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Step2 > MSK/Rheum > Flashcards

MSK/Rheum Flashcards

1
Q

Gout dx test?

Acute tx?

A

Negative bifringence TAP

NSAIDS –> Steroids –> Colchicine

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2
Q

Best HTN tx w/ gout?

worst?

A

Best: Losartan

Worst: Thiazide

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3
Q

Allopurinol s/e?

A

Hypersensitivity

TEN/SJS

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4
Q

Causes of pseudogout?

A 
Hemochromatosis
Hyperparathryoid
DM
Hypothyroid
Wilson disease
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5
Q

Tx for pseudogout?

A

NSAIDs –> Steroids

Chronic prevention: Colchicine

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6
Q

Most common cause of epidural abscess, how get there?

A

S aureus from hematogenous spread

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7
Q

LBP worse at rest?

A

Ank Spond

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8
Q

Tx for cord compression (no matter what cancer causes)?

A

Steroids first

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9
Q

LBP worse when walking up stairs, better when down?

A

Spinal Stneosis

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10
Q

Duptryen contracture tx?

A

Collagenase injections

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11
Q

Viral arthritis vs. Rheumatoid?

A 
Viral = +RF, -CCP
Rheum = +RF, +CCP
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12
Q

Felty syndrome?

A

RA + Splenomegaly + Neutropenia

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13
Q

Caplan syndrome?

A

RA + pneumoconiosis + Lung nodules

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14
Q

Sicca syndrome?

A

RA + dry eyes/MM

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15
Q

1 tx for RA?

A 
DMARDS!
- MTX
- Inflixumab
Hydroxycloroquine
Sulfasalazine
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16
Q

DMARDs safe in preg?

A

Sulfasalazine

Hydroxychloroquine

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17
Q

MTX
Inflixumab
Hydroxycloroquine
Sulfasalazine s/e?

A
  • Liver, BM, Lung
  • TB
  • retinal tox
  • Rash, BM
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18
Q

Salmon colored rash
Spiking high fever
joint effusion?

A

JRA (elevated ferritin ONLY)

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19
Q

Joint XR in SLE?

A

NORMAL (still joint pain in 90% of cases)

20
Q

SLE acute tx?

A

high dose steroids

21
Q

Coagulation labs in anti-phospholipid syndome?

A

ELEVATED aptt (doesn’t correct)

Normal INR/PT

22
Q

Tests for scleroderma?

A

BEST: Anti-centromere

Scl-70 = anti topo

23
Q

Best initial test for polymyositis/dermatomyositis?

A

CPK/Aldolase (elevated)

Muscle bx = most accurate

Anti-Jo = Pulm involvement

24
Q

Worst complication of sjogrens?

A

Lymphoma

25
Q

First test for sjogrens?

A

Eye-filter paper, SSA/SSB

Most accurate = Lip or parotid gland bx

26
Q

PAN organs?

A

Renal
GI
Neuro (mononeuritis muliplex)

Hep B/C

27
Q

Best bx for wegeners?

A

Lung > renal >sinus

28
Q

Pencil in a cup on finger XR?

A

Psoriatic arthritis

29
Q

Work up for suspected pseudogout?

A 
Ca studies (hyperparathyroid)
Fe studies (hemochromatosis)
30
Q

PMR vs. RA. vs. Myositis?

A

PMR = Stiffness w/o swelling (+ESR)

RA = Stiffness + swelling (+RF, +ESR)

Myositis = weakness (+ESR, +CK)

31
Q

LBP that improves with use (worst at night)>

A

Ank spond

Inflammation at joint/ligament insertion

32
Q

Baker’s cyst associated with which joint disease?

A

OA

33
Q

CREST vs. Scleroderma on exam?

A

CREST = limited thickening (hands, head, neck)

Systemic = Anywhere else (+Interstitial fibrosis)

34
Q

Anti-centromere ab?

A

CREST

35
Q

Anti-histone?

A

Drug SLE

36
Q

AMA ab?

A

PBC

37
Q

Gonnococcal vs. reactive arthritis?

A

GC = Fever, active purulent urethritis, migratory polyarhtirits

Reactive = Afebrile, back pain, mouth ulcers, non-purulent urethritis

38
Q

Asymptomatic erythema nodosum work up?

A 
CBC
LFT
Anti-streptolysin
Tb test (rare)
CXR (sarcoid)

Colonoscopy if GI symptoms

39
Q

Migratory arthritis
Chronic diarrhea
lymphatenopathy
PAS+ biopsy of SI?

A

Whipple disease

40
Q

Thumb pain when holding baby

A

Dequervain Tenosynovitis

41
Q

Behcet vs. reactive arthritis?

A

Both = Uveitis, urethritis, oral ulcers

Behcet = More skin, less joint, no preceeding GI disease, subacute but constant presentation

Reactive = More joint, less skin, GI infx starts, relapsing remitting course

42
Q

Cyclosporine tox? (IL2 inhibitor)

A 
Gingival hyperplasia
Hirsutism
Transient HTN (NA retention)
Reversible neuro
Glucose intolerance
SCC
Lymphoproliferative disease
43
Q

Tacrolimus tox (similar ot cyclosporine)

A

NOT Gingiva/hirsutism

More GI, glucose, neuro

44
Q

Mycophenalate tox? (reversible inosine monophosphate inhibitor)

A

BM supp

45
Q

Azathioprine tox?

A

Dose dep diarrhea
HEPATOTOX
Leukopenia

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