ABIM RHEUMATOLOGY Exam 76 Questions with Verified
Answers
The most appropriate and cost-effective means of assessing the cause of acute
monoarthritis - CORRECT ANSWER Aspiration and analysis of the synovial fluid for
leukocytes, Gram stain with culture, and crystals.
Ocular manifestations of systemic rheumatologic dx - CORRECT ANSWER
#Rheumatoid arthritis - episcleritis and scleritis #Spondyloarthritis and sarcoidosis
- uveitis and vasculitis
#Sjögren syndrome - Dry eyes ( kerato-conjunctivitis sicca)
Noninflammatory conditions causing elevations in ESR - CORRECT ANSWER Kidney
disease, DM, pregnancy, and obesity
Rheumatoid factor - CORRECT ANSWER Immunoglobulin directed against the Fc
portion of IgG
Most specific antibodies characteristic of RA - CORRECT ANSWER Anti-cyclic
citrullinated peptide
Synovial fluid leukocyte counts most often seen in infectious arthritis - CORRECT
ANSWER > 50,000/µL (50 × 109/L)
Prophylactic therapy for patients on chronic glucocorticoid therapy - CORRECT
ANSWER Calcium and vitamin D supplementation
SE of Methrothrexate - CORRECT ANSWER -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 - CORRECT ANSWER First line - NSAIDs
2nd line (if above fails) - TNF-α inhibitors
, Characteristic radiologic findings of RA - CORRECT ANSWER - 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 - CORRECT ANSWER Pericarditis , often
asymptomatic.
Bony enlargement of a DIP joint in OA - CORRECT ANSWER Heberden node
Bony enlargement of a PIP joint in OA - CORRECT ANSWER Bouchard node.
Radiographic Hallmarks of OA - CORRECT ANSWER - 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
- CORRECT ANSWER Diffuse idiopathic skeletal hyperostosis (DISH)
Pharmacological Rx of OA - CORRECT ANSWER Acetaminophen - First line
NSAID
SSRI - Duloxetine
Intra-articular glucocorticoid
Intra-articular hyaluronic acid - not effective
Arthroplasty
Mainstay of fibromyalgia treatment - CORRECT ANSWER Nonpharmacologic
therapy, including regular aerobic exercise
FDA approved meds for fibromyalgia. - CORRECT ANSWER Pregabalin, duloxetine,
and milnacipran
Answers
The most appropriate and cost-effective means of assessing the cause of acute
monoarthritis - CORRECT ANSWER Aspiration and analysis of the synovial fluid for
leukocytes, Gram stain with culture, and crystals.
Ocular manifestations of systemic rheumatologic dx - CORRECT ANSWER
#Rheumatoid arthritis - episcleritis and scleritis #Spondyloarthritis and sarcoidosis
- uveitis and vasculitis
#Sjögren syndrome - Dry eyes ( kerato-conjunctivitis sicca)
Noninflammatory conditions causing elevations in ESR - CORRECT ANSWER Kidney
disease, DM, pregnancy, and obesity
Rheumatoid factor - CORRECT ANSWER Immunoglobulin directed against the Fc
portion of IgG
Most specific antibodies characteristic of RA - CORRECT ANSWER Anti-cyclic
citrullinated peptide
Synovial fluid leukocyte counts most often seen in infectious arthritis - CORRECT
ANSWER > 50,000/µL (50 × 109/L)
Prophylactic therapy for patients on chronic glucocorticoid therapy - CORRECT
ANSWER Calcium and vitamin D supplementation
SE of Methrothrexate - CORRECT ANSWER -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 - CORRECT ANSWER First line - NSAIDs
2nd line (if above fails) - TNF-α inhibitors
, Characteristic radiologic findings of RA - CORRECT ANSWER - 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 - CORRECT ANSWER Pericarditis , often
asymptomatic.
Bony enlargement of a DIP joint in OA - CORRECT ANSWER Heberden node
Bony enlargement of a PIP joint in OA - CORRECT ANSWER Bouchard node.
Radiographic Hallmarks of OA - CORRECT ANSWER - 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
- CORRECT ANSWER Diffuse idiopathic skeletal hyperostosis (DISH)
Pharmacological Rx of OA - CORRECT ANSWER Acetaminophen - First line
NSAID
SSRI - Duloxetine
Intra-articular glucocorticoid
Intra-articular hyaluronic acid - not effective
Arthroplasty
Mainstay of fibromyalgia treatment - CORRECT ANSWER Nonpharmacologic
therapy, including regular aerobic exercise
FDA approved meds for fibromyalgia. - CORRECT ANSWER Pregabalin, duloxetine,
and milnacipran
