Rheumatology

Question 1

What are the differential diagnoses for a single joint pain?

Answer 1

Septic, crystals

Question 2

What are the differential diagnoses for a multiple joint pain?

Answer 2

Osteoarthritis, rheumatoid arthritis, Seronegatives, lupus, scleroderma, myositis

Question 3

What are the differential diagnoses for a Acute joint pain?

Answer 3

Septic, crystals, reactive, trauma

Question 4

What are the differential diagnoses for a Chronic joint pain?

Answer 4

Osteoarthritis, rheumatoid arthritis, Lupus, scleroderma, myositis, seronegative

Question 5

What are the differential diagnoses for joint pain with systemic manifestations?

Answer 5

Seronegative (IBD), lupus (Face, CNS, Renal, heart lung), rheumatoid (nodules, Serositis), reactive (oral, genital ulcer)

Question 6

What describes non-inflammatory joint pain?

Answer 6

Osteoarthritis

Question 7

What are the percentage of poly that is present in arthrocentesis in down flag Tori as opposed to inflammatory? Sepsis? Normal?

Answer 7

Less than 20% in normal and noninflammatory. Greater and 50% in inflammatory and greater than 75% Sepsis

Question 8

What is considered inflammatory?

Answer 8

Everything that is not osteoarthritis or infection

Question 9

In arthrocentesis what is the of white blood cell count and inflammatory as opposed to noninflammatory?

Answer 9

Great and 50,000, less than 50,000 but greater than 2000

Question 10

What is the antibiotics for lupus? Lupus plus Renal involvement?

Answer 10

Anti-nuclear antibodies, anti-ds DNA antibodies,

Question 11

Antibiotic for autoimmune hepatitis?

Answer 11

Anti-smooth muscle antibody

Question 12

Antibiotics for primary biliary cirrhosis?

Answer 12

Anti-mitochondrial antibodies

Question 13

Antibody for rheumatoid arthritis?

Answer 13

Anti-CCP, anti-RF antibodies

Question 14

Antibiotics for systemic scleroderma? Crest scleroderma?

Answer 14

Anti-topoisomerase Antibodies, anticentromere antibodies

Question 15

What does MD SOAP BRAIN stand for?

Answer 15

Malar rash, Discoid Rash, Serositis, Oral Ulcers, Arthritis, Photosensitive, Blood, Renal failure, ANA, Immunologic, Neuro

Question 16

What happened to that complement levels in a lupus flare? In a lupus infection?

Answer 16

Complement levels decrease in flare and increase in infection

Question 17

What is given to lupus patient that is refractory to other medications, severe case?

Answer 17

Mycophenolate Mofetil

Question 18

How do you patients present that are infected with drug induced lupus?

Answer 18

Skin and joint symptoms only, no visceral involvement

Question 19

What is the pathophysiology for antiphospholipid antibody syndrome?

Answer 19

Lupus anticoagulant causes coagulation in the body.

Question 20

How do you do patience with anti-phospholipid antibody syndrome present?

Answer 20

Arterial and venous clots. Patient will have lupus. False positives RPR

Question 21

How are antiphospholipid antibody syndrome diagnosed?

Answer 21

PPT increased, normal INR, mixing study fails to correct, Russell viper venom test

Question 22

What is the treatment for anti-phospholipid antibody syndrome?

Answer 22

Warfarin plus aspirin

Question 23

Symmetric stiffness of hands describes what disease? What joints are spared? What does the x-ray show?

Answer 23

Rheumatoid arthritis, DIP, erosions

Question 24

What two diseases are given NSAIDs for symptoms and steroids for flares?

Answer 24

Lupus and rheumatoid arthritis

Question 25

We should be given to rheumatoid arthritis if refractory to other medication, severe cases? Severe Lupus?

Answer 25

Biologics: Etanercept, infliximab | Mycophenolate Mofetil

Question 26

What is the spinal involvement for Rheumatoid arthritis?

Answer 26

C1 and C2

Question 27

What non arthritis symptoms can be an early sign of rheumatoid arthritis?

Answer 27

Bilateral carpal tunnel

Question 28

What is Felty syndrome?

Answer 28

Rheumatoid arthritis plus neutropenia plus splenomegaly

Question 29

What is the pathophysiology for giant cell arteritis?

Answer 29

Multi nucleated Giant cells in large blood vessels like the temporal artery

Question 30

How does a patient with giant cell arteritis present?

Answer 30

Jaw Claudication, vision loss, unilateral head pain and tenderness. Greater than 50 in age

Question 31

What is the treatment for Giant cell arteritis?

Answer 31

Treat first with steroids then temporal artery biopsy

Question 32

How does a patient present that has polymyalgia rheumatica?

Answer 32

Symmetric pain and stiffness of neck, shoulder, hip girdle.

Question 33

How is polymyalgia rheumatica diagnosed? Proximal muscle weakness is indicative of what elevated biomarkers?

Answer 33

Normal CK, inflammatory myopathy elevated ESR, CRP. Diagnosed clinically

Question 34

What is the treatment for polymyalgia rheumatica?

Answer 34

Steroids

Question 35

Polymyalgia rheumatica is diagnosed clinically however what should be done to rule out other diseases?

Answer 35

Angiogram

Question 36

What is the pathophysiology for Takayasu Arteritis?

Answer 36

Giant cell arteritis of the aorta, subclavian, and axillary artery.

Question 37

How do patients with Takayasu Arteritis present?

Answer 37

Asymmetric pulselessness, discordant blood pressure from left to right arm

Question 38

What is the age difference between patients who have giant cell arteritis and Takayasu Arteritis⁉️

Answer 38

Giant cell arteritis greater than 50, less than 40

Question 39

Takayasu Arteritis Diagnosed?

Answer 39

Angiogram CT, MRI, direct

Question 40

Takayasu Arteritis Treated?

Answer 40

High dose prednisone

Question 41

How does the patient presents with polyarteritis nodosa?

Answer 41

Infarction of multiple organs without a common vascular distribution. Purpura, Mesenteric ischemia, Renal failure.

Question 42

How is polyarteritis nodosa diagnosed?

Answer 42

Angiogram microaneurysms and stenosis

Question 43

How is polyarteritis nodosa treated?

Answer 43

High dose steroids and cyclophosphamide

Question 44

What viral hepatitis is associated with poly arthritis nodosa? Cryoglobulinemia?

Answer 44

Hepatitis B, hepatitis C