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Internal Medicine Board Exam > Ortho/Rheumatology > Flashcards

Ortho/Rheumatology Flashcards

1
Q

What Rheum disease has daily fever, rash, and arthritis? This eventually resolves but does recur

A

Adult Still Disease

Pediatric Onset is the Systemic Juvenile Idiopathic Arthritis

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2
Q

Rheumatoid Patients that have chronic steroid use should be evaluated for what?

A

Osteoporosis

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3
Q

Thick skin over the hands, elevated BP, Raynaud Phenomenon, elevated BP 200+, elevated Creatinine, what should be given?

A

Captopril, ACE inhibitor, Scleroderma Renal Crisis

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4
Q

Anti-RNA polymerase III antibodies indicate what disease?
Anti-SCl antibodies, what is the disease?

A

Systemic Sclerosis

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5
Q

Ankylosing Spondylitis have a higher rate of what GI problem?

A

Inflammatory Bowel Disease

Look out for abdominal pain, diarrhea, or change in bowel habits

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6
Q

If patients have Sjogren Syndrome related oral dryness and candy does not work, what is the next best medications?

A

Cevimeline or Pilocarpine

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7
Q

Systemic Sclerosis -> interstitial lung disease, what is the mainstay of treatment?

A

Mycophenolate Mofetil

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8
Q

Renal Vasculature problems, nodular skin lesions, abdominal pain, and mononeuritis multiplex

A

Pan Nodularis

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9
Q

Rheumatoid Arthritis + Neutropenia + Splenomegaly is what?

A

Felty Syndrome

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10
Q

Lupus Nephritis, systemic disease, patient’s get steroids and what two other drugs?

A

Hydroxychloroquine and Mycophenolate

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11
Q

Multiple episodes of abdominal pain, rash, arthritis that resolve after 1 week, grandparents had a similar work up. What is this?

A

Familial Mediterranean Fever

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12
Q

Acute gout, without any kidney disease. What is the first line?

A

Colchicine

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13
Q

Proximal and Distal Muscle Weakness, over a long period of time, autoimmune, what might this be?

A

Inclusion Body Myositis

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14
Q

Polymyositis has what distinct muscle characteristic?

A

Proximal Muscle weakness, happens fairly quickly, happens over a period of weeks

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15
Q

Granulomatosis with Polyangitis (GPA), what is the treatment?

A

Steroids and Rituximab

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16
Q

What is this?

A

Discoid subacute cutaneous lupus

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17
Q

Skin and joint problems while taking Minocycline, what is this? Think about autoimmune issues

A

Drug induced Lupus

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18
Q

Patient has mixed osteolytic changes, back pain, and elevated ALP, what is this?

A

Paget Disease of the Bone

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19
Q

Lupus Perino is a skin manifestation seen in some patients with what disease?
Are these rashes photosensitive

A

Sarcoidosis

No

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20
Q

Pustular Lesions and visible telangiectasia that does not spare the nasolabial fold is what?

A

Rosacea

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21
Q

Dermatomyositis patients that are using steroids, what two medications should be looked at to decrease overall steroid use?

A

Methotrexate or Azathioprine

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22
Q

Small Intestinal Bacterial Overgrowth has usual hallmark signs?

A

Explosive diarrhea, right after a meal

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23
Q

Small Intestinal bacteria overgrowth is detected and treated how?

A

Glucose and Lactulose Breath Tests

Antibiotics, every month rotating which ones are given

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24
Q

Poorly Controlled Ankylosing Spondylitis, can develop what?

A

Renal Amyloidosis

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25
Q

Poorly Controlled Ankylosing Spondylitis via NSAIDS, what is the next medication?

A

Etanercept

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26
Q

What is this?

A

Acute Lupus Flare

27
Q

Reactive Arthritis occurs after an enteric infection or a bout of nongonococcal urethritis or cervicitis?

A

2-3 weeks

28
Q

What two medication groups can cause a dry mouth?

A

Anti-depressants and Anti-histamines, mouth breathing are common causes of dry mouth

29
Q

Contraindications to allopurinol therapy, what is the next medication?

A

Febuxostat, best in moderate to severe CKD

30
Q

Fibromylagia, what is the best treatment of choice?

A

Pregabalin

31
Q

What type of secondary arthritis should be suspected when arthritis of an early age occurs?

A

Hereditary Hemochromatosis

32
Q

Pregnant patients having a Lupus flare, what is the best treatment?

A

Prednisone treatment

33
Q

HLAB 57:01, has be tested for what antibiotic evaluation?

A

Abacavir

34
Q

HLAB 58:01, has to be tested for what medication evaluation in Hans-Chinese patients?

A

Allopurinol Hypersensitivity

35
Q

Giant Cell Arteritis treatment, to spare using steroids, what should be used?

A

Tocilizumab

36
Q

Sjogren’s Syndrome, what is the patient at an increased risk for of getting?

A

Lymphoma

37
Q

Osteoarthritis, initial treatment, what is the best medication, Tylenol or NSAID?

A

NSAID

38
Q

Does a patient have to have a positive antibody histone to have and SLE drug induced reaction?

A

No

39
Q

What is +ANA, + anti-centromere, +anti-Scl-70, anti-RNA pol III?

A

Systemic Sclerosis, CREST syndrome,

40
Q

What is the anti-U1 RNP and ANA positive?

A

MCTD

41
Q

What is +ANA, +anti-jo-1, +anti-synthetase

A

Inflammatory myopathies (Inflammatory Myopathies)?

42
Q

What is a + ANA, + anti-centromere antibodies?

A

Limited Cutaneous SS

43
Q

What is + ANA, + anti-topoisomerase I (anti- scl-70) and anti-RNA polymerase III?

A

Diffuse Cutaneous SS

44
Q

Churg Strauss has a positive what type of antibody?

A

+ Anti-myeloperoxidase antibodies

45
Q

Behcet Disease is associated with what HLA?

A

HLA B51

46
Q

Anterior Uveitis, chronic oral aphthae, skin hyperpigmentation, erythema nodosum, and autoimmune is what?

A

Behcet Disease

47
Q

Physical exam shows Rash (Silvery scale) on red patches, Nail pitting, Dactylitis, and Arthritis Multilans (Digital Shortening due to resorptive arthritis, pencil in cup), what is this?

A

Psoriatic Arthritis

48
Q

Lymphocytic infiltration of salivary glands and lacrimal glands, collections of focal lymphocyte aggregates, what disease is this?

A

Sjogren Syndrome

49
Q

Hand Xray that has hook-like osteophytes and squared off bone ends as well as chondrocalcinosis, what is this?

A

Hemochromatosis Arthropathy

50
Q

What is seen in the XR hand?

A

Gout

51
Q

Hand Osteoarthritis of the first CMC joint, what is the first line treatment?

A

Joint Orthoses, hand brace

52
Q

What medication can help with low back pain, not tylenol or NSAID?

A

Duloxetine

53
Q

Patient has an anatomical snuff box fracture, what test should be done after a negative X-ray?

A

MRI Hand, concern for scaphoid fracture

54
Q

Sjogren’s Syndrome has increased risk of what cancer?

A

Non-Hodgkin Lymphoma

55
Q

What is the MOA of Secukinumab? When is it used?

A

IL-17 inhibitor, used with active psoriatic arthritis refractory to 2 different TNF inhibitors

56
Q

What is the first line medication for Fibromyalgia?

A

Amitriptyline

57
Q

Can Methotrexate be continued during pregnancy?

A

No, should be stopped 3 cycles before starting to conceive

58
Q

Tocilizumab can be a treatment for Rheumatoid Arthritis. What is the MOA? What should be monitored while taking the drug?

A

IL-6 inhibitor

Lipid Profile

59
Q

Limited Cutaneous Systemic Sclerosis and Raynaud Phenomenon that has failed multiple therapies, what should be given, almost last line?

A

lloprost
Prostacyclin PGI2 analogue, dilates systemic and pulmonary arterial vascular beds

60
Q

Joint culture that shows cells of 50K to 150K, PMN > 75% is what?

A

Septic Joint

61
Q

Tofacitinib is being considered for RA treatment. The patient has +TB skin test. No active symptoms, what should be done?

A

Latent TB should be treated before Medication initiation

62
Q

Fibromyalgia, what is a mainstay of treatment?

A

CBT, is #1

63
Q

Rheumatoid Arthritis that has not improved with max methotrexate. What is the next step?

A

Adalimumab, TNF inhibitor

64
Q
A

Internal Medicine Board Exam (18 decks)

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