Diagnosis
Medications
Imaging
Others
The Final Countdown
100
Most common disease associated with Anti-U1-ribonucleoprotein antibodies.
Mixed Connective Tissue Disease
100
What therapy is used in conjunction with Methotrexate to decrease medication complications?
Folic Acid
100
Radiographic findings (at least 2) in OA
1. Asymmetric joint-space narrowing.
2. Osteophytes
3. Subchondrial Cyst
4. Subchoncrial Sclerosis
100
Most common cause of death in patients with RA?
Atherosclerotic Heart Disease
200
What is the most likely diagnosis in a patient with; acute peripheral oligoarticular arthritis, enthestisis, uveitis?
Reactive Arthritis
200
Raynaud - Common medication that exacerbate this phenomenon?
Possible answers; BBs, Alpha agonist (Clonidine, pseudoephedrine, phenylephrine), Triptans, methamphetamines, Ergotamine, Bleomycin, Vinblastine, Cisplastin.
200
X-Ray finding in Psoriatic Arthritis.
DIP joint involvement. (Pencil-in-cup deformity)
200
Evaluation needed prior to initiation of hydroxychloroquine.
Opthalmologic examination
200
Gout
1. Synovial fluid analysis findings (100)
2. Medication for acute management (100)
3. Medications for chronic management (100)
4. Medications for severe, non-resolving tophaceous gout or gout non-responding to initial mangement (200)
5. Indications to start allopurinol (at least 2) and what test you should do in Chinese/Thai/Korean/African American/African descent. (200, 100)
6. Target of uric acid in patients with and in patients without topaceous gout. (100(1), 200 (2))
1. Monosodium urate, negatively birefringent, needle-shaped crystals.
2. NSAIDs, Colchicine, Steroids.
3. Allopurinol, Febuxostat, Probenecid.
4. Pegloticase.
5A. A. Frequent gout flares (2 or more attacks in a year). B. Presence of tophaceous gout (tophi). C. Gouty erosions on radiograph D. Uric acid nephrolithiasis.
5B. HLA-B*5801
6. < 6 mg/dL in non tophi, < 5 mg/dL in patients with tophaceous gout.
300
Patient with RA, develops neutropenia and splenomegaly. Diagnosis?
Felty Syndrome
300
Drug and dose in a patient with GCA without ocular involvement?
(100 BONUS points: Dose in PMR without GCA?)
1. Prendsione 40-60 mg/day (max 80mg/day) or 1 mg/kg of prednisone or equivalent, up to a maximum of 80 mg daily.
2. Prednisone 12.5-25 mg/day
300
Pre-operative imaging in long-standing RA.
(50 points BONUS; What are you worried about?(25) What views do you need? (25))
Cervical spine radiography.
(Atlanta-axial subluxation, Cervical flexion and extension radiographs)
300
What is the RA cause of hoarseness, dysphagia, stridor, sore throat?
Cricoarytenoid artheritis
300
Ankylosing Spondylitis -
1. MC laboratory findings and imaging technique (with specific site of interest) for diagnosis (100, 100)
2. Next step if first evaluation of a patient with suspected Ankylosing Spondylitis is normal? (150)
3. First-line therapy and for how long (at least) it needs to be done before consider it a failure. (100, 200).
4. Second line treatment if first line is not tolerated or has failed? (150)
5. How you differentiate Ankylosing Spondylitis from DISH? (250)
1. Labs; ESR/CRP elevated, positive HLA-B27. X-Ray of the SI joint.
2. MRI of the SI joint.
3. A. First-line therapy - NSAIDs. B. At least 4 weeks (2 different).
4. The American College of Rheumatology (ACR) recommends the use of a tumor necrosis factor (TNF) inhibitor after failure of a trial of at least two NSAIDs for 2 to 4 weeks each, or if NSAIDs cannot be tolerated.
5. DISH - Non-inflammatory back pain and NO SI joint involvement with preserved disc height.
400
Diagnosis of a patient with history of systemic sclerosis and presenting with diarrhea, bloating, and malabsorption.
SIBO
400
Treatment of life-threatening granulomatosis with polyangitis.
Glucocorticoids plus Cyclophosphamide/Rituximab.
400
Dermatomyositis
400
Patient with Raynaud's phenomenon, positive antinuclear antibody (ANA), pulmonary arterial hypertension, and esophageal dysmotility, without skin tickening. Most likely Diagnosis.
Systemic Sclerosis Sine Scleroderma
500
Interstitial lung disease, Raynaud phenomenon, inflammatory arthritis and mechanic's hand. Diagnosis?
Antisynthetase Syndrome
500
Drug of choice to treat ILD in patients with Systemic Scleroderma?
Mycophenilate - 100% of points.
Cyclosporine - 1/2 of points.
500
Radriographic findings in diffuse idiopathic skeletal hyperostosis.
Linear calcification and ossification along the anterolateral aspects of the vertebral bodies in at least four contiguous vertebrae.
500
Life-threatening pulmonary manifestations of SLE?
Large pneumonitis and diffuse alveolar hemorrhage.