Rheumatology

Question 1

clinical prediction tool for gout

Answer 1

Clinical Prediction Rule for Gout
CLINICAL VARIABLE POINTS
Acute onset, with maximal symptoms on day 1 -0.5
Joint erythema -1.0
Hypertension or cardiovascular disease–1.5
Male sex–2.0
Previous episode of arthritis or joint pain–2.0
First metatarsophalangeal joint involvement–2.5
Serum uric acid > 5.8 mg per dL (0.35 mmol per L)–3.5

Total score (0 to 13 points):

———
Score

≥ 8: high risk: Diagnose gout

4.5 to 7.5: intermediate risk: Perform or refer for joint aspiration and polarized light microscopy analysis of crystals

≤ 4: low risk: Consider alternative diagnosis

Question 2

Potential concerns with usage of Uloric

Answer 2

Inc cardiac and all cause mortality

Question 3

compare naproxen and prednisone in the treatment of Gout

Answer 3

Oral prednisolone (35 mg once daily) is equal to naproxen (500 mg twice daily) in the treatment of acute gout, with no significant difference in pain relief or adverse effects.

Question 4

What is high and low dose colchicine and compare effectiveness and Side Effects

Answer 4

In acute gout, low-dose colchicine (1.2 mg orally followed by 0.6 mg one hour later) was as effective as high-dose colchicine (1.2 mg followed by 0.6 mg every hour for six hours) and had fewer adverse effects.

Question 5

avoid NSAIDs in gout if?

Answer 5

Nonsteroidal anti-inflammatory drugs are first-line treatment unless use is contraindicated (e.g., cardiovascular disease, cerebrovascular disease, chronic kidney disease, history of gastric bypass, history of gastrointestinal bleeding, inflammatory bowel disease, peptic ulcer disease, pregnancy

Question 6

potential blood test for fibromyalgia

Answer 6

FMA

Question 7

When to treat in Osteopenia

Answer 7

T score between -1 and -2.5 in Femoral neck or spine, and a 10 yr probability of Hip fxr >3% or probability of major fxr >20%

Question 8

First test to order when you suspect SLE?

Answer 8

ANA positive at least greater than 1:80. This is very sensitive 95%, which means it successfully ruled out the disease (snout). Order double stranded, DNA, anti-Smith, anti-cardiolipin and lupus anticoagulant next.

Question 9

Differential diagnosis of SLE

Answer 9

Question 10

When to treat for low bone mass

Answer 10

10 yr risk of hip fxr >3%, 10 yr risk of major osteoporotic fxr >20%, consider doing a DEXA on people that have >8.4-10% risk of fxr based on FRAX.

Question 11

main determinate for bone health

Answer 11

90% genetics, Early life bone density

Question 12

What should you think of in an Obese, Diabetic with neuropathy who presents with unilateral LE swelling, redness, and no pain?

Answer 12

Cellulitis, DVT, Charcot Joint. Get xrays.