MSK Lectures

A

100

Most macrolide usage requires adjustment of dosages of other medications, due to their inhibition of CYP enzymes. What is the only macrolide where this doesn't need to be taken into account? 

Azithromycin 

200

HLA haplotype associated with ankylosing spondylitis

HLA-B27

300

A 3 month old infant presents to the clinic with tachypnea and cyanosis. Hx reveals patient recently had a meningococcal infection treated with an antibiotic that targets protein synthesis. What medication used likely lead to the above sxs? 

Chlorampenicol

400

Dupuytrens contracture is actually a type of benign "sarcoma". What is the fancy term for this disorder from our sarcoma lecture?

Palmar fibromatosis 

500

A patient with a 10 year history of relapsing joint pain undergoes a tissue biopsy. H&E staining of a substance from around the joint reveals a large aggregate of crystals surrounded by multinucleated giant cells. This microscopic finding, pathognomonic for gout, is termed what? 

tophus 

B

100

The disseminated disease caused by N. gonorrhea, once it spreads to the skin and joints, is called this: 

gonococcemia

200

A patient taking cyclosporine for her RA suddenly develops hypertension, cardiac abnormalities, and acute kidney failure. Medical history reveals that she has been stable on this medication for a while with no changes in dosage, and that her symptoms only started recently. She did recently start a diet to attempt to lose weight, and bought a bunch of grapefruit from the local farmer's market. What effect would this change in her diet have on the medication that could have precipitated her symptoms.

Grapefruit juice increases the bioavailability of cyclosporine from 20-30% to about 60%, thus her dosage effectively doubled, leading to her side effects. 

300

Back pain that decreases with exercise is indicative of this type of arthritic disorder

Ankylosing spondylitis. Most other forms of arthritis become more painful while exercising 

400

An 8 month old child presents to the clinic with signs of self-mutilation, intellectual deficits, and a sandy-orange precipitate in his urine. What enzyme is most likely deficient? 

HGPRT 

500

10 year old male presents to clinic with painful swelling of both the R shoulder and left knee over the past six months. Additionally, he has developed redness in his eyes. Bloodwork reveals normal levels of CRP, ANA, RF. What is the most likely diagnosis? 

Idiopathic juvenile arthritis- Oligoarthritis form

C

100

administering Adalimumab with this medication at the same time reduces the clearance of Adalimumab by 40%

methotrexate

200

co-administration of cyclosporine with cholchicine can increase cholchicine levels via the inhibition of what protein channel?

MDR

300

A 2 Yo female presents to the clinic with c/o worsening pain and swelling in the left knee. An aspirate of the knee showed a purulent fluid that revealed gram negative coccobacilli that formed a "pitting" pattern on blood agar plates. What is the most likely etiology? 

Kingella Kingae

400

A type of primary bone tumor that typically arises on the surface of facial bones. Histologically appears to be made of normal cortical bone

osteoma

500

Pannus formation, marginal erosions, periarticular osteopenia, synovial villi formation, and synovial hyperplasia with marked leukocytic infiltration are hallmark signs of which joint-affecting disorder? 

RA 

D

100

Name 3 non-pharmacological interventions that can be used to initially treat osteoarthritis

Weightloss, exercise, braces, OMM, ect.

200

A patient presents with edema of the lower limbs, hypernatremia, and elevated blood pressure. Bloodwork reveals exceptionally increased levels of ADH being secreted into his system. Which antibiotic, typically used to inhibit the 30s ribosomal subunit, could be used to treat his condition? 

demeclocycline

300

parotid gland swelling and dry eyes could be indicative of a certain type of autoimmune disorder. What are two auto-antibodies we can check for in the lab to diagnose this disorder? 

anti Ro-SSA, anti La-SSB (also can see increased in RAF and ANA)

400

While methotrexate can act to decrease lymphocytes through its inhibition of Dihydrofolate reductase, it predominately acts on the enzyme AICAR, which increases extracellular levels of this: 

Bonus: Co-administration of Methotrexate with this can reduce hepatoxicity 

Adenosine

Bonus: Folic acid supplementation

500

A patient is Dx'd with ankylosing spondylitis. What is the first line DMARD used for treatment? 

Sulfasalazine

E

100

A psychiatric facility employee was bitten by a patient. Which oxidase positive, gram negative coccobacilli should the patient be most worried about? 

Eikenella Corrodens 

200

Give the classic triad of signs for felty's syndrome

RA with high rheumatoid factor titers, splenomegaly, leukopenia

300

A 57 Yo male presents with R knee pain that has been worsening over the past 2 years. Associated stiffness and aching in the morning, which improves once he starts moving around. However, pain does worsen throughout the day, especially one days when he reports to work as a roofer. - fever, fatigue, weakness, rash. What is the most likely cause of his knee pain? 

osteoarthritis

400

A new patient presents to your clinic with c/o recurring joint pain occurring at increasing intervals over the past few months. Hx reveals that pt was diagnosed with gout by his old PCP, and was instructed to take indomethacin when he was having a flare-up. Pt states that he moved a few months ago and lost his medication, so he started using some other pain pills that he bought from Walgreens. Since then, his attacks have gotten worse and became more frequent. What NSAID did he likely start using that caused an increase in his attacks? 

aspirin. At low doses in increases retention of uric acid, thus making gout attacks more likely to occur. 

500

Azathioprine should not be co-administered with this anti-gout medication, as it may lead to severe bone marrow suppression

allopurinol