CMN 574 EXAM 3 STUDY GUIDE 2026/2027
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
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Question 1
A 65-year-old female presents with morning stiffness in her knees and hands lasting
approximately 20 minutes. Her pain is relieved by rest, and she has no systemic
symptoms. ESR is normal. What is the most likely diagnosis?
A) Rheumatoid Arthritis
B) Osteoarthritis
C) Systemic Lupus Erythematosus
D) Gout
Answer: B - Osteoarthritis is characterized by morning stiffness lasting less than 30
minutes, pain relieved by rest, absence of systemic symptoms, slow onset, involvement
of weight-bearing joints, and normal ESR with non-inflammatory synovial fluid .
Question 2
Which of the following is a non-pharmacologic treatment for osteoarthritis?
A) Methotrexate
B) Weight loss and Vitamin D management
C) Colchicine
D) Prednisone
Answer: B - Weight loss and Vitamin D management are important non-pharmacologic
treatments for osteoarthritis. Splinting for hands and physical therapy are also
recommended. Tylenol 3g/24hr is the first-line medication .
,Question 3
A patient with knee osteoarthritis has not responded to over-the-counter medications.
Which intervention is appropriate?
A) Triamcinolone injection into the knee
B) Triamcinolone injection into the hands
C) Initiation of methotrexate
D) Colchicine therapy
Answer: A - Triamcinolone injections can be used for knee or hip osteoarthritis if there
is no response to OTC medications. Injections are NOT indicated for hands .
Question 4
What is the first-line pharmacologic treatment for osteoarthritis?
A) NSAIDs
B) Tylenol (Acetaminophen) 3g/24hr
C) Corticosteroids
D) Methotrexate
Answer: B - Tylenol (Acetaminophen) up to 3g per 24 hours is the first-line
pharmacologic treatment for osteoarthritis. NSAIDs are used for patients who do not
respond to acetaminophen .
Question 5
A 45-year-old man presents with sudden onset of intense pain, swelling, and redness in
his left great toe. He reports the pain began overnight and is excruciating. What is the
most likely diagnosis?
A) Osteoarthritis
B) Rheumatoid Arthritis
C) Gout
D) Septic Arthritis
,Answer: C - Acute gout presents with mono-articular inflammation, typically affecting
the 1st MTP joint (podagra), with intense pain, warmth, and dusky red skin. Onset is
acute, often overnight .
Question 6
Which of the following is a characteristic finding in gout?
A) AM stiffness lasting 45 minutes
B) Tophi in cartilage, subcutaneous tissue, or bone
C) Symmetrical joint involvement
D) Systemic symptoms including fever and weight loss
Answer: B - Tophi (urate crystal deposits) can be found in cartilage,
subcutaneous/periarticular tissue, bone, and kidney in gout. AM stiffness lasting 45
minutes is characteristic of RA, and symmetrical joint involvement is also seen in RA .
Question 7
A 35-year-old man presents with his first acute gout attack. His serum uric acid is 7.2
mg/dL. What is the most appropriate acute treatment?
A) Allopurinol
B) NSAIDs or Colchicine
C) Urate-lowering therapy
D) Methotrexate
Answer: B - Acute gout is treated with NSAIDs or colchicine (within 36 hours of attack;
1.2mg followed by 0.6mg one hour later, then 0.6mg BID for prophylaxis).
Corticosteroids are used for patients with NSAID contraindications .
Question 8
A patient has had two episodes of gout in the past year. What is the appropriate
management?
A) Continue acute treatment only
B) Initiate urate-lowering medication and maintain serum uric acid at or below 6 mg/dL
, C) Prescribe only NSAIDs
D) Refer for joint replacement
Answer: B - For patients with 2+ episodes of gout per year, initiate urate-lowering
medication (e.g., colchicine) and maintain serum uric acid at or below 6 mg/dL .
Question 9
Which of the following is a risk factor for secondary gout?
A) Hereditary predisposition
B) Age >30 years in men
C) Postmenopausal women
D) Diuretic use
Answer: D - Secondary gout is caused by acquired hyperuricemia from conditions such
as excessive alcohol (especially beer), diuretics, aspirin, cyclosporine, niacin, and changes
in diet or fluid intake .
Question 10
Which foods should a patient with gout avoid?
A) Fresh fruits and vegetables
B) Organ meats, seafood, and beer
C) Low-fat dairy products
D) Whole grains
Answer: B - Patients with gout should avoid high-purine foods including organ meats,
yeast (beer), seafood, beans/peas/lentils, oatmeal, spinach, asparagus, cauliflower, and
mushrooms. Corn syrup drinks should also be avoided .
Question 11
What is the diagnostic test for gout?
A) Serum uric acid only
B) Sodium urate crystals in aspirated joint fluid
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS LATEST VERSION
Question 1
A 65-year-old female presents with morning stiffness in her knees and hands lasting
approximately 20 minutes. Her pain is relieved by rest, and she has no systemic
symptoms. ESR is normal. What is the most likely diagnosis?
A) Rheumatoid Arthritis
B) Osteoarthritis
C) Systemic Lupus Erythematosus
D) Gout
Answer: B - Osteoarthritis is characterized by morning stiffness lasting less than 30
minutes, pain relieved by rest, absence of systemic symptoms, slow onset, involvement
of weight-bearing joints, and normal ESR with non-inflammatory synovial fluid .
Question 2
Which of the following is a non-pharmacologic treatment for osteoarthritis?
A) Methotrexate
B) Weight loss and Vitamin D management
C) Colchicine
D) Prednisone
Answer: B - Weight loss and Vitamin D management are important non-pharmacologic
treatments for osteoarthritis. Splinting for hands and physical therapy are also
recommended. Tylenol 3g/24hr is the first-line medication .
,Question 3
A patient with knee osteoarthritis has not responded to over-the-counter medications.
Which intervention is appropriate?
A) Triamcinolone injection into the knee
B) Triamcinolone injection into the hands
C) Initiation of methotrexate
D) Colchicine therapy
Answer: A - Triamcinolone injections can be used for knee or hip osteoarthritis if there
is no response to OTC medications. Injections are NOT indicated for hands .
Question 4
What is the first-line pharmacologic treatment for osteoarthritis?
A) NSAIDs
B) Tylenol (Acetaminophen) 3g/24hr
C) Corticosteroids
D) Methotrexate
Answer: B - Tylenol (Acetaminophen) up to 3g per 24 hours is the first-line
pharmacologic treatment for osteoarthritis. NSAIDs are used for patients who do not
respond to acetaminophen .
Question 5
A 45-year-old man presents with sudden onset of intense pain, swelling, and redness in
his left great toe. He reports the pain began overnight and is excruciating. What is the
most likely diagnosis?
A) Osteoarthritis
B) Rheumatoid Arthritis
C) Gout
D) Septic Arthritis
,Answer: C - Acute gout presents with mono-articular inflammation, typically affecting
the 1st MTP joint (podagra), with intense pain, warmth, and dusky red skin. Onset is
acute, often overnight .
Question 6
Which of the following is a characteristic finding in gout?
A) AM stiffness lasting 45 minutes
B) Tophi in cartilage, subcutaneous tissue, or bone
C) Symmetrical joint involvement
D) Systemic symptoms including fever and weight loss
Answer: B - Tophi (urate crystal deposits) can be found in cartilage,
subcutaneous/periarticular tissue, bone, and kidney in gout. AM stiffness lasting 45
minutes is characteristic of RA, and symmetrical joint involvement is also seen in RA .
Question 7
A 35-year-old man presents with his first acute gout attack. His serum uric acid is 7.2
mg/dL. What is the most appropriate acute treatment?
A) Allopurinol
B) NSAIDs or Colchicine
C) Urate-lowering therapy
D) Methotrexate
Answer: B - Acute gout is treated with NSAIDs or colchicine (within 36 hours of attack;
1.2mg followed by 0.6mg one hour later, then 0.6mg BID for prophylaxis).
Corticosteroids are used for patients with NSAID contraindications .
Question 8
A patient has had two episodes of gout in the past year. What is the appropriate
management?
A) Continue acute treatment only
B) Initiate urate-lowering medication and maintain serum uric acid at or below 6 mg/dL
, C) Prescribe only NSAIDs
D) Refer for joint replacement
Answer: B - For patients with 2+ episodes of gout per year, initiate urate-lowering
medication (e.g., colchicine) and maintain serum uric acid at or below 6 mg/dL .
Question 9
Which of the following is a risk factor for secondary gout?
A) Hereditary predisposition
B) Age >30 years in men
C) Postmenopausal women
D) Diuretic use
Answer: D - Secondary gout is caused by acquired hyperuricemia from conditions such
as excessive alcohol (especially beer), diuretics, aspirin, cyclosporine, niacin, and changes
in diet or fluid intake .
Question 10
Which foods should a patient with gout avoid?
A) Fresh fruits and vegetables
B) Organ meats, seafood, and beer
C) Low-fat dairy products
D) Whole grains
Answer: B - Patients with gout should avoid high-purine foods including organ meats,
yeast (beer), seafood, beans/peas/lentils, oatmeal, spinach, asparagus, cauliflower, and
mushrooms. Corn syrup drinks should also be avoided .
Question 11
What is the diagnostic test for gout?
A) Serum uric acid only
B) Sodium urate crystals in aspirated joint fluid
