Uworld Rheum

Question 0

Effect of steroids on hip?

Answer 0

Avascular necrosis

Question 1

Bahcet’s syndrome? Complications?

Answer 1

Erythema nodosum, recurrent oral and genital ulcers

Aortic aneurysms and alveolar hemorrhage

Question 2

Part of spine affected in RA? Complications?

Answer 2

Cervical spine. Can cause subluxation or spinal compression.

Question 3

Evidence of pseudogout on X-ray?

Answer 3

Chrondocalcinosis

Question 4

Viral arthritis versus rheumatic arthritis?

Answer 4

Acute onset of symptoms, morning symptoms lasting <30 minutes, lack of joint swelling

Question 5

Fibromyalgia diagnosis depends on?

Answer 5

Tenderness in 11/18 trigger sites

Question 6

Rheumatic arthritis increases risk of developing?

Answer 6

Osteopenia and osteoporosis due to disease, steroids, female sex, inability to weight bear

Question 7

Baker cyst associated with what disease?

Answer 7

Rheumatoid arthritis

Question 8

Cervical spondylosis Sx? X-ray findings?

Answer 8

Chronic neck pain, limited neck rotation and lateral bending, osteophyte induced radiculopathy, sensory abnormalities,

Bony spurs and sclerotic facet joints

Question 9

Signs of catheter induced atheroembolism?

Answer 9

Blue toe syndrome – cyanotic and painful toes with intact pulses

Organ dysfunction, livedo reticulatus

Question 10

Signs of vertebral osteomyelitis?

Answer 10

1. Tenderness to gentle percussion
2. No relief with rest
3. ESR>100

Question 11

Enthesitis? Associated with?

Answer 11

Inflammation at site of tendons/ ligament attachment. Associated with arthropathies.

Question 12

Systemic diseases with oral ulcers?

Answer 12

Lupus, crohn’s and behcet’s

Question 13

Episcleritis associated with what diseases?

Answer 13

RA and IBD

Question 14

Pain with pulling, pushing or lifting arm above shoulder with:

1) no improvement with lidocaine
2) with improvement with lidocaine

Answer 14

1) Rotator cuff tear

2) rotator cuff tendonitis/impingement

Question 15

avascular necrosis can be complications of?

Answer 15

Corticosteroids, trauma, lupus, sickle cell

Question 16

X-rays of joints affected by chronic gout show?

Answer 16

Punched-out erosions with overhanging cortical bone

Question 17

Consider fibromyalgia when?

Answer 17

1. Woman ages 20 to 55
2. Normal ESR
3. Diffuse musculoskeletal pain or weakness without joint swelling

Question 18

Myasthenia gravis versus Lambert-Eaton versus dermatomyositis: involved sites? Clinical features?

Answer 18

Postsynaptic ACh Receptor 
versus 
presynaptic Ca channels 
versus
 muscle fiber injury

Question 19

Myasthenia gravis versus Lambert-Eaton versus dermatomyositis: All three can present as? Clinical features?

Answer 19

All three can present as paraneoplastic syndrome

Fluctuating muscle weakness (ocular, bulbar, facial, neck)

Proximal muscle weakness, autonomic dysfunction, cranial nerve involvement, no deep tendon reflexes

Symmetric and proximal muscle weakness, interstitial lung disease, esophageal dismotility, skin findings

Question 20

Felty syndrome?

Answer 20

Rheumatoid Arthritis, splenomegaly, granulocytopenia

Question 21

Whipple’s disease symptoms?

Answer 21

Diarrhea, weight loss, migratory arthritis, low-grade fever, Lymphadenopathy

Question 22

Treatment of fibromyalgia?

Answer 22

Tricyclics and exercise

Question 23

Lumbar spinal stenosis – symptoms?

Answer 23

Low back pain, difficulty walking. Pain is worse with standing and walking uphill.

Question 24

Symptoms of subacromial bursitis?

Answer 24

Pain with internal rotation and flexion shoulder with no signs deltoid atrophy

Caused by repetitive overhead motions (tennis players)

Question 25

Can make a diagnosis of polymyalgia rheumatica if? Treatment?

Answer 25

Age >50
Pain in neck, shoulders, pelvis
Morning stiffness lasting >1 hour
ESR >40

Low dose prednisone

Question 26

Causes splenomegaly and pruritis with hot baths? Mechanism?

Answer 26

Polycythemia vera. Histamine release from increased basophils

Question 27

Bone pain caused by metastasis versus bone pain caused by degenerative disease?

Answer 27

Constant and worse at night versus exacerbated by exercise and relieved by rest

Question 28

Dermatomyositis is associated with?

Answer 28

Ovarian, breast, lung cancers

Question 29

Inflammatory diseases associated with aortic aneurysms?

Answer 29

1. Vasculities - Takayasu and Giant cell arteritis
2. ankylosing spondyloarthropathies
3. rheumatoid arthritis
4. Behcet syndrome

Question 30

Inflammatory diseases associated with Alveolar hemorrhage?

Answer 30

1. Goodpasture’s
2. Wegner’s
3. Chrug-Strauss
4. Behcet syndrome
5. Antiphospholipid antibody syndrome

Question 31

Inflammatory diseases associated with carpal tunnel syndrome?

Answer 31

Rheumatoid arthritis, sarcoidosis, amyloidosis

Question 32

Causes of Erythema nodosum?

Answer 32

Most common: recent streptococcal infection

2. Sarcoidosis
3. TV/histoplasmosis
4. IBD

Question 33

Pain of spinal stenosis vs herniated disk vs spinal cord compression vs ankylosing spondylitis

(Pain worse/better when? Leg raise test?)

Answer 33

Worse with standing (spinal extension), leg raise negative
Vs
Worse when sitting and positive leg raise
Vs
Paralysis, incontinence and hyperreflexia
Vs
Symptoms improve with exercise and no leg pain

Question 34

Treatment for antiphospholipid antibody syndrome In a pregnant female?

Answer 34

Low molecular weight heparin