Rheumatology Flashcards
1
Q
Preferred treatment of life-threatening granulomatosis with polyangiitis
A
Glucocorticoids plus rituximab
MKSAP 20
2
Q
Antibodies associated with mixed connective tissue disease
A
Anti–U1-ribonucleoprotein antibodies
MKSAP 20
3
Q
Antibodies in pregnant patients that increase risk for neonatal lupus erythematosus
A
Anti-Ro/SSA or anti-La/SSB antibodies
MKSAP 20
4
Q
Antibodies associated with antisynthetase syndrome
A
Anti–aminoacyl-tRNA synthetase (commonly anti–Jo-1)
MKSAP 20
5
Q
Initial treatment of ankylosing spondylitis
A
NSAIDs
MKSAP 20
6
Q
Insidious onset of proximal and distal symmetric muscle weakness
A
Inclusion body myositis
MKSAP 20
7
Q
Typical synovial fluid leukocyte count in patients with OA and joint effusion
A
≤2000/µL
MKSAP 20
8
Q
Inflammatory destructive arthritis of shoulder in older women
A
Basic calcium phosphate deposition (“Milwaukee shoulder”)
MKSAP 20
9
Q
Most effective maintenance therapy in granulomatosis with polyangiitis
A
Rituximab
MKSAP 20
10
Q
Treatment of suspected giant cell arteritis
A
Immediate high-dose glucocorticoids
MKSAP 20
11
Q
Sensitive serum marker of muscle pathology
A
Creatine kinase level
MKSAP 20
12
Q
Potential causes of CPP deposition in younger patients
A
Hyperparathyroidism, hemochromatosis, hypophosphatasia, or hypomagnesemia
MKSAP 20
13
Q
Late RA radiographic findings of hands and/or feet
A
Periarticular osteopenia, marginal erosions, joint-space narrowing
MKSAP 20
14
Q
Noninflammatory synovial cell count
A
<2000/µL
MKSAP 20
15
Q
Gastrointestinal pathogens associated with reactive arthritis
A
Salmonella, Shigella, Campylobacter, Yersinia
MKSAP 20
16
Q
Nonpharmacologic treatments for knee OA
A
Graduated aerobic exercise and strength training
MKSAP 20
17
Q
Risk assessment for azathioprine-induced myelosuppression
A
Thiopurine methyltransferase enzyme testing
MKSAP 20
18
Q
Most important modifiable risk factor for knee OA
A
Obesity
MKSAP 20
19
Q
Coadministration with colchicine reduces hepatic catabolism and could lead to colchicine overdose
A
CYP3A4 inhibitors (such as clarithromycin)
MKSAP 20
20
Q
Antibodies associated with scleroderma renal crisis
A
Anti-RNA polymerase III antibodies
MKSAP 20
21
Q
Highly teratogenic RA medications
A
Methotrexate, leflunomide
MKSAP 20
22
Q
Contraindications to pregnancy in patients with systemic sclerosis
A
Pulmonary artery hypertension and severe restrictive lung disease
MKSAP 20
23
Q
Antibodies associated with greatest risk for thrombosis in SLE
A
Lupus anticoagulant, anti–β2 glycoprotein, anticardiolipin
MKSAP 20
24
Q
The three forms of ANCA-associated vasculitis
A
Granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis
MKSAP 20
25
Pulmonary manifestations of mixed connective tissue disease
Pulmonary arterial hypertension, interstitial lung disease
| MKSAP 20
26
Cardiovascular complication of Kawasaki disease
Coronary artery aneurysm
| MKSAP 20
27
# MKSAP 20
Common nonpharmacologic measure for rheumatologic diseases
Physical therapy
| MKSAP 20
28
Antiepileptic agents for treatment of fibromyalgia
Gabapentin and pregabalin
| MKSAP 20
29
Clinical manifestation of acute lupus pneumonitis
Cough, dyspnea, fever, hypoxemia, pleuritic chest pain, pulmonary infiltrates
| MKSAP 20
30
Characteristic presentation of scleroderma renal crisis
Hypertensive emergency
| MKSAP 20
31
Spondyloarthritis most frequently involving sacroiliac joints
Ankylosing spondylitis
| MKSAP 20
32
Major cause of death in mixed connective tissue disease
Pulmonary arterial hypertension
| MKSAP 20
33
Antibodies specific for primary Sjögren disease
Anti-Ro/SSA autoantibodies
| MKSAP 20
34
Radiographic findings of established gout
Punched-out lesions with overhanging edges of cortical bone
| MKSAP 20
35
Preferred therapy if immunosuppressive agent is imperative in SLE during pregnancy
Azathioprine
| MKSAP 20
36
Serious cause of hip pain in SLE
Osteonecrosis
| MKSAP 20
37
Prophylaxis effective for most patients when initiating urate-lowering treatment
Colchicine
| MKSAP 20
38
Indications for osteoporosis risk assessment in long-term glucocorticoid therapy
Taking ≥2.5 mg of prednisone daily for >3 months
| MKSAP 20
39
Rheumatologic diseases most commonly associated with secondary Sjögren disease
RA and SLE
| MKSAP 20
40
Widespread chronic pain, nonrestorative sleep, fatigue, cognitive symptoms
Fibromyalgia
| MKSAP 20
41
Radiographic findings in diffuse idiopathic skeletal hyperostosis
Confluent right-sided spinal ligamentous ossification of ≥4 contiguous vertebral levels
| MKSAP 20
42
Hematologic complications of methotrexate
Macrocytic anemia, pancytopenia
| MKSAP 20
43
Management of severe organ-threatening disease in polyarteritis nodosa
Intravenous pulse glucocorticoids and cyclophosphamide
| MKSAP 20
44
Screening before TNF inhibitor therapy
Latent or active tuberculosis screening, HBV and HCV serologic testing, HIV screening
| MKSAP 20
45
Cause of GI bleeding in systemic sclerosis
Gastric antral vascular ectasia
| MKSAP 20
46
Common sites of enthesitis in psoriatic arthritis
Achilles tendon, plantar fascia
| MKSAP 20
47
Skin rash in reactive arthritis
Keratoderma blennorrhagicum
| MKSAP 20
48
Biologic agents for bowel and joint symptoms in enteropathic arthritis
TNF inhibitors
| MKSAP 20
49
Initial evaluation for suspected ankylosing spondylitis
Radiography of SI joint
| MKSAP 20
50
Prednisone dose for relapse of polymyalgia rheumatica
Last dose that controlled disease
| MKSAP 20
51
Time frame for temporal artery biopsy in GCA after starting glucocorticoids
At least 1 month
| MKSAP 20
52
Treatment of acute gout flares
NSAIDs, colchicine, or glucocorticoids
| MKSAP 20
53
Concomitant use with azathioprine is relatively contraindicated
Xanthine oxidase inhibitors (allopurinol, febuxostat)
| MKSAP 20
54
External ear redness and swelling without ear lobe involvement
Relapsing polychondritis
| MKSAP 20
55
Preferred drug treatment in older patients with OA
Topical NSAIDs
| MKSAP 20
56
Clinical manifestations of limited cutaneous systemic sclerosis
Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia
| MKSAP 20
57
Most common ocular manifestation in RA
Dry eye (keratoconjunctivitis sicca)
| MKSAP 20
58
Major benefit of NSAIDs in RA
Symptom control
| MKSAP 20
59
Nonpharmacologic fibromyalgia therapy
Disease education, aerobic exercise, psychosocial support
| MKSAP 20
60
Main causes of death in granulomatosis with polyangiitis
Kidney failure and infection
| MKSAP 20
61
Treatment of systemic sclerosis–related interstitial lung disease
Mycophenolate mofetil
| MKSAP 20
62
Painful oral and genital ulcers, uveitis, DVT
Behçet syndrome
| MKSAP 20
63
Laboratory findings correlating with increased SLE activity
Elevated ESR and anti–double-stranded DNA antibody titer, low complement levels
| MKSAP 20
64
Pulmonary vascular disease in limited cutaneous systemic sclerosis
Pulmonary arterial hypertension
| MKSAP 20
65
Fever with associated evanescent salmon-colored rash, arthralgias, leukocytosis
Adult-onset Still disease
| MKSAP 20
66
Pulmonary alveolar hemorrhage, pauci-immune glomerulonephritis, positive p-ANCA
Microscopic polyangiitis
| MKSAP 20
67
Inflammatory marker that may be normal in active SLE
C-reactive protein
| MKSAP 20
68
One of earliest manifestations of systemic sclerosis
Raynaud phenomenon
| MKSAP 20
69
Therapy to decrease methotrexate complications
Folic acid
| MKSAP 20
70
Treatment of scleroderma renal crisis
Captopril
| MKSAP 20
71
Major cause of excess death in patients with RA
Coronary artery disease
| MKSAP 20
72
Possible adverse effects of oral NSAIDs
GI bleeding and CV events
| MKSAP 20
73
Most common neuropsychiatric manifestations of SLE
Headache, mild cognitive dysfunction, mood disorder
| MKSAP 20
74
Definitive knee OA therapy after failure of conservative measures
Knee joint replacement
| MKSAP 20
75
First imaging modality to assess inflammatory arthritis and OA
Radiography
| MKSAP 20
76
Radiographic findings in erosive OA
Central interphalangeal joint erosions with “gull-wing” deformity
| MKSAP 20
77
Rheumatologic conditions associated with higher risk for coexistent fibromyalgia
Sjogren disease, SLE, rheumatoid arthritis
| MKSAP 20
78
Imaging test in suspected spondyloarthritis with normal radiographs
MRI of SI joints
| MKSAP 20
79
Treatment of primary CNS angiitis
Cyclophosphamide with high-dose glucocorticoids
| MKSAP 20
80
RA, neutropenia, splenomegaly
Felty syndrome
| MKSAP 20
81
Benefits of treating RA to remission or low disease activity
Less radiographic damage, reduced CV risk, increased work productivity
| MKSAP 20
82
# MKSAP 20
An infectious cause of mixed cryoglobulinemia
Hepatitis C virus infection
| MKSAP 20
83
Confirmatory diagnostic test for IgG4-related disease
Biopsy of involved tissue
| MKSAP 20
84
Cause of airway obstruction in relapsing polychondritis
Involvement of tracheal rings
| MKSAP 20
85
Most common site of first gout flares in men with gout
First metatarsophalangeal joint of great toe
| MKSAP 20
86
Test for suspected Sjögren disease with negative anti-Ro/SSA antibodies
Lip (minor salivary gland) biopsy
| MKSAP 20
87
Recommended first-line urate-lowering therapy for gout
Allopurinol
| MKSAP 20
88
SNRIs approved for fibromyalgia
Duloxetine and milnacipran
| MKSAP 20
89
Initial prednisone dose for polymyalgia rheumatica
12.5-20 mg/d
| MKSAP 20
90
Most commonly involved joints in erosive OA
DIP and PIP
| MKSAP 20
91
Bilateral hilar adenopathy, arthritis, erythema nodosum
Löfgren syndrome
| MKSAP 20
92
Most specific antibody test for diagnosis of SLE
Anti-Smith antibody
| MKSAP 20
93
Radiographic findings in psoriatic arthritis
Pencil-in-cup deformity
| MKSAP 20
94
Diagnostic procedure and tests in acute monoarthritis
Joint aspiration and synovial fluid analysis
| MKSAP 20
95
GI disease risk in patients with ankylosing spondylitis
IBD
| MKSAP 20
96
SLE-related annular rash with central clearing or erythematous plaques and papules
Subacute cutaneous lupus erythematosus
| MKSAP 20
97
Indications for high-dose glucocorticoids in SLE
Profound cytopenias, class III/IV nephritis, seizures, psychosis
| MKSAP 20
98
Factors differentiating diffuse idiopathic skeletal hyperostosis from ankylosing spondylitis
Confluent ossification of spinal ligaments and no SI joint involvement
| MKSAP 20
99
Malignancy associated with Sjögren disease
Non-Hodgkin lymphoma
| MKSAP 20
100
Treatment for most forms of idiopathic inflammatory myopathy
Glucocorticoids
| MKSAP 20
101
Gold standard for diagnosis of gout
Negatively birefringent, needle-like crystals
| MKSAP 20
## Footnote
This refers to the characteristic appearance of urate crystals under polarized light microscopy.
102
Serious pulmonary manifestations of SLE
Lupus pneumonitis and diffuse alveolar hemorrhage
| MKSAP 20
## Footnote
These are significant complications of systemic lupus erythematosus affecting the lungs.
103
Most sensitive imaging test for bony erosions
CT
| MKSAP 20
## Footnote
Computed Tomography is superior in detecting early bony changes compared to other imaging modalities.
104
Preoperative imaging in long-standing RA
Cervical spine radiography to assess for atlantoaxial subluxation
| MKSAP 20
## Footnote
This is important due to the risk of spinal cord injury in rheumatoid arthritis patients.
105
Modifiable risk factor for RA
Cigarette smoking
| MKSAP 20
## Footnote
Smoking is a known environmental trigger that increases the risk of developing rheumatoid arthritis.
106
Firm, painless subcutaneous nodules over extensor surfaces of joints and tendons
Rheumatoid nodules
| MKSAP 20
## Footnote
These nodules are characteristic of rheumatoid arthritis and are typically found in chronic disease.
107
Goal of OA drug therapy
Symptom control
| MKSAP 20
## Footnote
Treatment focus in osteoarthritis is primarily on alleviating pain and improving function.
108
Genetic testing in patients at high risk for allopurinol hypersensitivity
HLA-B*58:01 allele
| MKSAP 20
## Footnote
Testing for this allele can help identify patients at risk for severe reactions to allopurinol.
109
Imaging test to identify muscle biopsy location in idiopathic inflammatory myopathies
MRI
| MKSAP 20
## Footnote
Magnetic Resonance Imaging is useful for visualizing muscle inflammation and guiding biopsy.
110
Cause of hoarseness, sore throat, dysphagia, stridor in RA
Cricoarytenoid arthritis
| MKSAP 20
## Footnote
This condition affects the laryngeal joints in rheumatoid arthritis, leading to airway symptoms.
111
Drug therapy for all patients with SLE without contraindications
Hydroxychloroquine
| MKSAP 20
## Footnote
Hydroxychloroquine is a cornerstone treatment in systemic lupus erythematosus for its immunomodulatory effects.
112
Main disease-related cause of death in diffuse cutaneous systemic sclerosis
Interstitial lung disease
| MKSAP 20
## Footnote
Lung involvement is a significant complication leading to increased mortality in systemic sclerosis.
113
Most common organ involved in systemic sclerosis
Skin
| MKSAP 20
## Footnote
Skin changes are typically the first signs of systemic sclerosis, including sclerosis and thickening.
114
Hypertension, limb claudication, tenderness over carotid arteries in young women
Takayasu arteritis
| MKSAP 20
## Footnote
This is a large vessel vasculitis that commonly affects young women and can lead to significant vascular complications.
115
Indications for kidney biopsy in SLE
Abnormal proteinuria, active urinary sediment, and/or elevated creatinine level
| MKSAP 20
## Footnote
These findings suggest renal involvement in lupus and warrant further evaluation.
116
Treatments for fibromyalgia with depression
Duloxetine, milnacipran, tricyclic antidepressants
| MKSAP 20
## Footnote
These medications address both pain and mood symptoms in patients with fibromyalgia.
117
Most specific serologic test for RA
Anti–cyclic citrullinated peptide antibody
| MKSAP 20
## Footnote
This test is highly specific for rheumatoid arthritis and aids in diagnosis.
118
IV treatment of recurrent and/or tophaceous gout
Pegloticase
| MKSAP 20
## Footnote
Pegloticase is used for severe cases of gout that do not respond to conventional therapy.
119
Important cause of morbidity and mortality in dermatomyositis and polymyositis
Interstitial lung disease
| MKSAP 20
## Footnote
Lung complications significantly impact the prognosis in these inflammatory myopathies.
120
Spondyloarthritis most strongly associated with HLA-B27
Ankylosing spondylitis
| MKSAP 20
## Footnote
The presence of HLA-B27 is a strong genetic marker for ankylosing spondylitis.
121
Radiographic findings in OA
Asymmetric joint-space narrowing, osteophytes, bone cysts, subchondral sclerosis
| MKSAP 20
## Footnote
These features are characteristic of osteoarthritis on X-ray imaging.
122
Acute peripheral pauciarticular arthritis with enthesitis and dactylitis
Reactive arthritis
| MKSAP 20
## Footnote
This condition often follows infections and is characterized by inflammation at tendon insertions.
123
Acute severe myopathy and anti–HMG Co-A reductase antibodies
Immune-mediated necrotizing myopathy
| MKSAP 20
## Footnote
This condition is associated with statin use and presents with rapid muscle weakness.
124
Most common pulmonary manifestation of SLE
Pleural disease
| MKSAP 20
## Footnote
Patients with SLE often experience pleuritis or pleural effusions as part of their disease.
125
Skin finding on eyelids in dermatomyositis
Heliotrope rash
| MKSAP 20
## Footnote
This violaceous rash is a classic cutaneous manifestation of dermatomyositis.
126
Preferred initial monotherapy for RA
Methotrexate
| MKSAP 20
## Footnote
Methotrexate is commonly used as a first-line treatment in rheumatoid arthritis.
127
Initial OTC management of sicca symptoms
Artificial tears and sugar-free candies
| MKSAP 20
## Footnote
These are recommended to alleviate dry mouth and dry eye symptoms.
128
DIP and PIP bony joint hypertrophy in OA
Heberden and Bouchard nodes
| MKSAP 20
## Footnote
Heberden nodes are found at the DIP joints, while Bouchard nodes are at the PIP joints.
129
Ocular manifestation of reactive arthritis
Conjunctivitis
| MKSAP 20
## Footnote
Reactive arthritis can lead to inflammation of the eye, including conjunctivitis.
