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Category 1
Category 2
Category 3
Category 4
Category 5
100
Anti-dsDNA and ANti-Smith are very specific for this disease
What is SLE?
100
Difference between c-ANCA and p-ANCA? *Hint think location
What is c-ANCA: antibodies are diffuse in the cytoplasm. p-ANCA antibodies are perinuclear
100
Antibody associated with drug-induced lupus?
What is antihistone
100
Adulterant in cocaine that is associated with agranulocytosis, leukoencephalopathy or cutaneous vasculitis?
What is levamisole
100
In cocaine associated myocardial ischemia, what class of drugs are contraindicated?
What are beta-blockers
200
Value above which ANA titers are considered positive?
What is > 1:80
200
Disease characterized by malar rash that spares the nasolabial folds?
What is SLE
200
Three examples of small-vessel vasculitides
What is Hypersensitivity vasculitis (leukocytoclastic vasculitis), Henoch-Schonlein purpura (IgA vasculitis), cryoglobulinemia, Anti-glomerular basement membrane disease/
200
Adulterant in cocaine that can cause hyperglycemia & hypokalemia?
What is clenbuterol
200
Small bleeding into the skin, 1-2mm in size
What is petechiae
300
A rash of purple spots caused by internal bleeding from small blood vessels >3mm
What is purpura
300
Large vessel vasculitis associated with polymyalgia rheumatica?
What is Giant cell (temporal) arteritis
300
Cocaine addiction has been linked to what neuronal system? That is which neurotransmitter pathway?
What is the dopaminergic pathway
300
Half life of levamisole?
What is 5.6 hours
300
Syndrome of hemorrhagic alveolitis from inhalational cocaine use? Cough and SOB are common presenting symptoms
What is crack lung
400
Patient comes in w/acute cocaine intoxication & is unable to maintain their airway. You have to perform rapid sequence tracheal intubation. What agent do you want to avoid? A) Rocuronium B) Succinylcholine C) Etomidate D) Propofol
What is succinylcholine. It can prolong the effects of cocaine. Both are metabolized by plasma cholinesterase (PChE). Coadministration of both can prolong effects of cocaine & paralysis from succinylcholine. In the setting of rhabdomyolysis and hyperthermia, succinylcholine may worsen hyperkalemia and cause life-threatening arrhythmias
400
In the past levamisole was used as adjuvant therapy for what type of cancer?
What is colon cancer
400
Intranasal and inhalational cocaine is associated with 3 "p"s (medical complications). Name at least two.
What is pneumothorax, penumomediastinum, pneumopericardium.
400
Which of the following meds does not cause drug induced lupus? 1. Procainamide 2. Hydralazine 3. Infliximab 4. Atenolol
What is atenolol
400
Patient comes in, states he has been using cocaine & is complaining of chest pain. Ideally if no other complications on vitals, labs, EKG, what medication would you give first?
What is a benzo
500
52yo male comes in w/2 weeks of fever, malaise, gradual onset SOB, pleuritic chest pain, myalgia, arthralgia & rash. No cough. Has 15yr history of rheumatoid arthritis, well controlled with methotrexate & etanercept, last flare was 1 year ago. Vitals WNL, cardiac exam normal, Pulm exam reveals left pleural friction rub. Synovial thickening of wrists & MCP and PIP noted and small b/l knee effusions. Non-blanching purpuric rash noted over distal lower extremities. CXR no infiltrate seen. ESR 86, Hgb 9.8, Leukocyte 2600. What is most appropriate diagnostic test to perform next? 1. ANA & Anti-dsDNA 2. Bone marrow aspiration & biopsy 3. CT of chest, abdomen & pelvis 4. Rheumatoid factor & Anti-CCP antibody Assay
What is ANA & Anti-dSDNA Drug induced lupus caused by tumor necrosis factor alpha inhibitors.
500
67yo woman returns for follow up of suspected giant cell arteritis. At that time prednisone 60mg initiated and left temporal artery biopsy done, biopsy results were negative. Also has HTN, DM, CKD. On exam, she has temp to 100.5, BP 130/90, pulse 90, RR 14. Pulses present in both temporal arteries. Diffuse scalp tenderness noted. Hematocrit 34%, ESR 105, Cr. 2.1, GFR 38, UA normal. What is the most appropriate management? 1. CT angio of aortic arch, carotid & subclavian vessels 2. Decrease prednisone to 10mg/d 3. MR angiography of aortic arch, carotid & subclavian 4. Ultrasound guided biopsy of right temporal artery
What is 4. Ultrasound guided biopsy of right temporal artery. If temporal artery biopsy results are negative for GCA in a patient with cranial symptoms, a biopsy of the contralateral temporal artery is then indicated.
500
52yo F evaluated for 3 month history of fatigue, photosensitive malar rash, and hand pain accompanied by morning stiffness. 5mm ulcer noted on hard palate on exam. Livedo rash on knees also. Tenderness of MCP & PIP noted. Initial labs WNL, ANA positive with titer of 1:160. Which of the following tests is most specific in confirming diagnosis? 1. Anti-double stranded DNA antibodies 2. Anti-Ro/SSA and Anti-La/SSB Abs 3. Anti-U1-ribonucleoprotein antibodies 4. Antiproteinase-3 antibodies
What is 1. Anti-double stranded DNA antibodies
500
Classic skin findings of dermatomyositis? (2)
What is heliotrope rash & gottron's papules
500
Difference between bullous pemphigoid & pemphigus vulgaris? In terms of pathophysiology
What is Bullous Pemphigoid: The bullae are formed by an immune reaction, initiated by the formation of IgG autoantibodies targeting Dystonin, also called Bullous Pemphigoid Antigen 1, and/or type XVII collagen, which is a component of hemidesmosomes. Pemphigus vulgaris is a chronic blistering skin disease with skin lesions that are rarely pruritic, but which are often painful. It is classified as a type II hypersensitivity reaction, with the formation of anti-desmosome antibodies.