Hot Stuff!
Name that bump, associated with deposition of multiple needle-shaped negatively birefringent crystals on polarized microscopy.
What is a tophus?
You wish to begin your patient on a long acting, basal insulin. You give a prescription for one of these.
What are detemir (Levemir) and glargine (Toujeo, Lantus, and Basaglar)?
65 y/o F presents to clinic for evaluation of lumps on fingers. Her mother had similar a similar condition. Name these lumps and bumps.
What are Heberden’s (DIP) and Bouchard’s (PIP)
Nodes?
Name this XR finding and the disease.
What is Bamboo Spine (ossification along the margins of the disk spaces, SI joints are also fused)?
What is Ankylosing Spondylitis?
A young woman presents with heat intolerance, palpitations, tremor, weight loss and goiter. Name the most appropriate first lab in this clinical setting.
What is “TSH”?
A 40 yo M presents with palpitations, heat intolerance, emotional lability and poor sleep one week following a viral syndrome. PE shows an exquisitely tender anterior neck. At the top of your differential is this diagnosis.
What is “subacute thyroiditis”?
These are the only 3 drugs FDA approved for fibromyalgia.
What are (Cymbalta), Milnacipran (Savella), and Pregablin (Lyrica)?
A 47 yo F presents with fatigue, weight gain, dry skin and constipation. Her neck exam reveals a small, firm thyroid. Name the most common etiology of this thyroid presentation.
What is Hashimoto’s Thyroiditis?
Your patient with hyperthyroidism returns to review her thyroid scan and uptake. The uptake is increased and the image is shown confirming this type of hyperthyroidism.
What is Graves Disease?
Patient is a 36 y/o F who presents to the office for work up of a + ANA, drawn by PCP. Her symptoms include keratoconjunctivitis sicca, xerostomia and parotid glad swelling. Lip biopsy shows chronic lymphocytic infiltrate
Name that syndrome! And associated anti-bodies!
What are Sjogren’s Syndrome and anti-SSA (Ro) and anti-SSB (La) antibodies?
: A 25-year-old woman with a history of sarcoidosis presents with fever, fatigue, and joint pain over the past week. Yesterday, she developed a bruise-like and raised painful rash on her shins despite having no recent trauma to the area. Physical exam reveals multiple 2-4 cm erythematous and tender nodules with poorly demarcated borders on her anterior shins. Laboratory examination reveals elevated inflammatory markers. Name those lumps.
What is Erythema nodosum?
You have made your first diagnosis of Graves’ hyperthyroidism and need to initiate therapy. In addition to a beta-blocker you prescribe one of these meds to decrease thyroid hormone production and release.
What are PTU and methimazole?
A form of inflammatory arthritis that develops in response to an infection (classic triad: conjunctivitis, nongonococcal urethritis, asymmetric oligoarthritis).
What is Reiter’s Syndrome- AKA reactive arthritis?
Name this XR finding and associated disease
What is Chondrocalcinosis or Calcium pyrophosphate deposition disease (CPPD)?
A young woman complains that menses have become scant and further apart. She also notes some milky nipple discharge. This lab test will be particularly useful.
What is “Prolactin level”?
: A 54 yo F presents with c/o episodic palpitations, headache, and diaphoresis lasting few to several minutes. Colleagues note her to be pale when these occur. A BP taken at during an episode was 200/108. This diagnosis is at the top of your differential.
What is Pheochromocytoma?
The bulb of a meadow saffron yields this medication.
What is Colchicine?
The correct name for the plant is colchicum autumnale
A 45 yo M on no meds has worsening am drowsiness, headache. His symptoms resolve with eating but recur with missed meals or vigorous exercise. You suspect this is your first case of a rare endocrine disorder.
What is insulinoma?
A 58 yo M is new to your clinic. He reports decreased libido, sexual hair and headache. You perform a visual field to confrontation as and discover a bitemporal field cut. You see this abnormality on MRI of the brain.
What is a pituitary mass abutting the optic chiasm?
46 y/o F presents with symmetrical polyarthritis, weight loss, lymphadenopathy, subcutaneous nodules, fever, diarrhea, and BP 80/50. This is the best test or procedure to diagnose this disease?
What is Whipple’s Disease and a Small Bowel Biopsy?
These lumpy bumps are associated with a syndrome that also includes Raynaud’s, esophageal dysmotility, sclerodactyly, telangectasias
What is Calcinosis?
An elderly female who is at fall risk presents with evidence by bone density of osteoporosis. She is not a candidate for bisphosphonate treatment. You prescribe a medication that is FDA approved to treat osteoporosis and will stimulate bone formation.
What is teriparatide (Forteo)
Disease characterized by genetic defect of multiple extracellular matrix (ECM) proteins causing joint hypermobility, skin hyperelasticity, and fragile blood vessels.
What is Ehlers- Danlos Syndrome?
30 y/o F with SLE on hydroxychloroquine, prednisone 10 mg daily, develops b/l knee pain over the past 6-8 months that worsens with weight bearing. No effusion, good range of motion. This finding is seen on Xray.
What is Avascular Necrosis?
A 54 yo M presents with difficult to control hypertension and persistent hypokalemia. CT abdomen shows a 2.5 cm nodule on the L adrenal. This ratio of these two values will confirm your diagnosis.
What the ratio of Aldosterone and Renin?