Font size
S
M
L
XL
WorksheetsRheum exam 1 part 2
Total questions: 73
Worksheet time: 38mins
Name
Class
Date
1.
Which stereotype is matched with its common dx?
a)
tennis players--> Lateral epicondylitis
b)
Runners --> infrapatellar bursitis
c)
Golfers --> subacromial bursitis
d)
Baseball pitchers --> Subacromial bursitis
e)
Runners --> trochanteric bursitis
2.
_____ are flattened, synovial lined sacs that serve as a protective buffer and are filled w/ small amounts of fluid to facilitate movement during muscle contraction, can be SF or deep
a)
tendons
b)
bursae
c)
joints
d)
enthesis
3.
Cortisone shots can be given in the tendon sheath or bursa but not the tendon itself
a)
true
b)
false
4.
25 y/o F pt presents w/ ear clicking, HA, bruxism, and a dull ache in the temporal & masseter muscles. What x ray view would you like to order?
a)
odontoid
b)
open mouth
c)
panorex
d)
cervical
5.
34 y/o patient presents with TMJ, during the PE you find crepitus over the joint, unilateral facial swelling, and tenderness to palpation. Which of the following are mainstays of tx?
a)
NSAIDs
b)
cortisone injections
c)
benzodiazepines
d)
opioids
6.
Pt is a 34 y/o F, who is 34 weeks pregnant and works as a secretary at a busy law firm. She presents with numbness in her fingers and decreased hand strength. Which nerve is affected and what is a good tx option?
a)
radial nerve - surgical release
b)
ulnar nerve - tylenol
c)
median nerve - splinting at night & NSAIDs
d)
musculocutaneous nerve - cortisone injection
7.
Which of the following are affected in thoracic outlet syndrome?
a)
brachial plexus
b)
carotid artery
c)
subclavian vein
d)
subclavian artery
e)
carotid vein
8.
You have just performed the adson maneuver, wright test, and roos stress test on your patient and they all came back positive. What is the most likely diagnosis?
a)
carpal tunnel syndrome
b)
Costochondritis
c)
Reflex sympathetic dystrophy
d)
Thoracic outlet syndrome
9.
Pt presents w/ chest pain after recently recovered from a URI last week. Her pain is exacerbated by deep breathing and she describes it as sharp and localized. Palpation over ribs 2-5 causes pain and you notice swelling around the area. Diagnosis and tx?
a)
costochondritis - steroids
b)
tietze's - NSAIDs
10.
Pt presents w/ reflex sympathetic dystrophy d/t partial nerve injury. What type is this?
a)
RSD type 1
b)
RSD type 2
11.
9 y/o girl presents to ED after having minor surgery several weeks ago and now has burning pain, allodynia, edema, and a cold blue dusky lower extremity. what would radiographic findings show? (2)
a)
erosions
b)
osteopenia
c)
soft tissue swelling
d)
joint space narrowing
12.
Which of the following are possible treatments for RSD?
a)
physical therapy
b)
surgical ablation/sympathectomy
c)
anti depressants
d)
anti convulsants
e)
analgesics
13.
what are some ocular manifestations for RA?
a)
Keratoconjunctivitis sicca
b)
Episcleritis
c)
Uveitis
d)
Scleritis
e)
Scleromalacia perforans
14.
40 y/o F presents with symmetrical joint pain in her PIPs, knees, wrists, and elbows. She is complaining of some chest discomfort with SOB. What do you expect to see on chest X-ray d/t the extra-articular manifestations of her dz and what is this syndrome called?
a)
Pulmonary nodules; caplan’s syndrome
b)
bronchiectasis, caplan’s syndrome
c)
Pulmonary nodules, cystic fibrosis
d)
bronchiectasis, cystic fibrosis
15.
Pt started on a biologic for RA. What diseases/infections are they at increased risk for?
a)
TB
b)
Lymphoma and melanoma
c)
Drug induced ANA
d)
Drug induced lupus
16.
T/F: The GI and renal systems are commonly affected by RA alone
a)
True, what a terrible dz
b)
False, this is bc of the meds they use
17.
14 y/o female dx with arthritis. Which one is most likely?
a)
Juvenile Idiopathic arthritis
b)
Osteoarthritis
c)
Rheumatoid arthritis
d)
Psoriatic arthritis
18.
Which subtype of JIA involves constitutional symptoms?
a)
Systemic
b)
Polyarticular RF +
c)
Oligoarticular
d)
Psoriatic
19.
40 y/o F presents with symmetrical joint pain in her PIP, wrists, elbows, knees, and C1 &C2. Morning stiffness for 2 hours every morning for the past 8 months. What is the first line tx?
a)
Methotrexate
b)
Leflunomide
c)
Cyclosporine
d)
Sulfasalazine
20.
Which subtype of JIA is found in males >6, HLAB27 +, FHx of enthesopathy and has SI joint tenderness and uveitis.
a)
Enthesitis-related
b)
Psoriatic
c)
Undifferentiated
d)
Polyarticular RF -
21.
Which subtype of JIA is common in girls and is ANA + causing uveitis?
a)
Oligoarticular
b)
Psoriatic
c)
Enthesitis - related
d)
Undifferentiated
22.
66 y/o obese female presents with the gelling phenomenon and morning stiffness for 30 minutes for the past 5 months. The joints involved are asymmetric and includes the DIP joints, hips, and knees. The wrist, elbow, and shoulder are spared. Dx?
a)
Rheumatoid arthritis
b)
Osteoarthritis
c)
Psoriatic arthritis
d)
Septic joint
23.
What is the target for osteoarthritis?
a)
Synovial membrane
b)
Cartilage
c)
Enthesis
d)
Bursa
24.
which is more common in OA?
a)
Varus
b)
Valgus
25.
Involves C5-C7, lumbar spine, hips, knees, 1st CMC joint, PIP, and DIP joints. OA or RA?
a)
OA
b)
RA
26.
X-ray findings with diffuse idiopathic skeletal hyperostosis (DISH) in OA patients.
a)
Syndesmophytes and normal disc height
b)
Syndemophytes with flattened discs
c)
Pencil in cup deformity
d)
Salt and pepper bone
27.
Which is matched correctly?
a)
Heberden’s nodes = DIP
b)
Heberden’s nodes = PIP
c)
Bouchard’s nodes = PIP
d)
Bouchard’s nodes = DIP
28.
54 y/o obese male with OA. Recently dx with DISH on spinal X-ray. What labs should be checked next?
a)
CBC
b)
CMP
c)
lipid profile
d)
HbA1c
29.
Which is NOT an indicated treatment for pseudogout?
a)
NSAIDs
b)
DMARDs
c)
Steroids
d)
Colchicine
30.
Which medications are used to treat Paget's Disease because they can regulate bone building and resoprtion?
a)
Bisphosphonates
b)
TNF-a inhibitors
c)
Biologics
d)
PTH (1-34) Teriparatide
31.
Which bisphosphonate can be taken as an injection once yearly, instead of daily over the course of some months?
a)
Alendronate (Fosamax) or etidronate (Didronel)
b)
Tiludronate (Skelid)
c)
Risedronate (Actonel)
d)
Zoledronic acid (Reclast)
32.
T/F: OA treatment should always involve systemic steroids.
a)
true
b)
false
33.
Sex hormones can improve RA.
a)
true
b)
false
34.
The _ is the primary target in RA from excess _. Over the course of the disease, a __ forms.
a)
synovium; TNF alpha; pannus
b)
cartilage; wear and tear; bone spur
c)
bursa; activity; fluid filled cyst
d)
cortex; osteoblast and osteoclast activity; salt and pepper pattern
35.
Which of the following are the correct new criteria for diagnosing RA? (2)
a)
Arthritis in 3 or more joints with greater than 1 hour of morning stiffness.
b)
Pts who have at least one large joint or 2-10 joints with definite synovitis
c)
+Anti-CCP
d)
+RF only
36.
Pt has a swollen knee joint and warm, swollen MCP joints. Xrays show bony erosions. The pt also has a hallux valgus deformity. What disease typically presents like this?
a)
RA
b)
OA
c)
Paget's Disease
d)
Osteoporosis
37.
Which disease is this?
a)
RA
b)
OA
c)
Gout
d)
Psoriatc arthritis
38.
Which joints are typically involved in RA?
a)
DIP
b)
PIP
c)
MCP
d)
C1-C2
e)
C5-C7
39.
Which of the following correctly describes a Swann Neck deformity, characteristic of RA?
a)
Hyperextension of the PIP with hyperflexion of the DIP
b)
Hyperflexion of the PIP with hyperextension of the DIP
c)
Hyperextension of the PIP with hyperextension of the DIP
d)
hyperflexion of the PIP with hyperflexion of the DIP
40.
What is the wink sign?
a)
Subluxation of the atlanto-axial region of the spine
b)
When your anus winks at you ;)
c)
Subluxation of L2-L4 in OA
d)
Rat bite necrosis
41.
What is this image showing and which disease?
a)
OA; acetabulo protrusio
b)
RA; acetabulo protrusio
c)
RA; degeneration of the superior portion of the joint
d)
OA; degeneration of the superior portion of the joint
42.
What is the MOST important thing in septic arthritis?
a)
Start whatever antibiotic you want ASAP
b)
FIND THE PORTAL OF ENTRY!!!
c)
STI testing
d)
Refer to ortho!
43.
Which of the following are manifestations of RA?
a)
Hammer toe deformity
b)
Splaying of the forefoot
c)
Popliteal cyst
d)
Knee effusion
e)
Subtalar joint involvement
44.
Which of the following has the best prognosis?
a)
Gonococcal bacterial arthritis
b)
Staph aureus bacterial arthritis
c)
Beta hemolytic streptococcal bacterial arthritis
d)
Gram-negative bacterial arthritis
45.
What is the classic triad of disseminated gonococal infection?
a)
Dermatitis
b)
Migratory polyarthritis
c)
Hepatitis
d)
Tenosynovitis
46.
What is the treatment for disseminated gonoccocal infection?
a)
Vancomycin
b)
Azithromycin
c)
Doxycycline
d)
Ceftriaxone
47.
Risk factors for Osteoporotic Fx's:
a)
Caucasian or Asian
b)
Hx of low trauma Fx in 1st degree relative
c)
use of corticosteroid therapy >3 months
d)
advancing age
e)
alcoholic consumption >2 drinks/day
48.
You have a patient with non-gonoccocal arthritis, and is an IVDA, what bacteria do you suspect? (Most common)
a)
Strep pyogenes
b)
Serratia
c)
H. Flu
d)
Staph aureus
49.
Fracture risk w/aging. Which are true?
a)
Vertebrae: highest incidence & ↑ as we age
b)
Hip fx uncommon until about age 70
c)
Sites w/↑ trabecular bone incur ↑ losses d/t greater metabolic activity
d)
Colles Fx have lower incidence of fx
50.
Osteoporosis risk factors for men include:
a)
Undiagnosed low testosterone
b)
Alcohol consumption
c)
smoking
d)
Intestinal disorders
e)
Hyperparathyroidism
51.
Medical conditions that may increase risk for Osteoporosis.
a)
Insulin dependent DM
b)
Eating disorders
c)
Rheumatoid arthritis
d)
IBD
52.
What are the most common viruses that cause viral arthritis?
a)
CMV
b)
Human parvovirus B-19
c)
Hepatitis B & C
d)
HIV
53.
Medications assoc w/reduced bone mass in adults include:
a)
Glucocorticoids
b)
Anticonvulsants (phenobarb, phenytoin)
c)
Blood thinners (warfarin, coumadin)
d)
Depo-provera
e)
Thyroid suppression
54.
Which fx are the most serious consequence of osteoporosis?
a)
Hip fx
b)
Tibial fx
c)
Femoral diaphysis fx
d)
Radial fx
55.
Which stages of Lyme disease is matched INCORRECTLY
a)
Early- Bell's Palsy
b)
Acute disseminated infection- meningoencephalitis
c)
Late- arthritis
56.
What is the GOLD STANDARD for the Dx of Osteoporosis?
a)
BMD
b)
VFA
c)
FRAX
d)
Bone turnover markers
57.
You went hiking, and you find a non engorged tick on your leg, what should you do?
a)
Ignore it, it will fall off on its own. (Ignorance is bliss)
b)
Squish that sucker! Make it suffer!
c)
Carefully remove the tick without squeezing the belly
d)
Set yourself on fire
58.
T-score: >-1 SD
a)
Normal BMD
b)
Osteopenia
c)
Osteoporosis
d)
Severe osteoporosis
59.
T-score: -2.5 SD or lower
a)
Normal BMD
b)
Ostopenia
c)
Osteoporosis
d)
Severe osteoporosis
60.
T-score: -2.5 SD and/or Fx's
a)
Normal BMD
b)
Osteopenia
c)
Osteoporosis
d)
Severe osteoporosis
61.
Who should have a BMD test?
a)
All women >65 yr
b)
Presence of fragility fx
c)
loss of height
d)
All men >70 yrs
62.
T/F: Calcitriol is the biologically active form of Vit D
a)
true
b)
false
63.
Which is matched correctly?
a)
Anti-resorptive: kills osteoclasts
b)
Anti-resorptive: potentiates osteoblasts
c)
Anabolic: kills osteoclasts
d)
Anabolic: potentiates osteoblasts
64.
What is the 1st line FDA approved pharmacologic options for osteoporosis?
a)
Bisphosphonates
b)
Calcitonin
c)
SERMs
d)
Denosumab
65.
Pt has a swollen, painful joint. Needle aspiration shows negatively birefringent needle-shaped crystals. Dx?
a)
Gout
b)
Pseudogout
c)
Hypercalcemia
d)
Osteoarthritis
66.
T/F: Gout is typically caused by overproduction of uric acid rather than undersecretion.
a)
true
b)
false
67.
4 yo patient presents with self-mutilation (biting lips/fingers), and neurological and behavioral dysfunction. Labs show hyperuricemia. What is the diagnosis and patient's prognosis?
a)
Lesch-Nyhan Syndrome; good prognosis
b)
Lesch-Nyhan Syndrome; bad prognosis
c)
Gout; good prognosis
d)
Gout; bad prognosis
68.
Most patients typically fall into which stage of gout?
a)
Asymptomatic hyperuricemia
b)
Acute intermittent gout
c)
Chronic tophaceous gout
69.
What is the target serum uric acid level for acute gouty flares?
a)
< 6 mg/dL
b)
<5 mg/dL
c)
<7 mg/dL
d)
<8 mg/dL
70.
When initiating a patient on allopurinol, it is inappropriate to bridge therapy with colchicine or NSAIDS.
a)
true
b)
false
71.
Which of the following is incorrect about CPPD?
a)
Causes acute inflammatory arthritis
b)
Accumulation of crystals of calcium pyrophosphate dihydrate
c)
Crystals are positively birefringement rhomboid-shaped crystals
d)
Causes chondrocalicinosis on X-ray
72.
Which disease can be likely found at the 2nd & 3rd MCPs?
a)
CPPD
b)
Pseudogout
c)
Gout
d)
OA
73.
Which of the following medications for gout is given as an infusion and used for chronic tophaceous and/or refractory gout?
a)
Pegloticase (Krystexxa or Savient)
b)
Lesinurad (Zurampic)
c)
Allopurinol
d)
Febuxostat
Reset
