Internal Med Orthopedics

Question 1

presentation of fibromyalgia

Answer 1

• chronic fatigue
• generalized aching pain

Question 1

etiology of fibromyalgia

Answer 1

presence of central sensitization to pain and deficits in endogenous pain inhibitory mechanism

Question 2

diagnostic criteria of fibromyalgia

Answer 2

• pain index over 7
• sx for at least 3 months
• no other condition that can explain patient’s sx

Question 3

management of fibromyalgia

Answer 3

• reassurance
• exercise
• cyclobenzaprine or amitriptyline
• Cymbalta

Question 4

etiology of gout

Answer 4

hyperuricemia

Question 5

s/s of gout

Answer 5

red, swollen, painful, hot joint

Question 6

diagnosis of gout

Answer 6

• negatively birefringent joint fluid analysis
• rat bite on xray

Question 7

treatment of gout

Answer 7

• low purine diet
• NSAIDs, colchicine, corticosteroids
• allopurinol to prevent

Question 8

etiology of polyarteritis nodosa

Answer 8

arteritis of small and medium arteries

Question 9

s/s of polyarteritis nodosa

Answer 9

• nonspecific sx (fever, malaise, fatigue, HA)
• extremity pain
• livedo reticularis
• digital gangrene
• abdominal pain

Question 10

diagnosis of polyarteritis nodosa

Answer 10

• ANCA negative
• test for hep b
• tissue biopsy to confirm (shows evidence of arterial necrosis)

Question 11

Treatment of polyarteritis nodosa

Answer 11

high dose steroids

Question 12

S/s of polymyalgia rheumatica

Answer 12

• pain and stiffness in neck, shoulders, and pelvis
• fever, malaise, and weight loss
• difficulty with ADLs

Question 13

Treatment of polymyalgia rheumatica

Answer 13

Low dose prednisone

Question 14

s/s of polymyositis/dermatomyositis

Answer 14

• symmetric, progressive, painless, proximal muscle weakness
• gottrons papules
• heliotrope eruption
• hyperkeratotic hands
• shawl sign

Question 15

diagnosis of polymyositis/dermatomyositis

Answer 15

• anti-Mi2
• anti-Jo1
• anti-SRP

Question 16

treatment of polymyositis/dermatomyositis

Answer 16

steroids

Question 17

s/s of reactive arthritis

Answer 17

• urethritis
• uveitis
• arthritis
• mucocutaneous lesions
• lesions of palms and soles

Question 18

etiology of reactive arthritis

Answer 18

GI infection or STD

Question 19

Diagnosis of reactive arthritis

Answer 19

HLA-B27

Question 20

treatment of reactive arthritis

Answer 20

NSAIDs

Question 21

s/s of rheumatoid arthritis

Answer 21

• symmetrical swelling of multiple joints with tenderness
• stiffness persisting for >30 minutes to hours in prominent in the AM
• finger deformities
• rheumatoid nodules

Question 22

diagnosis of rheumatoid arthritis

Answer 22

• anti-CCP
• rheumatoid factor
• hypochromic normocytic anemia

Question 23

treatment of rheumatoid arthritis

Answer 23

• DMARDs (methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide)
• steroids

Question 24

s/s of sjogren's

Answer 24

dry eyes and dry mouth

Question 25

diagnosis of sjogren's

Answer 25

* anti-SSA * anti-SSB * salivary gland biopsy * schirmer test

Question 26

treatment of sjogren's

Answer 26

* symptomatic * pilocarpine

Question 27

precipitating factors of lupus

Answer 27

* sun exposure * stress * infection * pregnancy * stress

Question 28

s/s of lupus

Answer 28

* low grade fever * joint pain * malar rash

Question 29

diagnosis of lupus

Answer 29

* 4/11 symptoms * anti-dsDNA * anti-Smith

Question 30

treatment of lupus

Answer 30

hydroxychloroquine + NSAIDs + prednisone

Question 31

s/s of scleroderma

Answer 31

* C: calcium skin deposits * R: raynaud's * E: esophageal dysfunction * S: sclerodactyly * T: telengiectasias

Question 32

diagnosis of scleroderma

Answer 32

* anti-DNA top * anti-centromere * anti-RNA polym

Question 33

treatment of scleroderma

Answer 33

treat each symptom as they come