Rheumatology Flashcards
7 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning โ missed cards come back until you master them.
Read the first 7 Rheumatology flashcards as text
A 65-year-old woman presents with bilateral aching in her shoulders and hips, an ESR of 85 mm/hr, markedly elevated CRP, but no true synovitis on examination. What is the most likely diagnosis?
Answer: Polymyalgia rheumatica
Polymyalgia rheumatica typically presents in patients over 50 with bilateral proximal girdle pain, markedly elevated inflammatory markers, and no true synovitis.
A patient with polymyalgia rheumatica develops new-onset unilateral temporal headache, scalp tenderness, and jaw claudication. What is the most feared complication if giant cell arteritis is not promptly treated?
Answer: Irreversible blindness
Giant cell arteritis can cause ischemic optic neuropathy via involvement of the ophthalmic arteries, leading to irreversible blindness if high-dose corticosteroids are not started immediately.
Which antibody is characteristically associated with drug-induced lupus?
Answer: Anti-histone
Drug-induced lupus is characteristically associated with anti-histone antibodies; common culprits include hydralazine, procainamide, isoniazid, and minocycline.
A 40-year-old woman presents with proximal muscle weakness, heliotrope rash over the eyelids, and Gottron papules on her knuckles. Which laboratory finding most supports the diagnosis of dermatomyositis?
Answer: Elevated creatine kinase (CK)
Elevated creatine kinase (CK) is characteristic of inflammatory myopathies like dermatomyositis, reflecting ongoing muscle cell injury.
A patient with SLE, lupus anticoagulant, and anticardiolipin antibodies has a history of two miscarriages. What is the recommended anticoagulation strategy during her next pregnancy?
Answer: Low molecular weight heparin (LMWH) plus low-dose aspirin
In antiphospholipid syndrome with obstetric complications, low-dose aspirin plus LMWH throughout pregnancy is standard of care; warfarin is teratogenic in the first trimester.
What is the primary mechanism of action of colchicine in the treatment of acute gout?
Answer: Inhibition of neutrophil microtubule polymerization
Colchicine works by inhibiting microtubule polymerization in neutrophils, thereby impairing their migration and activation at sites of urate crystal deposition.
A 30-year-old man develops arthritis, urethritis, and conjunctivitis 2-4 weeks after a Salmonella gastroenteritis. What is the most likely diagnosis?
Answer: Reactive arthritis
Reactive arthritis presents with the classic triad of arthritis, urethritis, and conjunctivitis following a genitourinary or gastrointestinal infection.