Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

I > Rheuma > Flashcards

Rheuma Flashcards

1
Q

A 32/F presents to the OPD with chronic symmetric joint pains occurring intermittently over the past 3 months. Initial work up from a previous MD revealed normal ESR and CRP. Anti CCP antibodies were negative, but RF was minimally positive (2x upper limit of normal. What type of joint involvement should AT LEAST manifest in this patient for her to be diagnosed with rheumatoid arthritis?

a. 1 to 3 large joints

b. 2 to 3 small joints

c. 2 to 10 large joints

d. 4 to 6 small joints

A

4 to 6 small joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following joints will rheumatoid arthritis LEAST likely involve?

a. Elbows

b. Knees

c. Cervical spine

d. Lumbar spine

A

Lumbar spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A 42/F consulted for a 5-year history of progressive joint stiffness and swelling, which initially started in the hands and feet, more prominent upon waking up and resolved with movement. It eventually involved the knees, elbows and shoulders with longer duration of pain. She also had difficulty standing or ambulating due to foot and ankle pain. She also experienced chronic dry cough starting 3 months ago, with progressive shortness of breath. She had no chest pain or orthopnea. All of the following radiographic findings may be explained by her rheumatologic condition EXCEPT:

a. Bilateral interstitial infiltrates

b. Bronchiectasis

c. Lobar infiltrate

d. Solitary pulmonary nodule

A

Lobar infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 50/M admitted for non-ST-elevation acute coronary syndrome suddenly complained of severe ankle pain. On examination, the joint is erythematous, warm and tender. He had a similar episode a few months earlier, which spontaneously resolved in a week’s time with naproxen. Which of the following is the best management for his joint problem?

a. Allopurinol

b. Colchicine

c. Ibuprofen

d. Prednisone

A

Colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

According to the 2008 Philippine Clinical Practice Guidelines on the Management of Gout, which of the following statements is true regarding treatment of gouty arthritis?

a. Allopurinol should be started at 200 mg/day 2 weeks after the first symptoms of initial attack

b. If colchicine is contraindicated or not tolerated by the patient, NSAIDs or COX-2 inhibitors may be used as an alternative for prevention of gout flares during allopurinol initiation

c. The maximum dose of allopurinol that may be used to achieve target serum uric acid is 300 mg/day

d. Development of diarrhea with colchicine use should warrant discontinuation of the drug and shifting to a different agent.

A

The maximum dose of allopurinol that may be used to achieve target serum uric acid is 300 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the following medications does NOT have uricosuric effects?

a. Amlodipine

b. Febuxostat

c. Lesinurad

d. Losartan

A

Febuxostat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following LEAST likely contributes to the development of knee osteoarthritis?

a. Age

b. Genetics

c. Obesity

d. Repeated use of joint

A

Genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A 70/M came in due to chronic bilateral knee pain. He has difficulty getting up and walking in the morning but notes improvement within 10 minutes. Physical examination revealed crepitus on both knees. Which of the following radiographic finding/s is/are most consistent with the patient’s condition?

a. Narrowed joint space, sclerosis of the bone, and osteophyte formation

b. Cystic changes, well-defined erosions with sclerotic margins

c. Periarticular osteopenia

d. Periarticular calcifications with hypertrophic changes

A

Narrowed joint space, sclerosis of the bone, and osteophyte formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 76/M farmer came in due to chronic right hip pain. He has difficulty getting up in the morning but notes improvement within 30 minutes. What is the mainstay of management for his condition?

a. Paracetamol

b. Naproxen

c. Intraarticular glucocorticoids

d. Use of cane on the left hand

A

Use of cane on the left hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following qualifies as an immunologic manifestation of systemic lupus erythematosus according to the Systemic Lupus International Collaborating Clinic (SLICC) criteria?

a. Anti-Sm positive

b. Antihistone positive

c. High serum complement

d. Positive direct Coombs test in the presence of hemolytic anemia

A

Anti-Sm positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you call the erythematous rash over the extensor surfaces of joints such as knuckles, elbows, knees, and ankles seen in some patients with dermatomyositis?

a. Heliotrope rash

b. Gottron sign

c. Gottron papules

d. V-sign

A

Gottron sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following manifestations of systemic sclerosis is more commonly seen in limited cutaneous systemic sclerosis than in diffuse cutaneous systemic sclerosis?

a. Skin involvement

b. Ischemic digital ulcers

c. Interstitial lung disease

d. Myopathy

A

Ischemic digital ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. A 24 year old female had recent history of rash on the face and chest which was apparently diagnosed as allergy by her family physician. Few days later she was noted to have myalgias lower extremity weakness with difficulty in standing up from a sitting position. Initial work-ups revealed normal CBC ESR of 30 and negative ANA. What is the next best thing to do ?

a. Repeat ANA after 4 weeks
b. Request for Anti Jo-1
c. Request for Total CPK
d. Request for MRI

A

c. Request for Total CPK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. The following is true of dermatomyositis:

a. Antinuclear antibodies are positive in almost all cases.
b. May be associated with the ff Ab’s: melanoma differentiation antigen 5 (MDA5), transcriptional intermediary factor 1 (TIF1), Mi-2 and nuclear matrix protein 2 (NXP2)
c. Presents with Symmetric, distal greater than proximal weakness along with heliotrope rash
d. higher risk for malignancy in adult onset cases, 50% within the first year of disease onset

A

b. May be associated with the ff Ab’s: melanoma differentiation antigen 5 (MDA5), transcriptional intermediary factor 1 (TIF1), Mi-2 and nuclear matrix protein 2 (NXP2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. Which of the following is true of auto-antibodies in dermatomyositis?

a. antiMi 2 antibodies are associated with amyopathic DM with severe palmar rash, digital ulcers, and rapidly progressive ILD.
b. Anti-TIF1 (or p155) antibodies and anti-NXP2 antibodies are associated with an increased risk of cancer
c. anti-MDA5 antibodies are often associated with more benign DM and a favorable response to treatment.
d. Anti Jo 1 is highly specific for dermatomyositis

A

b. Anti-TIF1 (or p155) antibodies and anti-NXP2 antibodies are associated with an increased risk of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. A 55 yr old male with 4 wk history of dysphagia as well as slowly progressive asymmetrical weakness of lower extremity distal muscles, and accompanying muscle atrophy on quadriceps of both legs. CBC ANA and CPK were all normal. Your most likely diagnosis is

a. Dermatomyositis
b. Inclusion Body Mysositis
c. Polymyositis
d. Anti Synthetase syndrome

A

b. Inclusion Body Mysositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. Perimysial and Perivascular Inflammatory cell infiltrate on muscle biopsy is best seen in which of the ff:

a. Anti Synthethase syndrome
b. Dermatomyositis
c. Inclusion Body Mysositis
d. Polymyositis

A

b. Dermatomyositis

18
Q

AntiHMGCR or antiSRP antibodies is closely associated with which of the ff:

a. Anti Synthethase syndrome
b. Inclusion Body Mysositis
c. Necrotizing Myopathy
d. Polymyositis

A

c. Necrotizing Myopathy

19
Q
  1. Antisynthetase syndrome is best characterized with which of the ff:

a. distal lower extremity weakness
b. erosive arthritis
c. Interstitial lung disease
d. vasculitis

A

c. Interstitial lung disease

20
Q

A 50 yr old teacher came to the OPD due to 4 wk history of myalgias lower extremity weakness with facial rash periorbital edema, as well as rash on her anterior chest wall. Initial labs showed Total CPK of 680 and myopathic process on EMG NCV. The initial drug of choice in this case is:

a. Azathioprine
b. Corticosteroid
c. Methotrexate
d. Rituximab

A

b. Corticosteroid

21
Q

Endomysial and perivascular inflammation with Rimmed vacuoles on muscle biopsy is characteristic of :

a. Anti Sytnthethase syndrome
b. Inclusion Body Mysositis
c. Necrotizing Myopathy
d. Polymyositis

A

b. Inclusion Body Mysositis

22
Q

Raised erythematous rash over the knuckles best define which of the following cutaneous lesions in dermatomyositis?

a. Gottrons papules
b. Gottrons rash
c. Heliotrope rash
d. Shawl sign

A

a. Gottrons papules

23
Q

Which of the following is true regardimg prognosis in dermatomyosistis?

a. prognosis is g enerally poor in patients with DM, with 5-year survival rates ranging from 50-70%
b. malignancies carry a poor prognosis in 40% of cases
c. adequate treatment with steroids for at least 6 months is associated with good prognosis
d. poor prognostic factor include increased age,and ILD

A

d. poor prognostic factor include increased age,and ILD

24
Q

Laboratory Features of immune mediated necrotizing myopathy include:

a. CK levels may be normal or >4x elevated
b. IMNM can be associated withanti-synthetase antibodies.
c. EMG and skeletal muscle imaging findings are non-specifically abnormal
d. Muscle biopsies revea lmultifocal necrotic and regenerating muscle fibers with many inflammatory cells

A

c. EMG and skeletal muscle imaging findings are non-specifically abnormal

25
Q

A 40 yr old F diagnosed to have polymyositis in clinical remission for the past 6 months (currently on 20mg mg prednisone per day), was noted to have recurrence of lower extremity weakness. To differentiate a possible steroid myopathy from relapse in this case would include which of the following:

a. Weakness developing while on 10mg dosage
b. Increasing serum CK
c. Absence of muscle membrane irritability on EMG
d. abnormal spontaneousactivity on EMG.

A

c. Absence of muscle membrane irritability on EMG

26
Q

Proximal and distal predilection of weakness ( finger/wrist knee flexors is best seen in which of the ff:

a. Anti Sytnthethase syndrome
b. Inclusion Body Mysositis
c. Necrotizing Myopathy
d. Polymyositis

A

b. Inclusion Body Mysositis

27
Q

A 33 yr old male with history of lower extremity weakness and mildly elevated CPK was given an initial corticosteroid therapy of 1mg per kg which was subsequently tapered off. Total CPK has normalized two three months later however thertr was no significant improvement in his weakness . Your most likely impression in this case is:

a. Anti Sytnthethase syndrome
b. Inclusion Body Mysositis
c. Necrotizing Myopathy
d. Polymyositis

A

b. Inclusion Body Mysositis

28
Q

A 20 year old female presents purpuric rashes on lower extremities for the past three days after having a sorethroat a week ago, with no other accompanying symptoms except for arthralgia on ankle joints and recent abdominal pain. Your most likely diagnosis is:

a. Erythema Nodosum
b. IgA vasculitis
c. Post Strep Reactive arthritis
d. Rheumatoid Vasculitis

A

b. IgA vasculitis

29
Q

A 55 year old female presents with recurrent oral and vaginal ulcers for the past six months . She had recurrent DVT a year prior . Your most likely diagnosis is:

a. APAS
b. Behcet’s syndrome
c. SLE
d. MCTD

A

b. Behcet’s syndrome

30
Q

A 55 year old female presents with recurrent fever arthritis/synovitis and chronic anemia . Coombs test was positive while ANA of 1:640, RF of 1:360. Urinaylsis showed low grade proteinuria Your most likely diagnosis is

a. MCTD
b. Rheumatoid Arthritis
c. SLE
d. vasulitis

A

c. SLE

31
Q

A 38 year old female presents with headache , dizziness , recurrent fever and arm claudication; PE showed decreased left radial pulses. CBC showed anemia and elevated ESR at 110. Your most likely diagnosis is

a. Giant Cell arteritis
b. PAN
c. Takayasu arteritis
d. SLE

A

c. Takayasu arteritis

32
Q

Which of the following forms of vascultis involve a pathogenic T lymphocyte response and granuloma formation?

a. Wegener’s granulomatosis
b. microscopic polyangitis
c. Churg-Strauss syndrome
d. Takayasu arteritis

A

d. Takayasu arteritis

33
Q

A 34 year old female with prior history of Raynauds phenomenon now noted progressive skin tautness/tightness, and sclerodactyly . Which of of the following serologic marker is strongly associated with the case?:

a. anti-ss DNA
b. anti RNP
c. anti centromere
d. anti-Sm

A

c. anti centromere

34
Q

In the classification criteria the diagnosis of SLE, hematologic disorder is best defined as:

a. leukocytosis
b. Eosinohilia
c. Lymphopenia
d. Thrombocytosis

A

c. Lymphopenia

35
Q

Raynauds phenomenon is most commonly associated with which of the following?

a. Dermatomyopsitis
b. Scleroderma
c. sjogrens syndrome
d. SLE

A

b. Scleroderma

36
Q

Which of the auto antibodies in patients with SLE is associated with nephritis and clinical disease activity?

a. ANA
b. Anti-dsDNA
c. ANTI-Sm
d. Anti-RNP

A

b. Anti-dsDNA

37
Q

Which of the following is true of Sjogren’s Syndrome?

a. The presence of systemic features necessitates the prescription of moderate to high dose steroids
b. Use of DMARDS is necessary when there is myalgia or arthralgia.
c. immunosuppressives used include azathioprine , methotrexate and cyclophosphamide
d. Giving of DMARDs requires monitoring of ESR/CRP to monitor treatment response

A

c. immunosuppressives used include azathioprine , methotrexate and cyclophosphamide

38
Q

A 35 year old teacher has been noticing skin hypopigmentation for the past one yea r with extensive skin tautness on distal and proximal extremities, face and trunk and within thepast six months, progressive Raynauds have been noted. The most likely autoantibody associated with this case is:

a. anti-Smith
b. anti DS DNA
c. Anti-Ro and anti La
d. Anti-topoisomerase Ab

A

d. Anti-topoisomerase Ab

39
Q

Which of the following is NOT true of PAN?

a. PAN is characterized by segmental transmural inflammation of muscular arteries .
b. In contrast to many other forms of systemic vasculitis– PAN does not involve veins.
c. Characteric biopsy finding includes granulomatous cellular infiltrates with polymorphonuclear leukocytes and mononuclear cells
d. highly associated with hepatitis B

A

c. Characteric biopsy finding includes granulomatous cellular infiltrates with polymorphonuclear leukocytes and mononuclear cells

40
Q

A 38 year old female with prior history of recurrent deep venous thromobis came to the ER due to progressive left sided weakness , slurring of speech and facial asymmetry. To further evaluate the possible etiology of stroke in this young patient, which of the following antibodies would you request?

a. Anti RNP
b. AntiSm
c. Anti-phospholipid Ab
d. Anti SRP

A

c. Anti-phospholipid Ab

41
Q

Which of the following is NOT a feature of limited scleroderma?
a. Esophageal dysmotility
b. Interstitial Lung disease
c. Raynauds syndrome
d. Telangiectasiaia

A

b. Interstitial Lung disease

I (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions