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Exam (elaborations)

Orthopedics IM EORE (Internal Medicine) | 18 Questions | Rheumatology, Gout, SLE, Scleroderma | 2025

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This document contains 18 expertly verified flashcard-style questions and answers focused on high-yield orthopedic and rheumatologic disorders for the Internal Medicine End-of-Rotation Exam (IM EORE) in 2025. It emphasizes inflammatory, metabolic, and autoimmune musculoskeletal conditions, with detailed diagnostic features, hallmark symptoms, and stepwise treatments. The guide covers crystal arthropathies including: Gout (podagra, negatively birefringent urate crystals, punched-out lesions on X-ray), with treatment options such as NSAIDs, colchicine, allopurinol, and febuxostat. Pseudogout (positively birefringent calcium pyrophosphate crystals, chondrocalcinosis), treated similarly to gout. Extensive attention is given to autoimmune connective tissue diseases: Systemic lupus erythematosus (SLE) with classic malar rash, arthritis, and lab markers like ANA, anti-dsDNA, and anti-Sm. Systemic sclerosis (scleroderma) with CREST syndrome, Raynaud’s phenomenon, and key antibodies (anticentromere, SCL-70). Sjogren syndrome, characterized by xerostomia, xerophthalmia, and positive anti-Ro/SSA and anti-La/SSB. Polymyositis and polymyalgia rheumatica, both presenting with muscle-related symptoms but differentiated by lab markers, age, and response to corticosteroids. Reactive arthritis (Reiter’s syndrome) presenting after GI or GU infections with the classic triad of arthritis, urethritis, and conjunctivitis. The document also includes: Fibromyalgia, a diagnosis of exclusion with widespread pain and fatigue, managed through Lyrica, antidepressants, and exercise. Polyarteritis nodosa, a multi-organ vasculitis requiring angiography or biopsy and treated with high-dose corticosteroids. Compartment syndrome, a critical orthopedic emergency defined by pain out of proportion to injury and treated surgically with fasciotomy. This guide is ideal for: PA students preparing for IM EORE Orthopedics and Rheumatology Medical students (MD/DO) reviewing musculoskeletal and autoimmune disorders for boards or rotations Nursing and NP students covering chronic musculoskeletal conditions and systemic inflammatory syndromes Students preparing for PANCE, USMLE Step 2, or COMLEX needing quick, high-yield rheumatology facts With its clear structure and concise Q&A format, this document supports both rapid memorization and clinical application in diagnosing and managing key orthopedic and systemic inflammatory conditions. Keywords: gout, pseudogout, fibromyalgia, SLE, ANA, anti-dsDNA, polyarteritis nodosa, polymyositis, polymyalgia rheumatica, Reiter syndrome, reactive arthritis, scleroderma, CREST, Sjogren syndrome, anti-Ro, anti-La, compartment syndrome, fasciotomy, rheumatoid markers, musculoskeletal pain, autoimmune rheumatology, EORE orthopedics

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Uploaded on
December 18, 2025
Number of pages
5
Written in
2025/2026
Type
Exam (elaborations)
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Questions & answers

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IM EORE Ortho 2025 Expert Verified |
Ace the Test



Fibromyalgia - 🧠 ANSWER ✔✔*WHAT:* Pain above and below the waist

that is bilateral and axial for 3+ months.

*SSX:* Nonarticular musculoskeletal aches, pains, fatigue, sleep

disturbance, and multiple tender *"trigger"* points on exam.

*DIAGNOSTIC:* Diagnosis of exclusion (hypothyroidism, hepC, vitD

deficiency)

*TX:* Lyrica, antidepressants, and exercise.


Gout - 🧠 ANSWER ✔✔*WHAT:* Altered purine metabolism -> intra-articular

deposition of sodium urate crystals.

, *SSX:* Pain, swelling, redness, and tenderness in acute gout. Tophi in

chronic gout. Toe is the most affected (podagra).

*DIAGNOSTIC:* Negatively birefringent rate crystals in joint fluid analysis.

Punched out lesions (erosions) on x-ray.

*TX:* NSAIDs, colchicine, steroids, probenecid, allopurinol, febuxostat.


Pseudogout - 🧠 ANSWER ✔✔*WHAT:* Intra-articular deposition of calcium

pyrophosphate.

*SSX:* Mimics gout

*DIAGNOSTIC:* Positively birefringent crystal in joint fluid analysis that are

rhomboid-shaped. Chondrocalcinosis on x-ray

*TX:* NSAIDs, colchicine, and steroids.


Systemic lupus erythematous (SLE) - 🧠 ANSWER ✔✔*WHAT:*

Autoimmune disorder affecting multiple organs in women 15-45.

*SSX:* Malar (butterfly) rash, fatigue, arthritis, photosensitivity.

*DIAGNOSTIC:* ANA, double stranded DNA & anti-smith antibodies, low

complement.

*TX:* Hydroxchloroquine, NSAIDs, steroids, methotrexate, and exercise

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