RHEUMATOLOGY

Question 1

Morning stiffness
Joint pain
Joint swelling
Dx and treatment

Answer 1

Juvenile Rheumatoid Arthritis
Tx: nsaid

Question 2

Most common resentstion of arthritis in SLE

Answer 2

Symmetrical arthritis of joints I the hands

Question 3

Atlabtoaxial joint
Ra orOA

Answer 3

RA

Question 4

Cervical and lumbar spine
RA Or OA

Answer 4

OA

Question 5

1st carpometacarpal joint
1st Metatarsophalangeal joint
DIP
PIP
Knee joint
Hip Joint

Answer 5

OSTEOARTHRITIS

Question 6

Most commonly affected in Pdeudogout

Answer 6

Knee

Question 7

Non itchy, non-pitrinf swelling, laryngeal edema, abdominal pain,Vomiting and diarrhoea
Dx and investigation?

Answer 7

Hereditary angioedema
C1 and C4 levels

Question 8

Mouth Ulverstone
Ain’t and swelling 8n both wrists and MCP joints
Dx?

Answer 8

SLE

Question 9

Treatment of choice for acute gout

Answer 9

NSAIDS

Question 10

Treatment for chronic gout

Answer 10

Allopurinol

Question 11

Pain and stiffness hips and shoulders
Elevated ESR
Age over 50 years, typically 60-70

Answer 11

Polymyalgia Rheumatica

Question 12

Specific antibody test for diagnosing SLE

Answer 12

Anti- d’s DNA

Question 13

Screening test for SLE

Answer 13

Antinuclear Antibody

Question 14

Specific antibody for idiopathic inflammatory myopathies

Answer 14

Anti jo 1 antibody

Question 15

Sensitive marker for mixed connective tissue disease

Answer 15

Anti,-ribonucleoprotein antibody

Question 16

Nodules
No skin erosions
Arthralgias in multiple joints

Dx:
Tx

Answer 16

Rheumatoid Nodulosis
Intralesional steroid injection

Question 17

Both joints red, warm and tender
Ankle pain
Chronic alcohol use and binge drinking
Needle aspiration: needle shaped monosodium aspirate
Dx
Tx

Answer 17

Acute Gout
Prednisolone 50 mg / day

Question 18

Left sided throbbing headache
Jaw claudication with unexplained fever
Inv
Dx

Answer 18

Temporal artery biopsy
Giant cell arthritis

Question 19

Woman rheumatoid
On methotrexate and Hydroxychloroquine
Advice during pregnancy?

Answer 19

Yes continue to hydroxycholoroquine
But stop with methotrexate

Question 20

Treatment for Giant cell ateritis

Answer 20

Rednisolone 40-60 mg mg/d

Question 21

Atrophy of vast deferens

Answer 21

Sweat Chloride test
Cystic fibrosis

Question 22

Calcinosis
Raynauds phenomenon

Answer 22

Abticebtromere antibodies
Systemic Sclerosis

Question 23

Recurrent swelling of her face, arms and legs
Nonliving and nonpruiritic swelling
Inv
Dx

Answer 23

C1 AND c4 levels
Hereditary angioedema

Question 24

Multiple sclerosis
Approx one person in how many

Answer 24

1000

Question 25

Hypertension Indapamide Binge drinking every night

Answer 25

Acute Gout

Question 26

ANCA positive antiproteinase PR3 Antimyeloperoxidase or MpO

Answer 26

Wegeners Granulomatosis

Question 27

Low back pain Morning stiffness

Answer 27

Inflammatory Arthropathy

Question 28

Dry mouth, gritty sensation in the eyes Difficult to speak, no history of DM Salivary glands enlarged Management?

Answer 28

Schirmier test and measurement of antibodies

Question 29

Unable to climb stairs Rash on face, weakness on hip and shoulder girdle Purplish red discolorations OT the eyes and erythermatous discolorations of fingers and joints Dx?

Answer 29

Dermatomyositis - heliotrope rash **discoloration of the eyes that extends to the joints and extremities

Question 30

Pain and swelling of wrists and knees Several months fatigue MCP joints and wrists tender and warm Dx and Inv

Answer 30

Rheumatoid Arthritis And Rheumatoid Factor

Question 31

Painful swollen knee Cloudy fluid, wbc 50,000 mm3 More than 90,% PMN leukocytes Glucose fluid level decreased Dx?

Answer 31

Infectious Arthritis

Question 32

Myopathy Noncaseating Granulomas Dx,?

Answer 32

Sarcoidosis

Question 33

Worsening headaches, Episodes of transfer visual loss A Nd diploma Jaw muscle stops chewing Tender nodular at right temporal artery Normocystic anaemia Sedimentation rate 95 Dx?

Answer 33

Temporal arthritis

Question 34

What is the most feared complication of temporal arthritis?

Answer 34

Blindness

Question 35

Exposed to a children with febrile illness and rash

Answer 35

Parvovirus

Question 36

Highest specificity for rheumatoid arthritis?

Answer 36

Anti Citrullinated Peptide Antibody

Question 37

Ongoing back pain Ain't is severe at night and gets better after getting up and jojbt stiffness in the morning Inv? Dx¿?

Answer 37

Plain xrqy of the sacroiliac joints Analysing spondylositis

Question 38

What causes the increase risk for pseudogout

Answer 38

Hypothyroidism

Question 39

What are the other factors for Pseudogout?

Answer 39

Haemochromatosis Hyperparathyroidism Hypercalcaemia Hypomagnesemua More than 70 years.family history

Question 40

Joint pain both hands Stiffness lasting for hours once she wakes up in the morning Nocturnal pain Swelling around MCP and PIP Drug of choice?

Answer 40

Rheumatoid Arthritis Doc: Methotrexate

Question 41

Frequent fatigue and joint pain Weight loss Malar rash And oral ulcers SLE What is incorrect about SLE?

Answer 41

Anti Smith antibody is highly sensitive for SLE

Question 42

Knee pain Negative birefringent test

Answer 42

Gout ***needle shaped monosodium urate crystals with brightly birefringent in polarised light with negative elongation

Question 43

Drugs that doesn't cause SLE

Answer 43

Nitrofurantoin

Question 44

Interphalangeal joints tender and rash noted on cheeks and nose What initial investigation to do on this?

Answer 44

Antinuclear antibodies - SLE - best initial screening test

Question 45

What are the clinical symptoms of SLE

Answer 45

Arthritis Malar rash And anaemia

Question 46

Generalised pain to the neck and shoulder girdle, elbow, low back pain and legs

Answer 46

Fibromyalgia - pain in all 4 quadrants in the body

Question 47

Pain and swelling around the wrists hand joints more than 1 hr Which is correct regarding the dx of rheumatoid Arthritis?

Answer 47

Anti CCp sensitivity is 50-60 percent Specificity is 95-98%