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Musculoskeletal and Rheumatology > Rapid Style Questions > Flashcards

Rapid Style Questions Flashcards

1
Q
A
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2
Q

What is Complex Regional Pain Syndrome

A

Complex Regional Pain Syndrome

  • History of previous extremity injury, fracture, or surgery
  • More common in women, mean age of 40yrs
  • Pain > 6 months
  • Sx and findings: light touch causes extreme pain, allodynia, autonomic changes, alterations in skin appearance, motor symptoms
  • Tx options include physical therapy, NSAIDs, amitriptyline, gabapentin, nerve blocks
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3
Q

Describe the clinical manifestations of fibromyalgia?

A

Clinical manifestations include
* diffuse pain that is worse in the morning,
* extreme fatigue
* stiffness
* painful and tender joints
* SLEEP DISTURBANCES

Symptoms often worsened with physical and psychological stress

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4
Q

What medication class is typically used to treat fibromyalgia?

A

Anticonvulsants (pregabalin/gabapentin)

The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica)

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5
Q

What is the most commonly affected joint in gout?

A

The first metatarsophalangeal joint (big toe), also known as podagra

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6
Q

Which type of crystals are found in synovial fluid analysis of a gout patient?

A

Needle-shaped, negatively birefringent monosodium urate crystals

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7
Q

What lifestyle modification can help reduce gout attacks?

A

Reducing intake of purine-rich foods (e.g., red meat, seafood) and alcohol

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8
Q

Which medication inhibits xanthine oxidase to reduce uric acid production in gout?

What patient education must be done prior to prescribing?

A

Allopurinol

It may make gout worse at first. Rash is the m/c side effect.

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9
Q

What type of crystals are associated with pseudogout?

Which joint is most commonly affected by pseudogout?

A

Rhomboid-shaped, positively birefringent calcium pyrophosphate dihydrate (CPPD) crystals

Knee

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10
Q

Name a common risk factor for developing pseudogout

A

Advanced age or metabolic disorders like hyperparathyroidism or hypothyroidism

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11
Q

What is the radiographic finding characteristic of pseudogout?

A

Chondrocalcinosis (cartilage calcification)

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12
Q

What is the initial treatment for an acute pseudogout flare?

A

NSAIDs

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13
Q

What is the most commonly affected joint pattern in rheumatoid arthritis?

A

Symmetrical involvement of small joints (wrist, MCP, PIP, MTP).

Spares the DIP

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14
Q

What is the hallmark laboratory test for diagnosing rheumatoid arthritis?

What imaging finding is characteristic of long standing RA?

A

Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies

**Anti-CCP most specific **

Symmetric joint space narrowing and erosions

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15
Q

What is the first-line disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis?

What is the MOA? And what supplement needs to be initiated with its use?

A

Methotrexate

Folic antagonist - must initiate supplementation of folic acid

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16
Q

What type of blood vessels are primarily affected in polyarteritis nodosa?

A

Medium-sized arteries

17
Q

What is a common infectious association with polyarteritis nodosa?

Which organ systems are most commonly involved?

A

Hepatitis B virus (HBV) infection

The kidney’s, skin, peripheral nerves and GI system

18
Q

What is the gold standard diagnostic tool for confirming polyarteritis nodosa?

A

Tissue biopsy or angiography

19
Q

What are the typical symptoms of polymyalgia rheumatica?

What age group is most commonly affected?

A

Bilateral pain and stiffness in the shoulders, neck, and hips, especially in the morning.

Adults over 50

20
Q

Which laboratory marker is typically elevated in polymyalgia rheumatica?

A

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)

21
Q

What is the primary clinical feature of polymyositis?

Which laboratory marker is usually elevated in polymyositis?

A

Symmetrical proximal muscle weakness

Creatine Kinase (CK)

22
Q

What diagnostic test is definitive for confirming polymyositis?

Which autoantibody is often associated with polymyositis?

A

Muscle Biopsy

Anti-Jo-1 Antibody

23
Q

What is the first line treatment for polymyositis?

A

Corticosteroids (prednisone)

24
Q

What is the classic triad of symptoms in reactive arthritis?

A
  • Arthritis
  • Urethritis
  • Conjunctivitis
25
Q

What infections are commonly associated with triggering reactive arthritis?

What genetic marker is often associated with reactive arthritis?

A
  • Gastrointestinal (Shigella, Salmonella, Campylocator)
  • Genitourinary (Chlamydia)

HLA-B27

26
Q

What is the first line treatment for arthritis in reactive arthritis?

A

NSAIDs

27
Q

What is the typical joint involvement pattern in reactive arthritis?

A

Asymmetric involvement of large joints, especially the lower extremities (knee’s, ankles)

28
Q

What is the most common joint pattern affected by rheumatoid arthritis?

A

Symmetrical involvement of small joints, especially the hands (metacarpophalangeal and proximal interphalangeal joints).

29
Q

What is the hallmark lab test for diagnosing rheumatoid arthritis?

A

Positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP)

30
Q

What are the two most common clinical symptoms of Sjögren’s syndrome?

A
  • Dry Eyes (xerophthalmia)
  • Dry Mouth (xerostomia)
31
Q

Which autoantibodies are commonly associated with Sjogren’s Syndrome?

A

Anti-Ro/SSA and Anti-La/SSB antibodies

32
Q

What test is commonly used to evaluate tear production in suspected Sjogren’s syndrome?

A

Schirmer’s Test

33
Q

What is a common extra-glandular manifestation of Sjögren’s syndrome?

A
  • Arthralgias
  • Interstitial Lung Disease
  • Vasculitis
34
Q

What is the first-line treatment for dry eyes and dry mouth in Sjogren’s Syndrome?

A

Artificial Tears and Saliva Substitutes

35
Q

What is the most common cause of acute compartment syndrome?

A

Fractures, particularly of the tibia or forearm

Acute compartment syndrome commonly results from trauma, with fractures being the leading cause due to increased pressure from bleeding or swelling.

36
Q

What is the critical threshold of intracompartmental pressure that typically suggests the need for surgical intervention?

A

Greater than 30 mmHg

Compartment pressures above this level can compromise perfusion and tissue viability, necessitating fasciotomy.

37
Q

What is the most reliable clinical finding for diagnosing acute compartment syndrome?

A

Pain out of proportion to the injury

38
Q

What is the definitive treatment for acute compartment syndrome?

A

Fasciotomy

39
Q

Which nerve is most commonly affected in anterior compartment syndrome of the lower leg?

A

Deep peroneal nerve

This nerve runs through the anterior compartment and can be affected, leading to sensory and motor deficits

Musculoskeletal and Rheumatology (2 decks)

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