Rheum/MSK Part 2 Flashcards

1
Q

Systemic Sclerosis

Limited Cutaneous, what is the most common bad pathology?

A

Pulmonary Hypertension

Limited Cutaneous Systemic Sclerosis -> CREST syndrome

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2
Q

Systemic Sclerosis

What is the most common long term disease with diffuse cutaneous systemic sclerosis?

A

Interstitial Lung Disease
Scleroderma Renal Crisis

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3
Q

With reference to knee pain?

Lateral Knee pain reprodued on palpitation, flexion and extension of knees?

A

IT band syndrome

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4
Q

With reference to knee pain

What anterior knee pain can be reproduced with squatting?

A

Patellofemoral Syndrome

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5
Q

Back pain with these features, what is the next step?

Recent UTI
Age > 50
Noctural Pain

A

MRI Lumbar Spine

Concern for Vetebral osteomyelitis, need blood cultures

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6
Q

Systemic Sclerosis

What long term disease consequence occurs with limited cutaneous systemic sclerosis?

A

Pulmonary Hyptertension

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7
Q

Systemic Sclerosis

What GI condition can occur that can cause recurrent bleeding and chronic anemia?

A

Gastric Antral Vascular Ectasia (GAVE or “watermelon stomach”)

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8
Q

Systemic Sclerosis

If a patient has active alveolitis or rapidly progressive interstitial lung disease, what is the treatment?

A

Cyclophosphamide

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9
Q

Sjogren Syndrome

What is the gold standard to diagnosis?

A

Lip Biopsy

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10
Q

Systemic Sclerosis

Where does Limited Cutaneous appear?
Where does Diffuse Cutaneous appear?

A

Limited: Mostly Fingers
Diffuse: Trunk and Proximal Limbs

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11
Q

Systemic Sclerosis

What subtype is assoicated with CREST syndrome?

A

Limited Cutaneous Systemic Sclerosis

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12
Q

Complex Regional Pain Syndrome

What will be seen on an XR?

A

Patchy Bone Demineralization

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13
Q

What disease process has the following:

Neuropathic Pain
Autonomic Dysfunction
Swelling
Dystrophy (Hail loss, skin thinning, ulcers)
Movement disorder

A

Complex Regional Pain Syndrome

Bisphosphonates can treat non-osteoporosis pain

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14
Q

Rheumatoid Arthritis

What treatment is mild to moderate?
What treatment is moderate to severe?

A

Mild to Mod: Sulfasalazine and Hydroxychloroquine

Mod to Severe: Methotrexate

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15
Q

What MSK disease has the following concern?

When a needle is inserted, a papule > 2mm develops within 24-48 hours in the same area?

A

Behcet Disease

The description is a positive pathergy test

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16
Q

What disease treatment is needed?

PMHx of RA or Gout, arthrocentesis has WBC 3-5k, fever, redness, or inflmmation

A

Anti-staph antibiotics (concern for septic bursa)

17
Q

Can the following medications be used together for RA treatment?

Hydroxychloroquine
Sulfasalazine
Methotrexate

A

Yes, this regimen is more effective than monotherapy with methotrexate or sulfasalazine plus hydroxychloroquine

18
Q

What medication class can have the following side effects?

Pancytopenia
positive ANA formation
positive Lupus-Like Syndrome
Demyelinating Disorder

A

TNF alpha inhibitor therapy

19
Q

If a patient’s RA is not responding to methotrexate, what is the first biologic medication?

A

Tofacitinib

20
Q

Osteoarthritis has two variants, what are they?

A

Erosive OA
DISH

21
Q

What is the following:

Asymptomatic for of OA, similar to degenerative spondylosis or ankylosing spondylitis, ossification of the anterolateral aspect of the vertebral bodies, particulary anterior longitudinal ligament, more than 4 contiguous vertebrae. No disk-space narrowing nor syndesmophytes are visibile

A

DISH (Diffuse Idiopathic Skeletal Hyperostosis)

22
Q

Hypertrophic osteoarthropathy has what unique physical exam finding?

A

Pain is alleviated by elevating the affected limbs

23
Q

If a patient has an explosive onset or severe flare up of psoriatic arthritis, what type of testing should be done?

A

HIV testing

24
Q

NSAID, antimalarial drugs, and oral steroid withdrawl may exacerbate what autoimmune disease?

25
What cardiac symptoms can be seen in Ankylosing Spondylitis?
Aortic Valvular Regurgitation, Aortic Aneurysm, and cardiac conduction defects
26
What medications are used to treat primary Raynaud Disease?
Nifedipine Amlodipine Felodipine Sildenafil Nitroglycerin Paste
27
What medications are the first line therapy for gout?
NSAIDs Colchicine Steroids
28
Should Colchicine be used in kidney failure?
No
29
# A patient has a gout flare: When should a uric acid level be done and allopurinol restarted?
2 weeks after gout
30
Aspirin, loop diuretics, and HCTZ can cause an increase in what MSK condition?
Gout
31
# A patient's knee starts to hurt What is this and the disease association?
Calcium Pyrophosphate Depostion (Pseudo-gout) Chondrocalcinosis
32
Polymyalgia rheumatica is painless or painful? Polymyositis is painless or painful?
Polymyalgia Rheumatica -> painful, strength is intact Polymyositis -> painless, strength is diminished
33
# What disease process has the following concerns: Barbotage and Ultrasound guided lavage is done in order to help alleviated calcified tendons?
Calcific Tendonitis
34
# What is the following Repetive Bone/Joint Trauma secondary to a neuropathy (usually diabetes), patient has persistent foot/ankle pain, what could this?
Charcot Arthropathy Tx: Foot Cast and offload weight bearing
35
An immunocompromised patient develops Tinea Corpis (fungal infection of body, not groin), how should this be treated?
Oral Terbinafie, itraconazole, or fluconazole
36
What type of infection has a culture treated with potassium hydroxide that shows branching hyphae?
Tinea Infection