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CM - Spondyloarthropathies

Total questions: 23

Worksheet time: 12mins

Name
Class
Date
1.

What is a chronic inflammatory disease affecting the SI joints and axial skeleton that manifests with pain and progressive stiffening of the spine?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

2.

What disorders are assocaited with the HLA-B27 gene?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

3.

35 yo male pt presents with gradual onset of back pain and stiffness that is worse in the mornings and improves with activity. The sx seem to progress proximally. PE reveals flattened lumbar curve, exaggerated thoracic curve, and limited chest expansion. Pt may also present with enthesopathy and anterior uveitis. All of the following are treatment options, but what is 1st line?

a)

TNF inhibitors (enteracept)

b)

Sulfasalazine (Azulfidine)

c)

NSAIDs

d)

PT

e)

Corticosteroids

4.

What is NOT a lab finding for ankylosing spondylitis?

a)

Elevated ESR/CRP

b)

RF & CCP positive

c)

X-ray w/ bamboo spine

d)

MRI with fusion vertebra at margins

e)

CBC with mild anemia

5.

What disease is inflammation of the joints precipitated by a gastrointestinal or genitourinary infection?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

6.

What disease is characterized by arthritis, conjunctivitis, and urethritis?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

7.

26 yo male pt presents with asymmetric arthritis in the large weight-bearing joints, fever, weight loss, mucocutaneous lesions, fingernail involvement, conjunctivitis, anterior uveitis, carditis, and aortic regurgitation. All of the following are treatments, but what is the mainstay?

a)

TNF inhibitors

b)

Sulfasalazine (Azulfidine)

c)

NSAIDs

d)

ABX

e)

Methotrexate

8.

What is NOT a possible diagnostic test/finding for reactive arthritis?

a)

HLA-B27

b)

Cultures

c)

X-ray

d)

MRI

e)

Bamboo spine

9.

What disease is associated with balanitis, stomatitis, or keratoderma blennorrhagicum?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

10.

What disease is arthritis associated with inflammatory bowel condition and is a diagnosis of exclusion?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

11.

Pt presents with nondeforming asymmetric peripheral arthritis (oligoarthritis of large joints). PE also reveals spondylitis. Pt reports episode of bowel disease a few months ago. What is NOT part of the diagnsis and treatment?

a)

Sulfasalazine (Azulfidine)

b)

ROM exercises/PT

c)

NSAIDs

d)

X-ray

e)

MRI

12.

What disease is described as inflammatory arthritis with the presence of psoriasis?

a)

Ankylosing spondylitis

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

13.

Pt presents with symmetric polyarthritis resembling RA (or oligoarticular), DIP joints primarily, pitting of nails, onycholysis, and arthritis mutilans. Can also be spondylitic form. Of note, pt has a history of psoriasis. What is NOT a possible part of the treatment?

a)

NSAIDs

b)

Methotrexate

c)

ABX

d)

TNF inhibitors

e)

Corticosteroids

14.

Pt presents with symmetric polyarthritis resembling RA (or oligoarticular), DIP joints primarily, pitting of nails, onycholysis, and arthritis mutilans. Can also be spondylitic form. Of note, pt has a history of psoriasis. What is NOT a possible part of the treatment?

a)

Combo therapy

b)

PUVA therapy

c)

Cognitive behavioral therapy

d)

Apremilast (Otezla)

e)

Ustekinumab (Stelara)

15.

What is NOT a possible diagnostic test/finding for psoriatic arthritis?

a)

Elevated ESR

b)

US

c)

X-ray

d)

MRI

e)

RF positive

16.

What disease probably results from low-grade axial synovitis and bursitis, shows preference for the same HLA haplotypes as temporal arteritis, and has cytokines in blood/arteries?

a)

Polymyalgia rheumatica

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

e)

Fibromyalgia

17.

60 yo pr presents with should and hip pain/stiffness that has lasted several weeks. Pt also has fever, malaise, and weight loss. Pt denies muscle weakness. What is NOT part of the diagnosis and treatment?

a)

Decreased ESR/CRP

b)

CBC with anemia

c)

Benign x-ray

d)

Prednisone

e)

Methotrexate

18.

What disease is associated with giant cell (temporal) arteritis?

a)

Polymyalgia rheumatica

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

e)

Fibromyalgia

19.

What disease is a chronic pain syndrome that is characterized by widespread body pain for at least 3 months and tenderness of at least 11 or 18 designated tender point sites? It is a diagnsis of exclusion. Patho is possibly abnormal perception of pain stimuli, sleep disorders, depression, and viral infections.

a)

Polymyalgia rheumatica

b)

Reactive arthritis

c)

Enteropathic arthritis

d)

Psoriatic arthritis

e)

Fibromyalgia

20.

60 yo female pt with PMH significant for depression and hypothyroidism presents with chronic widespread pain, tender points, fatigue, sleep disturbances, depression/anxiety, cognitive dysfunction, chronic headaches, subjective numbness/tingling, stiffness, and fluid retention. Of note, her mother had similar sx throughout her life. What is NOT a possible treatment?

a)

Narcotics

b)

PT

c)

CBT

d)

Cyclobenzaprine

e)

Fluoxetine, Duloxetine

21.

60 yo female pt with PMH significant for depression and hypothyroidism presents with chronic widespread pain, tender points, fatigue, sleep disturbances, depression/anxiety, cognitive dysfunction, chronic headaches, subjective numbness/tingling, stiffness, and fluid retention. Of note, her mother had similar sx throughout her life. What is NOT a possible treatment?

a)

Pregabalin

b)

Gabapentin

c)

Acetaminophen

d)

Tramadol

e)

Narcotics

22.

What is NOT a lab that should be done for fibromyalgia work up?

a)

ESR/CRP

b)

Thyroid function tests

c)

Rheumatoid factor

d)

Vitamin B12

e)

CCP

23.

What is NOT a lab that should be done for fibromyalgia work up?

a)

Vitamin D 25-OH

b)

Aldolase

c)

CK

d)

AST

e)

ANA