Rheuma Retention Flashcards
- Arthritis of the cervical spine leads to the most severe limitation of which neck motion?
a. Lateral bending
b. Rotation
c. Extension
d. Flexion
b. Rotation
- Positive urethritis and conjunctivitis is seen in:
a. Felty’s syndrome
b. Reactive arthritis
c. SLE
d. Gout
e. OA
b. Reactive arthritis
- Which of the following is not a characteristic of psoriatic arthritis?
a. HLA B27 is positive
b. RF- positive
c. Asymmetric inflammatory arthritis
d. (+) dactylitis
e. None of these
b. RF- positive
- DIP hyperextension and PIP extension is a characteristic of:
a. Mallet finger
b. Hammer toes
c. Boutonniere
d. Swan neck
e. None of these
e. None of these
PIP flexion dapat
- The first manifestation of ankylosing spondylitis is usually:
a. Kyphosis
b. Sacroiliitis
c. Iritis
d. Carditis
b. Sacroiliitis
Symmetric + morning back pain
- IN confirming a diagnosis of osteoarthritis which labaoratory abnormality will you expect to note:
a. ESR is elevated
b. Rf-positive
c. Leukocytosis
d. Polyarticular involvement
e. None of these
e. None of these
- Most common age of onset for ankylosing spondylitis:
a. 30y/o
b. 40-60y/o
c. 20-40y/o
d. >60y/o
e. None of these
c. 20-40y/o
- Which of the following definition best fits the term enthesitis?
a. Alteration of joint alignment so that the articulating surfaces incompletely approximate each other
b. Inflammation at the site of tendinous or ligamentous insertion into bone
c. Inflammation of the periarticular membrane lining of the joint capsule
d. Inflammation of the sac like cavity near a joint that decreases friction
e. A crackling sensation elicited with joint motion
b. Inflammation at the site of tendinous or ligamentous insertion into bone
- Nerve compression syndromes may occur in rheumatoid arthritis. What is the most common?
a. Ulnar nerve compression at Guyon’s canal
b. Carpal tunnel syndrome
c. Tarsal tunnel syndrome
d. Ulnar nerve compression at the elbow
e. Thoracic outlet syndrome
b. Carpal tunnel syndrome
- An arthritic condition associated with cognitive impairment:
a. OA
b. RA
c. SLE
d. None of these
c. SLE
- A 36-year old female is diagnosed with rheumatoid arthritis, which of the following statements regarding RA is true:
a. There is an association with HLA-B27
b. The earliest lesion is an increase in the number of synovial lining cells with microvascular lesion
c. Females are affected 3x more often than are males, and it is maintained throughout life
d. African – Americans are involved
e. RF- positive is not predictive of the severity of RA and its complications
b. The earliest lesion is an increase in the number of synovial lining cells with microvascular lesion
a: ACPA
d: Caucasians
e: Predictive
- Arthritic joints, renal manifestations and photosensitivity:
a. OA
b. RA
c. Gout
d. SLE
e. None of these
d. SLE
Code: DOPAMINE RASH
Discoid rash
Oral ulcer
Photosensitivity
Anti-Nuclear Antibody
Malar rash
Immunologic SLE
Neurologic SLE
Renal dse
Arthritis
Serosis
Hematologic (Blood)
- Heberden’s nodes are seen in:
a. RA
b. Gout
c. OA
d. SLE
e. None of these
c. OA
HeberDIP
- The following statements describe fibromyalgia except:
a. A non- articular rheumatic disease of unknown origin characterized by tenderness at 11 or more of the 18 tender points sites
b. Cardiovascular training offers no benefits in reducing the symptoms
c. There maybe patient reported joint swelling without objective findings of swelling
d. The tender points are primarily localized to the musculotendinous junctions
e. Generalized fatigue, chronic headache and sleep disturbance may be present
b. Cardiovascular training offers no benefits in reducing the symptoms
- On examination of a female obese patient with knee pain, she complains of years of knee stiffness and pain for about 30 minutes every morning when she wakes up and has recurrent knee aches towards the end of the day. What is the common pathology?
a. Chondromalacia patella
b. Patellar bursitis
c. Patellar tendonitis
d. Knee OA
d. Knee OA
OA: <30 mins
RA: > 30 mins
- A 45-year old aunt complains of pain and swelling in both wrists and knees for three months. There is increased in the hands early in the morning, which last close to 40 minutes. The MCP joints and wrist are warm and tender. There is no alopecia , photosensitivity, kidney disease, or rash. What is the most likely diagnosis of this patient?
a. Gouty arthritis
b. Systemic lupus erythematosus
c. Osteoarthritis
d. Rheumatoid arthritis
d. Rheumatoid arthritis
- Positive subchondral sclerosis, crescent sign and symmetric arthritis can be found in:
a. AS
b. RA
c. OA
d. SLE
e. Gout
d. SLE
- Acute gouty arthritis is characterized by:
a. Attack in big toe
b. Fever
c. Podagra
d. All of these
d. All of these
A and C are the same
- Most common arthritis seen in the elderly:
a. RA
b. OA
c. Gout
d. SLE
e. All of these
b. OA
- An individual with RA that has a functional capacity adequate to perform only a few or none of the duties of occupation or self- care is classified as CLASS:
a. III
b. IV
c. V
d. II
e. I
a. III
- Indicators of poor prognosis in rheumatoid arthritis include the following, except:
a. RF positive
b. Persistently elevated ESR or C- reactive protein accompanied by active synovitis
c. Generalized oligoarthritis involving both small and large joints
d. Radiographic erosions within 2 years of disease onset
e. None of these
c. Generalized oligoarthritis involving both small and large joints
Polyarthritis
- An individual with RA that is largely or wholly incapacitated, bedridden or using a wheelchair, permitting little or no self-care is classified as CLASS:
a. V
b. IV
c. I
d. III
e. II
b. IV
Tophaceous deposits of gouty arthritis are most commonly seen on the:
a. 1st MTP
b. Ear cartilage
c. Olecranon bursae
d. None of these
c. Olecranon bursae
Linear, vertical marginal syndesmophytes is seen in which of the following?
a. OA
b. Gout
c. RA
d. AS
e. None of these
d. AS
25.Involvement of the lumbosacral spine will suggest more of:
a. OA
b. RA
c. SLE
d. Gout
e. None of these
a. OA
Weightbearing
The inflammatory reaction that occurs in early RA involves the:
a. Articular cartilage
b. Enthesis
c. Synovium
d. Articular capsule
c. Synovium
Destructive changes in joints of patients with RA:
a. Erosion by synovial pannus
b. Vasculitis with infarction
c. Ligamentous instability
d. Osteoporosis with bone cysts
a. Erosion by synovial pannus
Boutonniere deformity is characterized by:
a. Flexion of both PIP and DIP of the hands
b. Rupture of the central slip of the extensor hood
c. Rupture of the lateral slip of the extensor hood
d. None of these
b. Rupture of the central slip of the extensor hood
Code:
Bottons ng damit nasa gitna (central slip)
Yung beak ng swan nasa gilid (lateral slip)
HLA B-27 is specific for
a. Psoriatic arthritis
b. Scleroderma
c. Ankylosing Spondylitis
d. Systemic Lupus Erythematosus
e. Gout
c. Ankylosing Spondylitis
MC and has the highest association with HLA B27
a: Psoriasis if no HLA B27
Indicators of a poor prognosis in rheumatoid arthritis include the following, except:
a. RF-positive
b. Persistently elevated ESR or C-reactive protein accompanied by active synovitis
c. Generalized oligoarthritis involving both small and large joints (>10 to 20 total joints)
d. Radiographic erosions within 2 years of disease onset
e. None of these
c. Generalized oligoarthritis involving both small and large joints (>10 to 20 total joints)
Manual Therapy may also be used for your 69- year-old aunt with severe deg OA of both knees. She has genu Varus and limitation towards full knee flexion and extension. Which of the following are allowed for her?
a. Passive ROM, accessory joint motions
b. All of the answers
c. Massage techniques
d. Soft tissue mobilization
e. None of these
b. All of the answers
Which hip- repair surgical procedure is indicated for severe hip pain from degenerative joint disease in elderly patients who are poor surgical risks and have little prospect of walking?
a. muscle release
b. femoral prosthesis
c. displacement osteotomy
d. double-cup arthroplasty
e. arthrodesis
e. arthrodesis
uniting 2 bones @ a joint
What hip repair surgical procedure is indicated for pain in early stages of degenerative joint disease before motion has been lost?
a. double-cup arthroplasty
b. femoral prosthesis
c. muscle release
d. arthrodesis
e. displacement osteotomy
e. displacement osteotomy
Changing the alignment of the bone/ alter WB stresses
True hip pain in rheumatoid involvement of the hip produces pain in the?
a. lateral aspect of the hip
b. groin
c. on the acetabular area
d. medial aspect of the thigh
e. posterior aspect of the thigh
b. groin
Felt in the groin > inguinal area > buttocks > knee
If you differentiate dermatomyositis form SLE, the latter is?
a. periorbital and oral area spared
b. heliotrophe rash around the eyes
c. rash around the knuckles
d. rash with purple coloration
e. proximal girdle muscle weakness
a. periorbital and oral area spared
Scleroderma is a disease due to excessive production of:
a. fibrous tissue
b. calcium
c. collagen
d. salts
c. collagen
What is the proper sequence of skin changes in scleroderma, from earliest to latest?
a. indurative, atrophic, edematous
b. atrophic, indurative, edematous
c. edematous, indurative, atrophic
d. indurative, edematous, atrophic
c. edematous, indurative, atrophic
Edematous: Skin thickening with puffy, swollen fingers
Indurative: Skin becomes firm and tightly bound to the underlying subcutaneous tissue
Atrophic: Skin thins and ulcerates easily
The best recreational exercise for patients with osteoarthritis of the hip is:
a. jogging
b. swimming
c. hiking
d. bicycling
b. swimming
Classification of polymyositis and dermatomyositis according to Bohan and Peter which is associated with malignancy:
a. Type 3
b. Type 1
c. Type 2
d. Type 4
a. Type 3
A 4- year old girl presents with a history of bilateral knee swelling and left ankle swelling. She is febrile with irregular pupils. She most likely has:
a. Systemic lupus erythematosus
b. Pauciarticular Juvenile Rheumatoid Arthritis
c. Still’s disease
d. Polyarticular Juvenile Rheumatoid Arthritis
b. Pauciarticular Juvenile Rheumatoid Arthritis
Code: Pauci KAWT (Knee, Ankle, Wrist, TMJ)
A 65- year old female patient complains of joint stiffness on pain especially to her shoulders and hip. And also sometimes has low grade fatigue and depression rheumatoid condition fever. What might be the condition?
a. Polymyalgia Rheumatica
b. RA
c. OA
d. MPS
a. Polymyalgia Rheumatica
Key word: Low grade fever
The facet joint most commonly affected by osteoarthritis in the cervical spine is ______.
a. C4-C5
b. C1-C2
c. C3-C4
d. C5-C6
d. C5-C6
b: RA
The most disabling problem in osteoarthritis of the hand is the involvement of the:
a. 1st metacarpal joint
b. carpal joints
c. distal interphalangeal joint
d. first carpometacarpal joint
d. first carpometacarpal joint
60% of hand fxn
In rheumatoid arthritis, if the glenohumeral joint is affected, this motion is limited early.
a. flexion
b. extension
c. internal rotation
d. external rotation
c. internal rotation
The most common deformity in osteoarthritis is:
a. hallux valgus
b. clubfoot
c. hallux rigidus
d. pes planus
a. hallux valgus
RD of big toe
The following are clinical features of mixed connective tissue disease except:
a. tightly swollen fingers
b. sclerodermatous changes
c. none of these
d. raynaud’s phenomenon
c. none of these
Which of the following is not part of CREST syndrome?
a. esophageal disease
b. calcinosis
c. tuberculosis
d. sclerodactyly
c. tuberculosis
CREST Syndrome
Calcinosis
Raynaud’s Phenomenon
Esophageal Disease
Sclerodactyly
Telangiectasia
The crystals seen in the joint spaces of patients with gouty arthritis are:
a. hydroxyapatite
b. calcium pyrophosphate
c. monosodium urate
d. calcium monophosphate
c. monosodium urate
Sjogren’s syndrome is characterized by:
a. decreased tear formation
b. all of these
c. decrease saliva formation
d. infection of the conjunctiva
b. all of these
a: Xeropthalmia
c: Xerostomia
+ Dyspareunia (Dryness of Vagina)
The gait abnormality typical of patients with RA is termed apropulsive because of:
a. Excessive push off
b. Absence of push off
c. Excessive heel strike
d. None of these
b. Absence of push off
1st MTP is affected
The following are symptoms of MPS, EXCEPT:
I. Trigger points
II. Referred patterns of pain
III. Tight band
IV. Fatigue complaints
A. I, II, III
B. I, II, IV
C. II , IV
D. IV only
E. NOTA
D. IV only
This is the drug of choice for refractory reactive arthritis which can also be used in patients with HIV infection
a. Intra-muscular gold
b. Sulfasalazine
c. Sulfamylon
d. D-penicillamine
e. Anti-malaria
b. Sulfasalazine
Which of the following conditions is a complication of primary polycythemia?
a. Ulcerative colitis
b. Reactive colitis
c. Gouty arthritis
d. Progressive systemic scleroderma
e. None of these
c. Gouty arthritis
A 41-year-old man was recently in a motor vehicle accident in which he was the driver. He states that he was wearing his seat belt at the time of the accident. A day after the accident, he developed neck pain that has now continued for 10 days. He notices crunching on extension and lateral bending of the neck. Physical examination reveals no neurologic deficits. His neck has no areas of tenderness and there are no areas of spasm. He has no normal lateral bend, extension, and flexion of the neck. Which of the following is the most likely diagnosis?
a. Ankylosing spondylitis
b. Osteoarthritis
c. Reiter’s syndrome
d. Whiplash
e. Wry neck
d. Whiplash
Keywords: MVA, wearing his seat belt
- The most frequent cause of death in the patient with SLE is:
a. Pericarditis
b. Stroke
c. Myocardial infarction
d. Malignancy
e. Nephritis
e. Nephritis
Kidney inflammation
All of the following are true about the criteria for the classification of acute gouty arthritis, except:
a. Maximal inflammation developed within 1 day
b. Joint redness observed
c. Asymmetric swelling within a joint
d. Subcortical cysts with erosions
e. None of these
d. Subcortical cysts with erosions
Global functional status in RA: Able to perform usual self-care and vocational activities, but limited in avocational activities
a. Class I
b. Class II
c. Class IV
d. Class III
e. Class V
b. Class II
a: Ok ALL
c: Lim voc and avoc
d: Lim ALL
ACR Criteria: Able to perform usual self-care activities, but limited in vocational and avocational activities
a. Class 1
b. Class 2
c. Class 3
d. Class 4
c. Class 3
a: Ok ALL
b: Ok self-care and voc, Lim avoc
d: Lim ALL
Kellgren and Lawrence Grading for OA described as definite osteophytes and absent or questionable narrowing of the joint space:
a. Grade 1
b. Grade 2
c. Grade 3
d. Grade 4
e. Grade 5
b. Grade 2
0: No radiographical findings
1: Doubtful narrowing, possible osteophyte
2: Possible narrowing, definite osteophyte
3: Mod multiple osteophyte, definite narrowing, small pseudo cystic area
4: Large osteophyte, marked narrowing, severe sclerosis, definite deformity of bone contour
Clinical classification criteria for hip OA include the following:
a. Pain present with hip IR >= 15 degrees
b. Morning stiffness <= 60 minutes
c. Pain on hip IR < 15 degrees and hip flexion < 115 degrees
d. All of these
e. None of these
d. All of these
Stage II rheumatoid arthritis, except:
a. Joint deformity without fibrous or bony ankylosis
b. Radiographic evidence of osteoporosis with or without slight subchondral bone destruction
c. Adjacent muscle atrophy
d. Extra-articular soft tissue lesions may be present
a. Joint deformity without fibrous or bony ankylosis
Criteria for hip osteoarthritis, except:
a. Pain on internal rotation
b. Hip internal rotation ≥ 15°
c. morning stiffness ≥ 60mins
d. age > 50years
c. morning stiffness ≥ 60mins
<30 mins
Stage III rheumatoid arthritis:
a. Radiographic evidence of cartilage and bone destruction without osteoporosis
b. Fibrous or bony ankylosis
c. Joint deformity without fibrous or bony ankylosis
d. No destructive changes on radiographic examination
c. Joint deformity without fibrous or bony ankylosis
Criteria for hand osteoarthritis, except:
a. presence of Heberden’s nodes
b. age less than 40 years
c. family history of nodes
d. joint space narrowing in any finger joint
b. age less than 40 years
More than
A patient is able to perform usual self-care and vocational activities but cannot do avocational activities. At what classification of functional status in RA does the patient belong to?
a. Class I
b. Class II
c. Class III
d. Class IV
b. Class II
What type of hypersensitivity reaction is noted in SLE?
a. Anaphylactic Allergic Reaction
b. Cytotoxic Allergic reaction
c. Immunologic complex Allergic reaction
d. Delayed hypersensitivity
e. NOTA
c. Immunologic complex Allergic reaction
Rheumatoid Arthritis is associated with which of the following HLA allele?
a. HLA- B47
b. HLA- B27
c. HLA- DR4
d. HLA- B72
e. HLA- BR4
c. HLA- DR4
Code: R4 (RA)
Which of the following is not a seronegative arthritis?
a. Psoriatic arthritis
b. Reiter’s Syndrome
c. Marie Strumpell
d. Crohn’s Dse
e. NOTA
e. NOTA
b: Reactive Arthritis
c: AS
d: IBD
The inflammatory reaction that occurs in early RA involves the:
a. Articular cartilage
b. Enthesis
c. Synovium
d. Articular capsule
c. Synovium
OA is characterized by:
a. All of these
b. Increased synthesis of ground substances
c. Destructive bony changes
d. Widening of joint space
c. Destructive bony changes
Oligoarticular JRA is defined as synovitis of:
a. 6 joints or more
b. More than 4 joints
c. Polyarticular
d. None of these
d. None of these
b: Only 1-4 joints
Destructive changes in joints of patients with RA:
a. Erosion by synovial pannus
b. Vasculitis with infarction
c. Ligamentous instabilities
d. Osteoporosis with bone cysts
a. Erosion by synovial pannus
This area of the shoulder has the highest incidence of degenerative arthritis:
a. Acromioclavicular joint
b. Sternocostal joint
c. Glenohumeral joint
d. Sternoclavicular joint
a. Acromioclavicular joint
c: RA
Psoriatic arthritis usually involves the:
a. DIP joints
b. PIP joints
c. Wrist joint
d. MCP joints
a. DIP joints
Code: DAKO
DIP affected
Auspitz sign- Bleeding
Koebner’s Phenomenon- Formation of new lesion
Onycholysis- nail changes
Treatment of ankylosing spondylitis should not include:
a. Deep breathing exercise
b. Back extension exercise
c. Stretching
d. None of these
d. None of these
Which joint is usually spared form involvement in the pauciarticular form of juvenile rheumatoid arthritis?
a. Hip
b. Ankle
c. Knee
d. Wrist
a. Hip
Code: KAWT
Knee
Ankle
Wrist
TMJ
Photosensitivity and alopecia are frequent signs of:
a. OA
b. RA
c. SLE
d. Gout
e. None of these
c. SLE
Progressive, symmetric, erosive form of arthritis:
a. OA
b. Gout
c. SLE
d. RA
e. None of these
d. RA
Koebner phenomenon is a finding in:
a. SLE
b. Psoriasis
c. OA
d. RA
e. None of these
b. Psoriasis
Code: DAKO
DIP affected
Auspitz sign- Bleeding
Koebner’s Phenomenon- Formation of new lesion
Onycholysis- nail changes
The best orthosis for relief of pain on osteoarthritis of the base of the thumb is:
a. 3 point IP orthosis
b. Thumb spica
c. Cock-up splint
d. All of these
b. Thumb spica
Erythematous rashes over the cheeks and fingertips associated with polyarthritis of small joints of the hands is suggestive of:
a. RA
b. OA
c. SLE
d. Psoriasis
e. None of these
c. SLE
Common pathologic findings in OA includes the following:
a. Degradation of articular cartilage
b. Thickening of subchondral bone
c. Osteophytes formation
d. All of these
d. All of these
Which of the following statements is not true about SLE?
a. Common in women
b. Males are spared
c. Common among blacks
d. Polyarticular involvement of small joints
e. None of these
b. Males are spared
Not spared
a: 15-45 years old
c: + Hispanic, Carribean
The most commonly involved joint in psoriasis is the:
a. 1st CMC
b. MCP
c. 1st MTP
d. MTP’s
e. NOTA
e. NOTA
DIP
Which of the following epidemiology of inflammatory arthritis is true?
a. RA is high in whites than blacks
b. Gout is common among Caucasians
c. SLE is common among Caucasians
d. All of these
e. None of these
a. RA is high in whites than blacks
In patients with acute RA, immobilization of joints is best accomplished by:
a. Static splinting
b. Bed rest for 1- 2 weeks
c. Traction
d. Suspension devices
a. Static splinting
SLE is common among:
a. Blacks
b. Caucasians
c. Asians
d. None of these
a. Blacks
To prevent thumb flexion deformity in RA, the position of splinting the thumb should be:
a. Extension, apposition
b. 10 degrees, IP flexion
c. Extension, same plane as thumb
d. 20 degrees IP extension
a. Extension, apposition
Which of the following statements is true about gout?
a. Asymmetric involvement of joints
b. Joints involved presents with agonizing pain and intense inflammation
c. Mainly affects peripheral joints of the lower extremities
d. Attacks are correlated with rapid increase in serum urate
e. All of these
e. All of these
If glenohumeral joint is involved in RA, this motion is limited early:
a. Flexion
b. Extension
c. Internal rotation
d. External rotation
c. Internal rotation
Jaccoud’s arthritis is seen in:
a. SLE
b. RA
c. Gout
d. Oa
e. Psoriasis
a. SLE
Code: JaccoLE
Fatigue, severe stiffness of the shoulder and pelvic girdles, depression, and low -grade fever are hallmarks of this disorder:
a. Polymyalgia rheumatica
b. Polyarteritis
c. Metabolic arthropathies
d. Systemic lupus erythematosus
a. Polymyalgia rheumatica
Keywords: Low grade fever
Systemic/ Still’s JRA: High grade fever
Tophi of gouty arthritis are usually seen on:
a. Ulnar surface of the forearm
b. Ears
c. All of these
d. Achilles tendon
c. All of these
Steroids are routinely used for rheumatic diseases. The rheumatic diseases which does not require routine steroids is________.
a. Rheumatoid arthritis
b. SLE
c. Dermatomyositis-polymyositis
d. Gouty arthritis
d. Gouty arthritis
Only be given one time (severe cases)
On examination of a patient with severe knee pain, there is note of knee redness, swelling, and warmth. Concomitantly, the patient has febrile episodes. What is this case.
a. Knee OA
b. Infective arthritis
c. Torn ACL
d. Knee bursitis
b. Infective arthritis
A 33-year old female named presents with malar rash that is exacerbated by sun exposure. She has experienced episodes of myalgia, pleural effusion, pericarditis and arthralgia without deformity over the course of several years. The best screening test for her would be:
a. Rheumatoid factor
b. Anti-ds-DNA antibody
c. Antinuclear antibody
d. HLA-B27
e. None of these
c. Antinuclear antibody
Hallmark of SLE
95% of more px with SLE have (+) ANA
Characteristics of Felty’s Syndrome include the following, except:
a. Arthritis
b. Anemia
c. Neutropenia
d. Leukopenia
e. None of these
e. None of these
Code: SLLAANT
Splenomegaly
Lymphadenopathy
Leukopenia
Anemia
Arthritis
Neutropenia
Thrombocytopenia
The organism most often found to cause infectious pyogenic arthritis in children is:
a. Staphylococcus aureus
b. Diplococcus pneumoniae
c. Streotococcus pyrogenes
d. Neisseria gonorrhoeae
e. Hemphilus influenza
a. Staphylococcus aureus
Keywords: infectious pyogenic arthritis
A patient presents with chest pain, tenderness, and firm swelling in the area of the left third costochondral junction. No history of trauma can be obtained. Deep breathing increases the pain. A likely diagnosis is:
a. Tietze’s syndrome
b. Atypical angina
c. Pneumonitis
d. Rib fracture
e. Scheuermann’s disease
a. Tietze’s syndrome
Keywords: Chest pain, tenderness, and firm swelling in the area of the left third costochondral junction
A 40-year-old male develops dermatomyositis. He should also be closely evaluated for the presence of:
a. Diabetes
b. Hyperparathyroidism
c. Addison’s disease
d. Malignant tumor
e. Hypertriglyceridemia
d. Malignant tumor
