Orthopedics/Rheumatology High Yield

Question 1

What is Gout

Answer 1

Uric Acid Deposition in soft tissue, joints, bones

Question 2

What is a common cause of Gout

Answer 2

Purine rich foods like alcohol, liver, oily fish, yeast

Question 3

Sx of Gout

Answer 3

Podagra: 1st MTP joint is red and painful

Tophi Deposition: Collection of solid uric acid in soft tissue

Question 4

Dx of Gout

Answer 4

Arthrocentesis: Negative Bifringent Needle Shape Urate Crystals
Xrays: Rat Bite, Punched out Erosions

Question 5

Tx of Gout

Answer 5

NSAIDS (indomethacin)
Colchicine 2nd line
For chronic: Allopurinol

Question 6

What is Pseudogout

Answer 6

Calcium Pyrophosphate deposition in joints
Knee is red, swollen and tender
See Cartilage Calcifications (Chondrocalcinosis)

Question 7

Dx of Pseudogout

Answer 7

Arthrocentesis: Positively birefringenet, Rhomboid Shaped CPP Crystals

Question 8

Tx of Pseudogout

Answer 8

Corticosteroids are 1st line
NSAIDS
Colchicine for prophylaxis

Question 9

What is Sjogren’s Syndrome

Answer 9

Autoimmune disorder attacking exocring glands

Question 10

Sx of Sjogren’s Syndrome

Answer 10

Salivary: Xerostoma (dry mouth)
Lacrimal: Keratoconjunctivitis sicca (dry eyes)
Parotid Enlargement

Question 11

Dx of Sjogren’s Syndrome

Answer 11

ANA
AntiSS-A
AntiSS-B
Positive RF
Shirmer Test (decreased tear production)
Biopsy of gland

Question 12

Tx of Sjogren’s Syndrome

Answer 12

Artificial Tears, Pilocarpine

Cevimeline stimulates muscarinic cholinergic receptors

Question 13

What is Polymyositis

Answer 13

Idiopathic inflammatory muscle disease of proximal limbs, neck, pharynx

Question 14

Sx of Polymyositis

Answer 14

Progressive symmetrical proximal muscle weakness (not painful)
Dysphagia, Skin Rash, Polyarthrlagias, Muscle Atrophy (difficulty combing hair, climbing stairs)

Question 15

Dx of Polymyositis

Answer 15

Aldolase
Anti-SRP antibody
Muscle Biopsy: See inflammation around the individual muscle fiber (endomysial involvement)

Question 16

Tx of Polymyositis

Answer 16

High dose steroids

Methotrexate

Question 17

What is Reactive Arthritis (Reiter’s Syndrome)

Answer 17

Autoimmune response to infection

Question 18

Sx of Reactive Arthritis

Answer 18

Can’t see, can’t pee, can’t climb a tree
Conjunctivitis/Uveitis, Urethritis, Asymmetric inflammatory arthritis
Sausage toes/fingers

Question 19

What infections preceded Reactive Arthritis

Answer 19

Chlamydia, Gonoarrhea, GI (Salmonella, Shigella)

Question 20

Dx of Reactive Arthritis

Answer 20

HLA-B27

Synovial Flud WBC will be

Question 21

Tx of Reactive Arthritis

Answer 21

NSAIDS

Question 22

What is Scleroderma

Answer 22

Systemic connective tissue disorder

Thickened skin, lung, heart, kidney, GI tract

Question 23

Sx of Scleroderma

Answer 23

Tight, Shiny, Thickened skin due to fibrous collagen buildup
CREST syndrome
Calcinosis cutis, Raynaud’s Phenomenon, Esophageal MOtility disorder, Sclerodactyly, Telangectasis
Pulmonary HTN

Question 24

Dx of Scleroderma

Answer 24

Anti-Centromere AB
Anti-SCL-70 antibodies
Positive-ANA

Question 25

Tx of Scleroderma

Answer 25

DMARDS, Steroids

Vasodilators for Raynaud’s: CCB, Prostacyclin