CMN 574 EXAM 1 STUDY GUIDE 2025/2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS
<LATEST VERSION>
1. MSK chest pain - ANSWER ✓ - Most common cause
- Muscle strain / costochondritis
- Broken rib
- Herpes zoster
- Fibromyalgia, SSC
- Chest wall contusion
- Protracted vomiting
2. -Young active pt - sports w/lifting
3. MSK chest pain RF - ANSWER ✓ - Trauma
- Overuse
- Hx chicken pox
4. MSK chest pain S/S - ANSWER ✓ - Gradual onset of sharp-dull
- More localized [can point with finger]
- Arm movement / deep inspiration [reproducible]
5. MSK chest pain DX - ANSWER ✓ No tests unless trauma = XR
6. MSK chest pain TX - ANSWER ✓ - Rest
- NSAIDs
- Ice/Heat
7. GI chest pain - ANSWER ✓ - 2nd common cause
- GERD
- Esophagitis / spasm
- PUD
- Hiatal hernia
, - Gallbladder
8. GI chest pain RF - ANSWER ✓ Hx of ulcers, smoking, ETOH,
NSAIDS/ASA (ask about OTC meds)
9. GI chest pain S/S - ANSWER ✓ - Recurrent [min-hr] of substernal burning
pain
- Esophageal spasm = squeezing/pressure
- PUD = epigastric to back (worse with meals / supine)
- Pain with palpation [epigastrium]
10.GI chest pain DX - ANSWER ✓ - Test for h.pylori
- EGD
11.GI chest pain TX - ANSWER ✓ - PPIs
- ABX [h. pylori]
- Diet
- Elevate HOB
12.Pysch chest pain - ANSWER ✓ - 3rd common cause
- Stress-related
- Panic attack
- Somatization
- Aggravates GERD ,asthma, angina
13.Pysch chest pain RF - ANSWER ✓ - Stress
- Hx of panic disorder or depression
14.Pysch chest pain S/S - ANSWER ✓ - Panic disorder = precordial CP
- Depression = constant/inter heaviness unrelated to meals / activity
(sudden or gradual)
- Anxiety, dyspnea, hyperventilation, tingling/numbness ext, dizziness
15.Pysch chest pain DX screening - ANSWER ✓ - 2 questions
- Last 6 mo: spell or attack of feeling anxious + heart racing felt faint
- Yes to either = psych
- No to both = panic d/o unlikely
,16.Resp chest pain causes - ANSWER ✓ - Bronchitis
- Pneumonia
- Asthma
- COPD
- Pleurisy
- PE
17.The most SPECIFIC lab for rheumatoid arthritis is? - ANSWER ✓ anti-CCP
antibodies
18.Rheumatoid factor maybe misleading b/c it can also be positive in what
conditions? - ANSWER ✓ syphilis, Hep C, TB, subacute endocarditis, or
elderly
19.Labs in Early RA disease may only have what percent sensitivity? -
ANSWER ✓ 50%
20.Which joints are affected the most in RA? - ANSWER ✓ PIP, MCP, wrists,
ankle, knee, MTP
21.RA can also affect what other systems besides the joints? - ANSWER ✓
ocular, cardiac, pulmonary, small vessels, subcut tissues(nodules)
22.Osteoarthritis spares which joints? - ANSWER ✓ wrist & MCP
23.Symmetric AM stiffness is associated with what? - ANSWER ✓ RA
24.T or F: OA/DJD shows less signs of articular inflammation - ANSWER ✓
True
25.A syndrome consisting of RA, neutropenia, & splenomegaly - ANSWER ✓
"Felty syndrome"
26.FACT: Early Gout will be monoarticular + urate crystals in the synovial
fluid - ANSWER ✓ Later, it may involve multiple joints
27.1st line Tx for RA? - ANSWER ✓ DMARDS
, 28.DMARD of choice for RA is? - ANSWER ✓ Methotrexate
29.Absolute contraindications for Methotrexate therapy? - ANSWER ✓ Any
chronic hepatitis
30.What should be Rx with Methotrexate to prevent gastric irritation,
stomatitis, cytopenias, and hepatotoxicity? - ANSWER ✓ Folate daily 1mg
OR weekly leucovorin calcium (24hrs after meth dose)
31.Most frequent SE of Methotrexate is? - ANSWER ✓ gastric irritation and
stomatitis
32.What should be avoided in those on methotrexate therapy? - ANSWER ✓
Alcohol & Probenecid, and other folate antagonist drugs (i.e. TMP-SMX)
33.Methotrexate increases the risk of which cancers? - ANSWER ✓ B cell
lymphomas
34.Give DMARDS how long to take effect? - ANSWER ✓ 2-6 weeks
35.NSAIDS can provide symptomatic relief for RA pain, but what should also
be Rx with them? - ANSWER ✓ PPI for stomach protection
36.T or F: all NSAIDS are equivalent in terms of efficacy - ANSWER ✓ T,
however may work differently for different people. GIve it 2-3 weeks before
trying another NSAID.
37.Using a COX-2 inhibitor for RA may be better than NSAIDS b/c why? -
ANSWER ✓ Less likely to have upper GI adverse events (bleeding,
ulceration)
38.Drawback for COX-2 use? - ANSWER ✓ Increased concern for
cardiovascular events (MI, stroke) due to impaired platelet effects
39.Which medicine may be used as a "bridge" to reduce RA disease activity
while waiting for DMARDs to work? - ANSWER ✓ Prednisone- no more
than 10mg day
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS
<LATEST VERSION>
1. MSK chest pain - ANSWER ✓ - Most common cause
- Muscle strain / costochondritis
- Broken rib
- Herpes zoster
- Fibromyalgia, SSC
- Chest wall contusion
- Protracted vomiting
2. -Young active pt - sports w/lifting
3. MSK chest pain RF - ANSWER ✓ - Trauma
- Overuse
- Hx chicken pox
4. MSK chest pain S/S - ANSWER ✓ - Gradual onset of sharp-dull
- More localized [can point with finger]
- Arm movement / deep inspiration [reproducible]
5. MSK chest pain DX - ANSWER ✓ No tests unless trauma = XR
6. MSK chest pain TX - ANSWER ✓ - Rest
- NSAIDs
- Ice/Heat
7. GI chest pain - ANSWER ✓ - 2nd common cause
- GERD
- Esophagitis / spasm
- PUD
- Hiatal hernia
, - Gallbladder
8. GI chest pain RF - ANSWER ✓ Hx of ulcers, smoking, ETOH,
NSAIDS/ASA (ask about OTC meds)
9. GI chest pain S/S - ANSWER ✓ - Recurrent [min-hr] of substernal burning
pain
- Esophageal spasm = squeezing/pressure
- PUD = epigastric to back (worse with meals / supine)
- Pain with palpation [epigastrium]
10.GI chest pain DX - ANSWER ✓ - Test for h.pylori
- EGD
11.GI chest pain TX - ANSWER ✓ - PPIs
- ABX [h. pylori]
- Diet
- Elevate HOB
12.Pysch chest pain - ANSWER ✓ - 3rd common cause
- Stress-related
- Panic attack
- Somatization
- Aggravates GERD ,asthma, angina
13.Pysch chest pain RF - ANSWER ✓ - Stress
- Hx of panic disorder or depression
14.Pysch chest pain S/S - ANSWER ✓ - Panic disorder = precordial CP
- Depression = constant/inter heaviness unrelated to meals / activity
(sudden or gradual)
- Anxiety, dyspnea, hyperventilation, tingling/numbness ext, dizziness
15.Pysch chest pain DX screening - ANSWER ✓ - 2 questions
- Last 6 mo: spell or attack of feeling anxious + heart racing felt faint
- Yes to either = psych
- No to both = panic d/o unlikely
,16.Resp chest pain causes - ANSWER ✓ - Bronchitis
- Pneumonia
- Asthma
- COPD
- Pleurisy
- PE
17.The most SPECIFIC lab for rheumatoid arthritis is? - ANSWER ✓ anti-CCP
antibodies
18.Rheumatoid factor maybe misleading b/c it can also be positive in what
conditions? - ANSWER ✓ syphilis, Hep C, TB, subacute endocarditis, or
elderly
19.Labs in Early RA disease may only have what percent sensitivity? -
ANSWER ✓ 50%
20.Which joints are affected the most in RA? - ANSWER ✓ PIP, MCP, wrists,
ankle, knee, MTP
21.RA can also affect what other systems besides the joints? - ANSWER ✓
ocular, cardiac, pulmonary, small vessels, subcut tissues(nodules)
22.Osteoarthritis spares which joints? - ANSWER ✓ wrist & MCP
23.Symmetric AM stiffness is associated with what? - ANSWER ✓ RA
24.T or F: OA/DJD shows less signs of articular inflammation - ANSWER ✓
True
25.A syndrome consisting of RA, neutropenia, & splenomegaly - ANSWER ✓
"Felty syndrome"
26.FACT: Early Gout will be monoarticular + urate crystals in the synovial
fluid - ANSWER ✓ Later, it may involve multiple joints
27.1st line Tx for RA? - ANSWER ✓ DMARDS
, 28.DMARD of choice for RA is? - ANSWER ✓ Methotrexate
29.Absolute contraindications for Methotrexate therapy? - ANSWER ✓ Any
chronic hepatitis
30.What should be Rx with Methotrexate to prevent gastric irritation,
stomatitis, cytopenias, and hepatotoxicity? - ANSWER ✓ Folate daily 1mg
OR weekly leucovorin calcium (24hrs after meth dose)
31.Most frequent SE of Methotrexate is? - ANSWER ✓ gastric irritation and
stomatitis
32.What should be avoided in those on methotrexate therapy? - ANSWER ✓
Alcohol & Probenecid, and other folate antagonist drugs (i.e. TMP-SMX)
33.Methotrexate increases the risk of which cancers? - ANSWER ✓ B cell
lymphomas
34.Give DMARDS how long to take effect? - ANSWER ✓ 2-6 weeks
35.NSAIDS can provide symptomatic relief for RA pain, but what should also
be Rx with them? - ANSWER ✓ PPI for stomach protection
36.T or F: all NSAIDS are equivalent in terms of efficacy - ANSWER ✓ T,
however may work differently for different people. GIve it 2-3 weeks before
trying another NSAID.
37.Using a COX-2 inhibitor for RA may be better than NSAIDS b/c why? -
ANSWER ✓ Less likely to have upper GI adverse events (bleeding,
ulceration)
38.Drawback for COX-2 use? - ANSWER ✓ Increased concern for
cardiovascular events (MI, stroke) due to impaired platelet effects
39.Which medicine may be used as a "bridge" to reduce RA disease activity
while waiting for DMARDs to work? - ANSWER ✓ Prednisone- no more
than 10mg day
