Who Knows
My life sucks
PA school drools
I am a sad human
I have no money
100
What is the typical onset for ankylosing spondylitis? What is the pathophysiology? What are some symptoms? Treatment? what is adverse effect of anti-TNF alpha agents?
What is 20-30; inflamed joint is infiltrated with CD4+ and CD8+ T cells and macrophages; persistent low back pain and prolonged morning stiffness; NSAIDS = first line, then anti-TNF alpha agents; infection
100
Pathophysiology of GOUT? 90% of the population has what kind of gout? What food can cause increase urate? Pt has a red, warm, painful, swelling joint and you suspect that it is gout, what do you do to diagnose an acute attack? Treatment? When should you not start prophylactic treatment?
What is negative birefringent crystals; underexcretors (often idiopathic); Meats and seafoods; arthrocentesis; NSAIDS, colchicine, and glucocorticoids; during an acute attack, wait about 2 weeks after the attack resolves!
100
What are the 3 cardinal features of scleroderma?
What is vasculopathy, cellular and humoral autoimmunity, progressive visceral and vascular fibrosis
100
Pt presents with joint pain that is worse with activity and better with rest, and has brief morning stiffness (<30minutes) what are you thinking?
What is OA
100
Treatment of RA?
What is Lifestyle changes, Conventional DMARDS (methotrexate), Biological DMARDS (anti-TNF agents, IL-1 inhibitors)
200
What is the most common GU bug associated with reactive arthritis? What is dactylitis? what is ketoderma blenorrhagica? What is a treatment for reactive arthritis?
What is chlamydia; sausage digits = diffuse swelling of a single finger or toe; skin lesions with consists of vesicles that become hyperkeratotic, ultimately forming a crust before disappearing; NSAIDS
200
Which prophylactic treatment used in gout should not be used in those with nephrolithiasis or impaired renal function Cr>2? Which is used in overproducers? What is the pathophysiology of pseudogout?
What is probenecid (also used in underexcretors); Allopurinol; calcium pyrophosphate deposition disease (CPPD)
200
Pt presents with hair loss, and taut shiny skin on face, what are you thinking? What are the CREST syndrome, and what are they associated with?
What is Scleroderma; C=calcinosis, R=raynaud's, E=esophageal dysmotility, S=sclerodactyly, T=telangiectasia -->Limited cutaneous scleroderma
200
What do you expect to find on PE of OA? What do you expect to find on x-ray?
What is crepitus; osteophytes
200
What are some examples of anti-TNF agents? What is a common SE?
What is Infliximab, Adalimumab, Etanercept; infection!
300
What are you thinking of if you see a "pencil-in-cup" deformity on radiographic findings? What is a common clinical feature found in inflammatory myopathies? what are some physical exam findings seen in dermatomyositis? Treatment?
What is psoriatic arthritis; proximal muscle weakness; facial erythema, heliotropic hue, gattron's sign, v sign, scalp changes; 1)corticosteroids 2)immunosuppressive drugs 3)IV IG
300
Who is SLE primarily found in? Environmental stimuli that can influence SLE? What are common presenting symptoms? Best screening test for SLE? Which drug used for SLE required yearly ophthalmologic visits because it has associated retinopathy? If patient has SLE and is pregnant what should you do?
What is black, females; Sun, Sick (EBV), Silica, Smoking; lived reticular, malar "butterfly rash", oral ulcers; ANA; hydroxychloroquine; switch them to prednisone!
300
If ACA (limited) and Anti-Scl-70 antibodies (diffuse) were not enough, what other diagnostic test can be performed for scleroderma?
What is skin biopsy
300
Treatment of OA?
What is Weight loss and NSAIDS!
300
Pt presents with widespread musculoskeletal pain, sleep disturbance, fatigue, cognitive disturbance, psychiatric symptoms, HA, and paresthesias (usually with a normal near exam)?
What is Fibromyalgia
400
What is the pathophysiology for a vasculitis syndrome? What sized vessels are affected in polyarteritis nodosa (PAN)? What is characteristic of PAN? What is the most common organ that is affected with PAN? Treatment?
What is deposition of inflammatory leukocytes in the vessel walls, which results in compromise of the vessel lumen; small and medium; Aneurysmal dilations; renal; high dose prednisone, cyclophosphamide - potent immunosuppressive agent
400
What are common symptoms associated with Sjogren's Syndrome?
What is Xerostomia and dry eyes
400
What treatment may provide a small benefit in skin thickening associated with scleroderma?
What is methotrexate or mycofenolate
400
Pathophysiology of RA?
What is Inflammation in synovial membrane --> destroys adjacent cartilage/bone/tendon/ligaments --> invades bone-cartilage-synovium interface (causes bone erosion!)
400
Pathophysiology of fibromyalgia?
What is Central pain disorder
500
What is a clinical feature of Giant Cell Arteritis? Treatment when there is ophthalmologic involvement? Pathophysiology for Takayasu's arteritis?
What is Jaw claudication; High dose prednisone and send to vascular surgeon; inflammatory mononuclear cell infiltrates and cause intimal proliferation and fibrosis and scarring of the media and luminal narrowing.
500
What labs should be done for Sjogren's Syndrome? What could help with diagnosis? Treatment for xerostomia?
What is Anti-Ro/SS-A, anti-La/SS-B; Shrimer's test, Salivary gland MRI or US, Salivary gland biopsy; frequent sips of water and pilocarpine.
500
What is the pathophysiology of OA?
What is noninflammatory, articular cartilage loss
500
Describe Sawn neck deformity?
What is extended PIP and flexed DIP
500
Treatment of fibromyalgia?
What is Education, exercise, cognitive behavioral strategies, Antidepressants (Amitriptyline, Duloxetine, Milnacipran), and Anticonvulsants (Pregabalin, Gapapentin)
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