcopenia be the most expected finding?

Answer 9

Elderly pt

Question 10

Why are so many HIV pts noncompliant

Answer 10

↓Access to care

Question 11

Know HIV testing:

Answer 11

ELISA confirmed with Western Blot. AIDS = CD4 <200 (800 is WDL) or <20%. Ideal viral load (by PCR) < 5000

Question 12

HIV pt with petechiae on legs (bone marrow suppression) and leg weakness (malaise) What should you test for?:

Answer 12

CMV

Question 13

HIV Meds S/E:

Answer 13

GI probs, N/V, skin rash, anemia

Question 14

ESR (sed rate) elevated with what diagnosis

Answer 14

RA, SLE, temporal arteritis, inflammation

Question 15

In addition to a positive serum ANA, what dx is supportive of dx. A patient with SLE ?

Answer 15

Leukopenia

Question 16

28 yo F presents with fever, malaise, rash across the back and splinter hemorrhages. Hgb 10, positive ANA, UA proteinuria and elevated ESR. What is the suspected diagnosis?

Answer 16

SLE (endocarditis was one of the wrong answers)

Question 17

RA tx

Answer 17

methotrexate, DMARDS, corticosteroids, hydrochloroquine, gold salts. most cost effective: methotrexate (monitor LFTs)

Question 18

Felty’s syndrome

Answer 18

RA + joint swelling + enlarged spleen + leukopenia (complication of RA)

Question 19

Pt c/o wrist /hand, swollen redness & pain worse in a.m and resolves as the day goes on. What dx would support RA?

Answer 19

↑ ESR

Question 20

OA treatment

Answer 20

ASA, APAP (1st line), NSAIDS, Cox2 inhibitors (Celebrex). Swimming for non-pharm. Cane goes on opposite side.

Question 21

57 yo M with PMH of cardiovascular disease presents with c/o of pain in both knees that is progressively worse throughout the day. You suspect OA. What medication is contraindicated?

Answer 21

Celebrex r/t ARF, MI and pts PMH + for cardiac disease

Question 22

What is associated with HA, fever, and elevated ESR?

Answer 22

Temporal Arteritis

Question 23

EYES: Best way to verify your treatment is working for open angle glaucoma?

Answer 23

Tonometry (normal IOP is 10-20 mmHg)

Question 24

Which of the following meds is not indicated in the management of open angle glaucoma?

Answer 24

Alpha 2 adrenergic agonist

Question 25

47 yo M comes in complaining of intense right eye pain which has worsened since he woke up. Eye exam: copious tearing/redness. Which of the following do you complete to confirm suspected dx?

Answer 25

Sodium fluorescein stain for corneal abrasion

Question 26

Picture of an elderly persons arm with a skin tear…

Answer 26

dermis thins in old age

Question 27

Older lady with iron deficiency anemia is opening a jar and sustains a spiral fx of her arm. Why?

Answer 27

Osteoporosis