Common Rheumatologic Disorders Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Common Rheumatologic Disorders flashcards as text
A 52-year-old woman presents with proximal muscle weakness, heliotrope rash, and Gottron's papules. CK is 4,500 U/L. Which malignancy screening is most important within the first year of diagnosis?
Answer: Ovarian cancer screening with CA-125 and transvaginal ultrasound
Dermatomyositis has the strongest cancer association, and ovarian cancer is one of the most commonly linked malignancies requiring active screening.
A patient with diffuse systemic sclerosis develops dyspnea and a dry cough. PFTs show a restrictive pattern with reduced DLCO. CT chest shows bilateral basilar ground-glass opacities and honeycombing. What is the first-line treatment?
Answer: Cyclophosphamide or mycophenolate mofetil
Interstitial lung disease in systemic sclerosis is treated with cyclophosphamide or mycophenolate mofetil as first-line immunosuppressive agents.
A 40-year-old woman with antiphospholipid syndrome has a second DVT despite therapeutic warfarin (INR 2.5). What is the recommended next step?
Answer: Increase warfarin target INR to 3.0-4.0
Patients with APS who have recurrent thrombosis despite standard anticoagulation should have the warfarin target INR raised to 3.0-4.0.
A 65-year-old man presents with symmetric proximal muscle pain and stiffness, elevated ESR of 95 mm/hr, and normal CK. He responds dramatically to prednisone 15mg/day within 48 hours. What is the most concerning complication to monitor for?
Answer: Giant cell arteritis with visual loss
Polymyalgia rheumatica is associated with giant cell (temporal) arteritis in 10-15% of cases, and vision loss from anterior ischemic optic neuropathy is a devastating complication.
A 28-year-old man presents with urethritis, asymmetric oligoarthritis, conjunctivitis, and oral ulcers 3 weeks after a chlamydial infection. What is the classic triad of reactive arthritis?
Answer: Urethritis, arthritis, and conjunctivitis
Reactive arthritis (formerly Reiter's syndrome) classically presents with the triad of urethritis, arthritis, and conjunctivitis following a triggering infection.
A patient with SLE is started on hydroxychloroquine. Which baseline test is mandatory before initiating therapy?
Answer: Ophthalmologic examination
Hydroxychloroquine can cause irreversible retinal toxicity, so a baseline ophthalmologic exam with retinal imaging is required before starting therapy.
A 70-year-old woman presents with acute wrist arthritis, chondrocalcinosis on X-ray, and positively birefringent rhomboid crystals in synovial fluid under polarized light. Which metabolic condition is most strongly associated with CPPD disease?
Answer: Hyperparathyroidism
Hyperparathyroidism causes hypercalcemia and hypophosphatemia, which predispose to calcium pyrophosphate crystal deposition (CPPD) disease.