Rheum

Question 1

ankylosing spondylitis mainly affects

Answer 1

SI joints

Question 2

ankylosing spondylitis more common in

Answer 2

males

Question 3

ankylosing spondylitis associated with

Answer 3

IBD

Question 4

bamboo spine on xray

Answer 4

ankylosing spondylitis

Question 5

night pain and morning back stiffness relieved by exercise

Answer 5

ankylosing spondylitis

Question 6

shiny or scaly skin over the interphalangeal joint

Answer 6

gottron’s sign (dermatomyositis)

Question 7

heliotrope rash, shiny/scaly extensor surfaces and interphalanges, difficulty getting dresses, voice change/difficulty swallowing

Answer 7

dermatomyositis

Question 8

most common systemic vasculitis in children

Answer 8

HSP

Question 9

palpable purpura, heme positive stool, colicky abdominal pain, hematuria

Answer 9

HSP

Question 10

most common rheumatologic disease of childhood

Answer 10

JIA

Question 11

JIA must present before what age

Answer 11

16 (at least 6 weeks in 1 joint)

Question 12

morning stiffness with gradual loss of motion and rash

Answer 12

JIA

Question 13

ANA in JIA

Answer 13

usually positive

Question 14

JIA is more common in

Answer 14

girls

Question 15

polyarthritis JIA

Answer 15

5 or more joints in the first 6 months, most females

Question 16

oligoarthritis/pauciarthritis JIA

Answer 16

4 or fewer joints during the first 6 months, ANA positive, usually young females, associated with chronic uveitis, boys w/ HLA b27 have a better prognosis

Question 17

systemic onset JIA

Answer 17

aka stills disease, affects males and females equally, extraarticular involvement is common

Question 18

enthesitis related arthritis

Answer 18

SI joint pain, more common in boys, HLA-B27

Question 19

first line JIA treatment

Answer 19

NSAID (indomethacin, ibuprofen, naproxen)

Question 20

2nd line JIA treatment

Answer 20

steroids and immunosuppressants if NSAIDs don’t work

Question 21

MTX MOA

Answer 21

folate antagonist - side effects = GI distress and pulmonary toxicity

Question 22

gold standard therapy for JIA

Answer 22

methotrexate

Question 23

mucocutaneous lymph node syndrome aka

Answer 23

kawasaki’s

Question 24

Kawasaki is more common in

Answer 24

asian, males, around 2 years old, mostly winter and spring

Question 25

Kawasaki's criteria

Answer 25

high fever for at least 5 days plus at least 4 - cervical LAD - cracked lips - non-exudative conjunctivitis - polymorphous exanthem on trunk - erythema/ desquamation of hands/feet

Question 26

things common in Kawasaki that are not part of the criteria

Answer 26

sterile pyuria, migratory poly arthritis, gallbladder hydrops, thrombocytosis

Question 27

thrombocytosis by what day with kawasaki

Answer 27

day 5

Question 28

leukocytosis by what day with kawasaki

Answer 28

day 12

Question 29

Kawasaki treatment

Answer 29

IVIG 2g/kg, initial high dose aspirin of 80mg/kg/day x24-48 hours then maintenance aspirin of 5 mg/kg/day x2 months

Question 30

what vaccines can't be given after IVIG

Answer 30

varicella and MMR cannot be given for 11 months after IVIG

Question 31

Lyme disease is carried by

Answer 31

ixodes deer tick

Question 32

ticks need to feed how long to transmit lyme disease

Answer 32

36 hours

Question 33

erythema chronic migrans

Answer 33

lyme disease

Question 34

second stage of lyme disease

Answer 34

carditis, arthritis, neurologic (Bell's palsy)

Question 35

treatment for Lyme disease if less than 8

Answer 35

amoxicillin

Question 36

treatment for Lyme disease if less than 8 and penicillin allergic

Answer 36

cefuroxime

Question 37

chills, fever and hypotension after treatment for lyme disease

Answer 37

jarisch-herxheimer reaction due to lysis of organism and release of endotoxin

Question 38

urethritis, iritis and arthritis

Answer 38

reactive arthritis

Question 39

most common cause of reactive arthritis in the US

Answer 39

chlamydia trachomatis

Question 40

reactive arthritis in kids is usually after

Answer 40

enteric infection

Question 41

weight loss and fatigue with hilar adenopathy

Answer 41

sarcoidosis

Question 42

granulomas in sarcoidosis

Answer 42

noncaseating but can secrete vitamin D causing hypercalcemia and hypercalciuria

Question 43

arthritis, rash and uveitis

Answer 43

sarcoidosis

Question 44

scleroderma is more common in

Answer 44

females

Question 45

sclerodactyly, pulmonary fibrosis and reflux

Answer 45

systemic scleroderma

Question 46

linear hyperpigmented patch and shiny hypo pigmented skin with a brown border

Answer 46

localized linear scleroderma

Question 47

SLE diagnosis requires

Answer 47

4 or more - malar rash - discoid lesions - photosensitivity - oral ulcerations - arthritis - hematologic abnormalities - renal abnormalities - anti-ds-DNA, and-DNA and anti-Smith Ab's - psychosis - positive ANA

Question 48

antibody specific to SLE

Answer 48

anti-ds-DNA and anti-smith DNA

Question 49

how to track severity of disease in SLE

Answer 49

anti-ds-DNA levels (fluctuate accordingly) or C3 and C4 levels (inversely proportional)

Question 50

rash on trunk and bradycardia with 3rd degree heart block in newborn

Answer 50

neonatal lupus

Question 51

most common cause of death in an infant born to a mom with SLE

Answer 51

heart block

Question 52

antibody associated with neonatal lupus

Answer 52

anti-SSA antibody (anti-Ro) and anti-SSB (anti-la)

Question 53

mild lupus treatment

Answer 53

NSAIDs and hydroxychloroquine

Question 54

hydoxychloroquine side effects

Answer 54

blurring of vision to permanent retinal damage and ototoxicity

Question 55

treatment for lupus with severe organ involvement

Answer 55

cyclophosphamide

Question 56

complications associated with high dose steroids

Answer 56

cataracts, glaucoma, osteoporosis, HTN, glucose intolerance, cushingoid features

Question 57

ANA pattern in mixed connective tissue disease

Answer 57

speckled ANA

Question 58

antibody in mixed connective tissue disease

Answer 58

anti-U1 ribonucleoprotein antibody (anti-U1 RNP)

Question 59

diagnosis in child with systemic JIA now with elevated LFTs, positive d-dimer, prolonged PTT and cytopenia

Answer 59

macrophages activation syndrome

Question 60

diagnosis with arthritis, dactylics and pitting of nails

Answer 60

juvenile psoriatic arthritis

Question 61

fever, weight loss, migratory arthralgia, nodules in lungs, elevated creatinine, positive c-ANCE

Answer 61

granulomatosis with polyangitis (Wegener's)

Question 62

pathergy test

Answer 62

prick skin with needle, pustule or papule surrounded by redness forms within 48 hours with Behcet disease

Question 63

painful recurrent oral and genital ulcers and uveitis

Answer 63

Behcet disease

Question 64

antibody that is likely the cause of miscarriages in lupus

Answer 64

antiphospholipid antibodies

Question 65

recurrent parotitis, dry eyes and mouth, anti-Ro positive

Answer 65

sjogren syndrome

Question 66

PFAPA

Answer 66

periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis

Question 67

Turkish girl with fevers for 3 days every 3 months with elevated ESR, CRP and WBC during fevers nut normal in between

Answer 67

familial mediterranean fever