ABIM RHEUMATOLOGY QUESTIONS AND VERIFIED ANSWERS The most appropriate and cost-effective means of assessing the cause of acute monoarthritis - Aspiration and analysis of the synovial fluid for leukocytes, Gram stain with culture, and crystals.
Ocular manifestations of systemic rheumatologic dx - #Rheumatoid arthritis - episcleritis and scleritis #Spondyloarthritis and sarcoidosis - uveitis and vasculitis
#Sjögren syndrome - Dry eyes ( kerato-conjunctivitis sicca)
Noninflammatory conditions causing elevations in ESR - Kidney disease, DM, pregnancy, and obesity
Rheumatoid factor - Immunoglobulin directed against the Fc portion of IgG
Most specific antibodies characteristic of RA - Anti-cyclic citrullinated peptide
Synovial fluid leukocyte counts most often seen in infectious arthritis - > 50,000/µL (50 × 109/L)
Prophylactic therapy for patients on chronic glucocorticoid therapy - Calcium and vitamin D supplementation ABIM RHEUMATOLOGY QUESTIONS AND VERIFIED ANSWERS SE of Methrothrexate - -Hepatitis =Bone marrow suppression (leukopenia, anemia). Patients with liver disease should not receive methotrexate, and limitation of alcohol intake is strongly advised.
Treatment of ankylosing spondylitis - First line - NSAIDs
2nd line (if above fails) - TNF-α inhibitors
Characteristic radiologic findings of RA - - Periarticular osteopenia and - Marginal (near the edges of the joint) erosions *Erosive changes may not be evident early in dx
Most common cardiac manifestation of RA - Pericarditis , often asymptomatic.
Bony enlargement of a DIP joint in OA - Heberden node
Bony enlargement of a PIP joint in OA - Bouchard node. ABIM RHEUMATOLOGY QUESTIONS AND VERIFIED ANSWERS Radiographic Hallmarks of OA - - Joint-space narrowing (articular cartilage loss)
- Osteophytes formation
- Sclerosis of subchondral bone, - Subchondral cysts
- Lack of periarticular osteopenia
Presence of flowing osteophytes involving the anterolateral aspect of the thoracic spine at 4 or more contiguous vertebrae with preservation of the intervertebral disk space and the absence of apophyseal joint or sacroiliac inflammatory changes
- Diffuse idiopathic skeletal hyperostosis (DISH)
Pharmacological Rx of OA - Acetaminophen - First line
NSAID
SSRI - Duloxetine
Intra-articular glucocorticoid
Intra-articular hyaluronic acid - not effective
Arthroplasty
Ocular manifestations of systemic rheumatologic dx - #Rheumatoid arthritis - episcleritis and scleritis #Spondyloarthritis and sarcoidosis - uveitis and vasculitis
#Sjögren syndrome - Dry eyes ( kerato-conjunctivitis sicca)
Noninflammatory conditions causing elevations in ESR - Kidney disease, DM, pregnancy, and obesity
Rheumatoid factor - Immunoglobulin directed against the Fc portion of IgG
Most specific antibodies characteristic of RA - Anti-cyclic citrullinated peptide
Synovial fluid leukocyte counts most often seen in infectious arthritis - > 50,000/µL (50 × 109/L)
Prophylactic therapy for patients on chronic glucocorticoid therapy - Calcium and vitamin D supplementation ABIM RHEUMATOLOGY QUESTIONS AND VERIFIED ANSWERS SE of Methrothrexate - -Hepatitis =Bone marrow suppression (leukopenia, anemia). Patients with liver disease should not receive methotrexate, and limitation of alcohol intake is strongly advised.
Treatment of ankylosing spondylitis - First line - NSAIDs
2nd line (if above fails) - TNF-α inhibitors
Characteristic radiologic findings of RA - - Periarticular osteopenia and - Marginal (near the edges of the joint) erosions *Erosive changes may not be evident early in dx
Most common cardiac manifestation of RA - Pericarditis , often asymptomatic.
Bony enlargement of a DIP joint in OA - Heberden node
Bony enlargement of a PIP joint in OA - Bouchard node. ABIM RHEUMATOLOGY QUESTIONS AND VERIFIED ANSWERS Radiographic Hallmarks of OA - - Joint-space narrowing (articular cartilage loss)
- Osteophytes formation
- Sclerosis of subchondral bone, - Subchondral cysts
- Lack of periarticular osteopenia
Presence of flowing osteophytes involving the anterolateral aspect of the thoracic spine at 4 or more contiguous vertebrae with preservation of the intervertebral disk space and the absence of apophyseal joint or sacroiliac inflammatory changes
- Diffuse idiopathic skeletal hyperostosis (DISH)
Pharmacological Rx of OA - Acetaminophen - First line
NSAID
SSRI - Duloxetine
Intra-articular glucocorticoid
Intra-articular hyaluronic acid - not effective
Arthroplasty
