Rheumatology and Orthopedics 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 Rheumatology and Orthopedics flashcards as text
A 25-year-old woman presents with recurrent miscarriages, livedo reticularis, and a prolonged aPTT that does not correct with mixing study. Which antibody panel should be ordered?
Answer: Anticardiolipin and anti-beta-2 glycoprotein I
Antiphospholipid syndrome presents with thrombosis and/or recurrent pregnancy loss with positive anticardiolipin or anti-beta-2 glycoprotein I antibodies and lupus anticoagulant.
A 68-year-old man develops acute monoarthritis of the knee with septic joint appearance. Arthrocentesis reveals positively birefringent, rhomboid-shaped crystals. What is the diagnosis?
Answer: Pseudogout (CPPD)
Pseudogout (calcium pyrophosphate deposition disease) is characterized by positively birefringent, rhomboid-shaped crystals, in contrast to the negatively birefringent needle-shaped crystals of gout.
A patient with RA on hydroxychloroquine for 5 years needs monitoring for which specific adverse effect?
Answer: Retinal toxicity
Hydroxychloroquine can cause irreversible retinal toxicity (bull's eye maculopathy), requiring annual ophthalmologic screening after 5 years of use.
A 55-year-old woman with RA develops a painful, hot knee joint while on methotrexate. What must be excluded before attributing the flare to RA?
Answer: Septic arthritis
Septic arthritis must be urgently excluded in any immunosuppressed patient with an acute hot joint, as it is a surgical emergency requiring prompt joint aspiration and culture.
A 35-year-old woman presents with bilateral knee pain and swelling, erythema nodosum on her shins, and bilateral hilar adenopathy on chest X-ray. Which rheumatologic diagnosis fits this picture?
Answer: Löfgren's syndrome (acute sarcoidosis)
Löfgren's syndrome is an acute form of sarcoidosis presenting with the triad of erythema nodosum, bilateral hilar adenopathy, and periarthritis, typically carrying a good prognosis.
A 70-year-old woman with known osteoporosis sustains a vertebral compression fracture. She is unable to tolerate bisphosphonates. Which agent builds new bone rather than preventing its resorption?
Answer: Teriparatide
Teriparatide (PTH 1-34) is an anabolic agent that stimulates osteoblast activity to build new bone, unlike antiresorptive agents which prevent bone breakdown.
A 50-year-old man with diffuse systemic sclerosis develops acute hypertensive crisis with creatinine rising from 1.0 to 3.5 mg/dL over days. What is the treatment of choice?
Answer: ACE inhibitors
Scleroderma renal crisis is treated with ACE inhibitors (preferably captopril), which have dramatically improved outcomes even in the setting of acute kidney injury.