Ace the Test
Signs and symptoms of a MI - ANSWER ✔✔-substernal chest pain or
discomfort that radiates to the jaw, left shoulder or arm
-Dyspnea, nausea, diaphoresis, syncope
Diagnostics to confirm MI - ANSWER ✔✔-Cardiac myocyte necrosis
(myoglobin, CK-MB and troponin I and T)
-without ST-elevation, abnormal CK-MB or troponin=MI
-ECG changes (new Q waves, ST elevation/depression, T-wave
flattening/inversion
Gouty arthritis - ANSWER ✔✔Sudden onset and frequently nocturnal
,Common precipitants are alcohol (beer)
Gouty arthritis diagnostics - ANSWER ✔✔-Serial measurements of
serum uric acid
-Increased WBC
Sodium urate crystals in joint fluid aspirated from tophus
-xray later in dx=punched-out erosions with an overhanging rim of
cortical bone develop "rat bite" adjacent to soft tissue tophus
-Smaller tophi imaged by US
Acute gout tx - ANSWER ✔✔1. NSAIDS- full dose of naproxen 500
mg BID or indomethacin 25-50 mg Q8 until symptoms resolve
(contraindicated in PUD, decreased kidney function)
2. Colchicine-Good if duration of attach is less than 36 hours
-Loading dose=1.2mg then 0.6 mg 1 hour later for prophylaxis
-0.6mg BID
3. Corticosteroids- IV or PO, 5-10 days with taper
4. Interleukin-1 inhibitors- anakinram canakinumab, and rilonacept not
FDA approved
Rheumatoid arthritis: Signs and Symptoms-
,Joints - ANSWER ✔✔-joint symptoms: symmetric swelling of multiple
joints with tenderness and pain
-stiffness longer than 30 mins in the morning
-may reoccur after daytime inactivity or be more severe after strenuous
activity
-fingers, wrists, knees, ankles, MTP joints
Rheumatoid arthritis: Signs and Symptoms-
Rheumatoid nodules - ANSWER ✔✔- subcutaneous nodules most
common over bony prominences
-can also occur in the bursae and tendon sheaths
-lungs, sclerae, other tissue
Rheumatoid arthritis: Signs and Symptoms-Ocular symptoms -
ANSWER ✔✔-dryness of eyes, mouth, mucus membranes especially
in advanced disease
-episcleritits, scleritis, scleromalacia d/t nodule
Rheumatoid arthritis: Signs and Symptoms-
Other symptoms - ANSWER ✔✔-interstitial lung disease
-pericarditits
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, -pleural disease
-palmar erythema
-felty syndrome=splenomegaly, neutropenia
Rheumatoid arthritis: lab tests - ANSWER ✔✔-Anti-CCP antibodies=
most specific
-rheumatoid factor (IgM)= can occur in other autoimmune disease
-ESR and CRP usually elevated based on disease activity
Rheumatoid arthritis: imaging - ANSWER ✔✔-radiographic changes
most specific
-1st 6 months of symptoms usually normal
Rheumatoid arthritis: treatment categories - ANSWER ✔✔-
Corticosteroids
-DMARDs:
-Synthetic
-Biologic DMARDs
-Combination DMARDs
RA: tx corticosteriods - ANSWER ✔✔-low-dose for anti-inflammatory
(5-7.5 mg)