Rheumatology/Orthopedics and Sports

Question 1

Juvenile Idiopathic Arhritis

Answer 1

Autoinflammatory disease of childhood

> 2 weeks of daily fever (quotidian)
FIXED arthritis > 6 weeks
Pink rash that worsens with fever
Morning stiffness, afternoon relief

Question 2

Diesase Modifying antirheumatic drugs (DMARD)

Answer 2

Methotrexate: folate antimetabolite. A/E: hepatotoxicity, stomatitis, cytopenias

Hydroxychloroquine: TNF alpha; IL1 suppressor. A/E: Retinopathy

Sulfasalazine: TNF alpha; IL1 suppressor. A/E: hepatotoxosity, stomatitis, hemolytic anemia

Question 3

Tacrolimus mechanism of action

Answer 3

calcineurin inhibitor

Question 4

Cyclosporine mechanism of action

Answer 4

Calcineurin inhibitor

Question 5

Etiology of Avascular Necrosis

Answer 5

Steroid use
Alcohol consumption
SLE
Antiphospholipid syndrome
Sickle Cell Disease
Infections
Decompression Sickness
Renal transplantation

Question 6

Bullous Pemphigoid

Answer 6

Autoimmune disorder

Patients older thatn 60, parkinson, depression, dementia

IgG C3 deposits

TTE: high potency steroids, doxycycline

Question 7

Fibromyalgia

Answer 7

Young to middle age women
Chronic WIDESPREAD pain
Fatigue, impaired concentration
Tenderness at trigger points

Question 8

Polymiositis

Answer 8

Proximal muscle WEAKNESS
Pain is mild or absent

Dx: elevated muscle enzymes, autoantibodies JO-1, ANA

Question 9

Polymyalgia Rheumatica

Answer 9

Women over 50 years old
Systemic S&S
Stiffness more than pain, in shoulders, hip, neck
Can be associated with GIANT CELL ARTERITIS

Dx: Elevated ESR, C-RP

Question 10

SLE markers

Answer 10

ANA (sensitive)

dsDNA - smith (specific)

Question 11

Hemolytic Uremic Syndrome

Answer 11

Hemolytic Anemia
Thrombocytopenia
AKI

Question 12

Slipped Capital Femoral Head

Answer 12

N 1 hip disorder in adolescents

Surgical Emergency

Question 13

patello femoral pain

Answer 13

N 1 cause of knee pain in the adolescents

Question 14

Movie goer sign

Answer 14

Knee pain after seating down for a prolonged period of time

Patelofemoral pain

Question 15

Patello fermoral pain syndrome and surgery

Answer 15

Only after 24 months of failed treatment

Avoid at all costs

Question 16

Clubfeet management

Answer 16

Serial molding casts

Then, long term bracing

Question 17

Down Syndrome muscular alterations

Answer 17

Atlantoaxial inestability, which can compress the spinal cord

Leads to upper motor nueron findings: spasticity, hyperreflexia, babinski

Question 18

Nutritional Rickets

Answer 18

Deficiency in vitamin D

Frontal blossing: delayed closing of fontanelles

Wrist enlargement: epiphyses enlargment

Costochondral junction enlargment: rachitic rosary

Bowing of the femur and tibia

Short stature

Question 19

Henoch Schonlein Purpura: complications

Answer 19

Intussusception :: IgA deposits leading to edema and bleeding

Question 20

Child Abuse lesions

Answer 20

Femur fracture in nonambulatory infants
Posterior rib fracture
Metaphysheal corner fractures
Retinal and subural hemorrhages

Question 21

Risk factor for septic arthritis

Answer 21

JIA

Question 22

Lyme Disease bacteria

Answer 22

Borrelia Burgdorferi

Question 23

Legg Calves Perthes disease

Answer 23

Avascular necrosis of the femur

Boy 3-12

tte w/ splinting, possible surgical repair

Question 24

Testicular pain + rash

Answer 24

Henoch Schonlein Purpura

IgA vasculitis