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PHYA520-Rheum-CO2027

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

What word would you use to describe your experience with orthopedics so far?

2 lines
2.

Which of the following is a modifiable risk factor for gout?

a)

Ethnicity

b)

Age

c)

Hypertension

d)

Sex

e)

Coronary Artery Disease

3.

Write T or F for True or False below.

A 42 yo male presents to PCP office. Gout suspected in the big toe x 12 hr. No hx arthritis. Joint red. No hx HTN. Is it true or false that gout can be diagnosed clinically in this patient? Write T or F in the space below

(a)  

4.

Write T or F forTrue or False below.

Synovial fluid is consistent with CPPD.

(a)  

5.

A 40 yo presents with CPPD. What is an etiology that should be tested for?

a)

Hyperphosphatasia

b)

Hypoparathyroidism

c)

Hypokalemia

d)

Hypernatremia

e)

Hypomagnesemia

6.

GCA is suspected in a patient who has no reported vision loss. Biopsy of temporal artery was done first and was negative. CDUS was then done and was also negative. However GCA is still suspected. What is next best step?

a)

FDG-PET aorta

b)

Contralateral Temporal Artery Biopsy

c)

Repeat CDUS

d)

MRI Aorta

e)

Referral to ophthalmology

7.

GCA is suspected in a patient. There is no vision loss, stroke, or diplopia. Oral prednisone is started. Which of the following would be a common duration for treatment with prednisone?

a)

2 weeks

b)

lifetime

c)

1 month

d)

9 months

e)

3 months

8.

What is one of the diagnostic elements for inflammatory back pain (IBP)?

a)

Onset <45 yo

b)

Pain worse in early morning

c)

Improves with exercise

d)

Sudden Onset

e)

Duration >6 months

9.

A patient presents with IBP. X-ray of the SI joints is negative. NSAID trial ineffective. On exam they have enthesitis. No dactylitis noted. Eye exam unremarkable. On labs the CRP is elevated. What is the next best step?

a)

Order HLA-B27

b)

Start adalimumab

c)

Order MRI SI joints

d)

Order X-ray spine

e)

Start physical therapy

10.

A patient is being evaluated by a rheumatologist. They have been diagnosed with reactive arthritis. They have had symptoms for 8 months. What is the preferred treatment?

a)

Ibuprofen

b)

Prednisone

c)

Infliximab

d)

Naproxen

e)

Sulfasalazine

11.

A 35-year-old male with reactive arthritis presents for routine follow-up 6 months after diagnosis. He initially responded well to high-dose NSAIDs but has had persistent joint pain and swelling for the past 3 months despite maximum NSAID therapy. He reports significant morning stiffness lasting 3 hours and functional impairment. Physical examination shows ongoing synovitis in multiple joints and enthesitis. His HLA-B27 status is positive. He asks about his long-term outlook. How should the patient be counseled on the typical prognosis for reactive arthritis?

a)

All patients develop chronic arthritis requiring lifelong immunosuppression

b)

In at least half of patients, all symptoms resolve in less than six months; in most patients, symptoms resolve within one year

c)

HLA-B27 positive patients always progress to ankylosing spondylitis

d)

Symptoms will definitely recur every 2-3 years regardless of treatment

e)

Complete recovery is impossible once symptoms persist beyond 3 months

12.

Write T or F for True or False below.

A patient presents to a rheumatologist. They present with a swollen painful knee joint that is consistent with an inflammatory arthritis. They have a first cousin with psoriasis. On exam there is nail pitting noted. No rash consistent with psoriasis is seen. Labs show negative RF. This patient meets CASPAR criteria for diagnosis of Psoriatic Arthritis. Write T or F in the space below.

(a)  

13.

A patient has peripheral psoriatic arthritis that is mild in severity. What would be a first line medication treatment?

a)

methotrexate

b)

infliximab

c)

naproxen

d)

IL-17 inhibitor

e)

abatacept

14.

A patient has Arthritis of IBD. They have arthritis in knees and SI joints. Ibuprofen and indomethacin are ineffective. Their IBD is stable. What is the next best step in management?

a)

sulfasalazine

b)

infliximab

c)

ustekinumab

d)

etanercept

e)

methotrexate

15.

What is the most common form of arthritis associated with enteropathic arthritis?

a)

Type 1 peripheral

b)

Type 2 peripheral

c)

Arthritis mutilans

d)

Axial

e)

Symmetric polyarthritis