General IM

MYALGIAS

100

55 year old patient with h/o weight loss and low grade fevers presents with: chronic bilateral pain in shoulders, hips, and back, normal strength testing, ESR >40, normal CPK

What is PMR

200

Elderly patient with h/o fevers, weight loss, chronic back and shoulder pain presents with:headache, scalp tenderness, jaw claudication, ESR>50, normal CPK

What is GCA

300

Female patient presents with :fatigue, myalgias, mental fogginess, interrupted sleep, normal CBC, chemistry, and ESR

What is fibromyalgia

400

60 year old male with years of: progressive weakness of hands, proximal muscle weakness, reduced DTRs, normal or mildly elevated AST,ALT,CPK, negative ANA, normal ESR. Muscle biopsy showing rimmed vacuoles and ragged red fibers

What is inclusion body myositis

500

Patient with Raynaud's presents with:fatigue, myalgia, arthralgia, joint stiffness, heartburn, chronic cough after eating, normocytic anemia, +ANA

What is systemic sclerosis

MISC

100

Patient with history of recurrent bilateral uveitis presents with:recurrent painful oral mucosal ulcers, never on the lips, recurrent painful genital mucosal ulcers

What is Bechet disease

200

Patient presents with:severe heal pain with the first couple of steps in the morning, pain with each step, tenderness on the bottom of the foot when the foot is dorsiflexed

What is plantar fascitis

300

Alcoholic patient presents with:unilateral groin ache, worse with weight bearing and at night, pain with internal rotation and abduction of the hip, and normal x-ray of the hip

What avascular necrosis

400

Diabetic patient 45 year old presents with: recurrent swollen and painful wrist, with no history of trauma, mildly elevated AST and ALT, x-ray shows chondrocalcinosis and hooked osteophytes at MCP

What is hemochromatosis

500

Middle aged Caucasian male presents with: weight loss, cachexia, chronic diarrhea, severe migratory arthralgias, vertical gaze palsy and ataxia

What is Whipples disease

LEG PAIN

100

Patient with OA of the knees presents with : worsened knee pain that wakes from sleep, point tenderness on inferomedial aspect of the knee (4-6 cm below patella)

What is pes anserine bursitis

200

Patient with known RA and a chronic knee effusion presents with : acute pain and swelling behind the knee, soft swollen area in the popliteal fossa, Ipsilateral knee effusion, US-no DVT

What is bakers cyst

300

Patient presents with : complaint of hip pain on the outer thigh, especially when lying down, point tenderness over lateral hip, normal gait, normal ROM

What is trochanteric bursitis

400

Patient who lays carpet for a living presents with: painful swollen knee, erythema and tenderness localized over patella, no crepitus or knee effusion

What is prepatellar bursitis

500

Patient with known HCV presents with: malaise and arthralgias, pins and needles in both feet, scattered lymphadenopathy, non blanching palpable violaceous rash around the , decreased C3 and C4, U/A proteinuria and red cells

What is cryoglobulinemia

UPPER EXTREMITY PAIN

100

Diabetic patient 50 years old presents with: chronic shoulder pain that limits overhead reach, gradual shoulder stiffness and decreased ROM, reduced active and passive motion of the glenohumeral joint, normal X-ray

What is adhesive capsulitis

200

Patient presents with : Lateral shoulder pain that disrupts sleep and inhibits ROM, most intense pain about 4 cm down the outer arm, reduced active but normal passive ROM

What is subacromial bursitis

300

Middle aged male presents with: Pain over the deltoid, worse with sleep and overhead reach, pain when adducted >90 degrees, inability to smoothly adduct the shoulder, weakness with external rotation of the flexed forearm against resistance

What is rotator cuff tear

400

Pregnant patient presents with: Pain over the radial wrist and hand, worse when pinching and grabbing, intense pain when thumb is flexed inside the fist and the hand is deviated towards the ulna

What is de Quervains tenosynovitis

500

Alcoholic male older than 50 develops: progressive contractures of the hand, palpable nodules across the palmar fascia

What is Dupuytren contracture

IM

100

Patient presents complaining of: intermittent mild pain and burning on the tongue, variable raised, yellow pattern on the tongue that changes position

What is geographic tongue

200

Sexually active adult presents with :pain in the genital region, rash on forearm, multiple small blisters on genitalia, several small target shaped lesions on forearm without scale or itch

What is erythema multiforme

300

Patients with HCV presents with: blistering lesions on the hands and feet that began as erythematous macules and adherent scale, increased AST, ALT, increased urine uroporphyrin

What is porphyria cutanea tarda

400

Who do you screen for AAA at 65

Men who have ever smoked

500

USPSTF recommends IPV (intimate partner violence) screening for all women of child bearing age (14-46). Name one screening tool

HITS-Hurt, Insult, Threaten, Scream

STat- Slapped, Threaten, and Thrown

HARK- Humiliation, Afraid, Rape, Kick