Rheum - Random

Question 0

Carpal tunnel syndrome presents with?

Signs?

Answer 0

#Pain in the hand worse at night 
#Atrophy of the thenar eminence

#Tinel Sign – reproduction of pain with tapping median nerve
 #phalen sign – reproduction of pain with flexion of the wrists

Question 1

Carpal tunnel syndrome associated with?

Answer 1

#Pregnancy
#RA
#Diabetes
#Hypothyroidism
#Amyloidosis
#Acromegaly

Question 2

Most accurate diagnostic test for carpal tunnel syndrome? Best initial therapy? Other therapies

Answer 2

Electromyography and nerve conduction testing

Wrist splints > Steroids > surgery

Question 3

Dupuytren’s contracture associated with? Medical therapy? When surgery?

Answer 3

Alcoholism and cirrhosis

#Triamcinolone
#lidocaine
#collagenase injection

When function is impaired

Question 4

Rotator cuff injury – history? Most accurate test? Treatment? When surgery?

Answer 4

Pain when lying on the shoulder

MRI

#NSAIDs, rest, physical therapy
#then steroids

Complete tear or not responding to therapy

Question 5

Patellofemoral syndrome – Where is the pain? Provoked by? Improves after?

X-ray findings? Treatment?

Answer 5

#In front of the knee or under the patella
#Pain worse when climbing stairs or walking after being seated for prolonged periods

Normal x-rays

Physical therapy and strength training

Question 6

Planter fasciitis versus tarsal tunnel syndrome? X-Ray May show?

Answer 6

Improves with use versus worsens with use

Bony spurs (but imaging is useless)

Question 7

CREST?

Answer 7

Calcinosis
Raynaud's
Esophageal dysmotility
Sclerodactyly
Telangiectasias

Question 8

Non-esophageal Gastrointestinal findings in scleroderma? Renal? Pulmonary? Cardiac?

Answer 8

Large mouth diverticula of intestines

hypertensive crisis

restrictive lung disease and pulmonary hypertension

Myocardial fibrosis, pericarditis, right ventricular hypertrophy and heart block

Question 9

Antibodies associated with scleroderma? ESR?

Answer 9

Anti-topoisomerase and Antiicentromere

Normal

Question 10

Scleroderma treatment?

Specific treatment for:

1. Renal crisis
2. Esophageal dysmotility
3. Raynaud’s
4. Pulmonary fibrosis
5. Pulmonary hypertension

Answer 10

Methotrexate

1. ACE inhibitor
2. PPI
3. Calcium channel blocker
4. Cyclophosphamide
5. Sildenafil, Bosentan, Prostacyclin analogs

Question 11

Dermatomyositis associated with which cancers?

Answer 11

Lung, G.I., ovarian, lymphoma

Question 12

Best initial Diagnostic tests for inflammatory myopathies? Most accurate test?

Anti-Jo antibody associated with?

Answer 12

CPK and aldolase

Muscle biopsy

Lung fibrosis

Question 13

Treatment for inflammatory myopathy?

Treatment for skin lesions in dermatomyositis?

Answer 13

Steroids > methotrexate/mycophenolate

Hydroxychloroquine

Question 14

Sjogren’s syndrome associated with?

Answer 14

#RA & SLE
#polymyositis
#Primary biliary cirrhosis
#Hashimoto's

Question 15

Most dangerous complication of Sjogren’s syndrome?

Answer 15

Lymphoma

Question 16

Best initial test for suspected Sjogren’s syndrome? Best initial blood test?

Most accurate test?

Answer 16

Schirmer test - filter paper is placed against the eye to observe amount of tears

SS-A and SS-B (Ro and La)

Lip or parotid gland biopsy for lymphoid infiltration

Question 17

Sjogren’s syndrome – best initial therapy?

Answer 17

Wasting mouth and eyes

Question 18

Complement levels in SLE versus Hep C?

Answer 18

SLE - decreased C3 (3 letters in SLE)

Hep C - decreased C4 (4 letters in Hep C)

Question 19

Best initial test for psoriatic arthritis?

Treatment?

Answer 19

X-ray of hand showing pencil in a cup deformity

NSAIDs then methotrexate then anti-TNF

Question 20

Pustular psoriasis on the penis? Suggests?

Answer 20

Keratoderma Blennorhagicum

Reactive arthritis