OA, RA, Gout, Lupus, Sleep Apnea, Dizziness

Question 1

Common sites for OA?

Answer 1

DIP, PIP, CMJ, great toe, hips, knees

Question 2

Vertebral sites for OA?

Answer 2

C5, T8, and L3

Question 3

Physical examination of fingers?

Answer 3

Huberden’s Nodes (DIP) and Bouchard’s Nodes (PIP)

Question 4

Physical findings for hand OA?

Answer 4

No welling over joint, minimal tenderness, reduced passive and active ROM

Question 5

Diagnosis of OA?

Answer 5

Largely clinical, but x-ray may show thinning of of the internal joint space

Question 6

Complimentary treatment for OA?

Answer 6

Physical therapy, exercise, weight loss

Question 7

Treatment for hand OA?

Answer 7

Topical capcasin, topical NSAID, oral NSAID, tramadol

Question 8

Treatment for Knee OA?

Answer 8

Oral NSAID, topical NsAID, Tramadol, IA injection

Question 9

Treatment for hip OA?

Answer 9

APAP, oral NSAID, tramadol, IA injection

Question 10

Consitutional symptoms of RA?

Answer 10

Alaise, wieght loss, low grade fever

Question 11

Symptoms of RA?

Answer 11

Peripheral symmetric polyarthritis >1 hour, warm, tender to palpation

Question 12

What is a Boutonniere Deformity?

Answer 12

PIP is in a state of continuous flexion

Question 13

Labs for RA?

Answer 13

Anti-CCP, ESR, C-reactive protein, RA, ANA antibodies, antiphospholipd antibodies, consider parvovirus, lyme disease, and hepatitis
-X-rays to monitor progress of disease

Question 14

What shouldn’t you do for RA?

Answer 14

Start corticosteroid right before seeing rheumatologist.

Question 15

What do patient’s need who take methotrexate?

Answer 15

Folic acid supplementation

Question 16

Who manages RA?

Answer 16

Rheumatologists

Question 17

Precpitating factors of gout?

Answer 17

Metabolic syndrome, alchol intake, lots of protein intacke

Question 18

Drugs that cause gout?

Answer 18

Diuretics, salicylate, niacin, cyclosporine, levodopa

Question 19

PE for gout?

Answer 19

Tophi in pinnae, olecranon tips, distal joints of hands and feet, helix and antihelix

Question 20

What’s the only way to make a definitive diagnosis of gout?

Answer 20

Joint aspirate with sodium rate crystal

Question 21

What’s the usual serum concentration for gout?

Answer 21

7.5 or greater

Question 22

What should you consider with acute gout?

Answer 22

Acute septic arthritis

Question 23

Mediations for gout?

Answer 23

Indomethacin 50 mg q 8 hours until pain decreases

• Colchicine 1.2 mg and then .6 mg every hour
• Steroids

Question 24

Medications to prevent gout?

Answer 24

Probenecid and allopurinol

Question 25

What food should you avoid with gout?

Answer 25

Meats, seafood, gravies, yeast, ETOH, lentils, asparagus, cauliflower, mushroom

Question 26

4/11 signs that must be present for Lupus

Answer 26

1. Arthritis
2. Photosensitivity
3. Oral or nasal ulcers
4. Malar Rash
5. Discoid rash
6. Serositis of pleura or pericardia
7. Renal Disease
8. hematological disorders
9. Neurological disease
10. Positive ANA
11. Positive other test

Question 27

Subjective findings of lupus?

Answer 27

Malaise, fever, anorexia, blurred vision, joint problems, vague abdominal pains, multiple miscarrages

Question 28

Objective findings for lupus

Answer 28

Rash, alopecia, slinter hemorrages, fingertpi lesions, adenopathy, reaynauds, joint pains, perasthesias, diminished DTRs, systolic mumur, oral ulcer, RUQ pain, RLQ pain from vasculitis

Question 29

Common labs for lupus?

Answer 29

CBC, CMP, serum albumin, ANA, UA, antibody screen for anti ds DNA, antiphospholipid antibodies, antismith antibodies

Question 30

Other labs and tests to order?

Answer 30

Anti ro, anti La, anti RNP, complement, VDRL, EKG, Echo

Question 31

Differential diagnosis with lupus?

Answer 31

Vasculitis, RA

Question 32

Common drugs causing lupus?

Answer 32

Procainamide, hydralzine, minocycline, andti TNF immunomodulators

Question 33

What antibiotics to avoid with lupus?

Answer 33

Bactrim and tetracycline because they cause light sensitivity

Question 34

Other drugs to treat lupus?

Answer 34

Hydroxychloroquine, coriosteroids, DHEA