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UWorld Medicine Ultra-HY > Rheum/MSK > Flashcards

Rheum/MSK Flashcards

1
Q

Disease associated with polymyalgia rheumatica

A

Giant cell / temporal arteritis

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2
Q

Specific serologic markers of Sjogren syndrome

A

Anti-Ro (SSA) and anti-La (SSB)

ANA and RF may also be positive but are not specific

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3
Q

Specific serologic markers of polymyositis and dermatomyositis

A

anti-Jo-1 and anti-Mi-2

ANA may also be positive but is not specific

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4
Q

Erythematous rash on dorsal fingers and upper eyelids with muscle weakness

A

Dermatomyositis

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5
Q

First choice treatment in mild knee OA

A

Topical NSAIDs like diclofenac or ketoprofen

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6
Q

Initial maintenance treatment in most RA patients

A

Methotrexate

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7
Q

What can be done to reduces AEs associated with methotrexate?

A

Give with folate (to prevent macrocytic anemias, as it inhibits dihydrofolate reductase)

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8
Q

Rare but serious effect of hydroxychloriquine that must be monitored for?

A

Retinopathy

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9
Q

DMARDs that can trigger hemolysis in G6PDD (2)

A

Sulfasalazine and hydroxychloroquine

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10
Q

Felty syndrome

A

Severe RA, neutropenia, and splenomegaly

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11
Q

HLA associated with RA? Seronegative spondylarthropathies?

A

RA: DR4

Seronegative spondylarthropathies: B27

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12
Q

Seronegative spondylarthropathies

A

PAID:

  • Psoriatic arthritis
  • Ankylosing spondylitis
  • IBD-associated arthritis
  • Reactive arthritis
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13
Q

Most common extra-articular manifestation of ankylosing spondylitis

A

Anterior uveitis

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14
Q

Triad of reactive arthritis?

Treatment?

A

Conjunctivitis, urethritis, and oligoarthritis

Treatment: NSAIDs are first-line

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15
Q

Arthritis with high fevers and a salmon-colored bumpy rash

A

Adult-onset Still’s disease (usually RF and ANA negative)

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16
Q

Crystals of gout? Pseudogout?

A

Gout: uric acid
Pseudogout: calcium pyrophosphate dihydrate

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17
Q

Classic medication that triggers gout?

A

Thiazide and loop diuretics (via hyperuricemia)

Aspirine and cyclosporine can as well

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18
Q

Joint pain with punched-out erosions on rim of cortical bone

A

Gout

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19
Q

Joint pain with chondrocalcinosis

A

Pseudogout

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20
Q

Classic disease that can lead to pseudogout

A

Hereditary hemochromatosis (iron deposition leads to chondrocalcinosis)

(Also associated with hyperparathyroid and thypothyroid)

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21
Q

Acute, polyarticular symmetric arthritis with a rash?

Treatment?

A

Parvovirus B19

No specific treatment (self-limited, 2-3 weeks)

22
Q

Tenosynovitis, dermatitis, and asymmetric migratory polyarthralgias?

Treatment?

A

Disseminated gonococcal infection (can also cause a purulent monoarthritis)

Treatment: Drain any septic joint, IV ceftriaxone (+axithro or doxy for chlamydia)

23
Q

Specific markers of SLE

A

anti-dsDNA and anti-SM (a.k.a. anti-Smith)

ANA is more sensitive but less specific

24
Q

Specific marker of drug-induced SLE

A

Anti-histone

25
Q

Thrombosis and prolonged aPTT with positive VDRL

A

Anti-phospholipid syndrome

26
Q

Markers of antiphospholipid syndrome

A

Anticardiolipin, anti-beta2-glycoprotein-I, and lupus anticoagulant

27
Q

Treatment of antiphospholipid syndrome in pregnancy

A

LMWH (decreases risk of miscarriage)

Warfarin is CI in pregnancy

28
Q

Specific marker of limited cutaneous systemic sclerosis (e.g. CREST)

A

Anti-centromere
(ANA positive but less specific)
(Anti-topo I and RNA pol III are for diffuse scleroderma)

29
Q

Specific marker of diffuse cutaneous systemic sclerosis?

A

Anti-topoisomerase I (a.k.a. anti-Scl-70) and anti-RNA pol III
(Anti-centromere is for limited scleroderma / CREST)

30
Q

CREST manifestations?

Another severe manifestation that is not part of the mnemonic?

A 
Calcinosis cutis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Talangiectasia

Pulmonary hypertension

31
Q

Three key manifestations of diffuse cutaneous systemic sclerosis?

A
  1. Interstitial lung disease
  2. Myocardial fibrosis and CHF
  3. Scleroderma renal crisis (AKI + microangiopathic hemolysis and thrombocytopenia)
32
Q

Vasculitis of arorta and primary branches in young Asian women

A

Takayasu arteritis

33
Q

Emergency in giant cell arteritis?

Treatment?

A

Anterior ischemic optic neuropathy presenting with sudden monocular vision loss
Treat with high-dose IV steroids

34
Q

Screening imaging in giant cell arteritis

A

CXR for aortic aneurysm

35
Q

What is associated with cANCA? pANCA?

A

cANCA: GPA/Wegener’s
pANCA: EGPA/Churg-Strauss and MPA

36
Q

Organ systems involved in GPA/Wegener’s?

A
  1. Upper respiratory (chronic rhinosinusitis/otitis)
  2. Lower respiratory (tracheal narrowing, cavitary lung nodules)
  3. Renal (GN, possibly RPGN)
  4. Skin (livedo reticularis, non-healing ulcers)
37
Q

Recurrent oral and genital ulcers

A

Behcet’s disease

38
Q

Urine hydroxyproline

A

Specific marker of bone turnover, elevated in e.g. Paget disease of bone

39
Q

Bone pain + hearing loss

A

Paget disease of bone

40
Q

Benign but locally agressive tumor of osteoclast-like giant cells?
Appearance on MRI?
Treatment?

A

Giant cell tumor of bone
MRI: Expansive “soap bubble” lesion
Treat with resection

41
Q

Frozen shoulder

A

Adhesive capsulitis

42
Q

Tendon inflammation from repeat abduction and extension of the thumb in a new mother?

A

De Quervain tenosynovitis

43
Q

First step in suspected epidural spinal compression

A

IV glucocorticoids

44
Q

Hemarthrosis with knee injury suggests…

A

ACL tear (rare in MCL and meniscus tears unless the ACL is also torn)

45
Q

Localized anterior medial tibial pain not aggrevated by valvus stress with normal x-rays

A

Pes anserinus pain syndrome (PAPS)

46
Q

Anterior knee pain elicited while extending the knee while compressing the patella

A

Patellofemoral pain syndrome (PFPS)

47
Q

Tenderness at the inferior patella

A

Patellar tendonitis (“jumper’s knee”)

48
Q

Arc of ecchymosis distal to the medial malleolus

A

Ruptured popliteal (Baker) cyst

49
Q

Focal pain in the plantar rearfoot that is worst when first get up and later in the day

A

Plantar fasciitis

50
Q

Numbness, aching, and burning in the distal forefoot from the metatarsal heads to the 3rd and 4th toes of a runner

A

Morton / interdigital neuroma (actually not a neuroma but mechanically-induced degeneration of interdigital nerves)

51
Q

Pain on weight bearing, hip abduction, and internal rotation with normal labs and x-rays

A

Avascular necrosis of the hip

Late x-ray shows crescent-sign, an area of subchondral lucency

UWorld Medicine Ultra-HY (13 decks)

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