INTERNAL MEDICINE BOARD REVIEW FLASHCARDS

Rheumatology
Includes 50 Flashcards for Board Exam prep

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KNOWMEDGE

INTERNAL MEDICINE BOARD REVIEW FLASHCARDS

Rheumatology

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Question 1

Whcih small vessel vasculitis has positive

c-ANCA and both lung and renal
involvement?

Answer 1

Wegener granulomatosis

Question 2

________ is the vasculitis that is most

likely associated with hepatitis B
infection.

Answer 2

Polyarteritis nodosa (PAN)

Question 3
What condition is being described here?
"Large vessel vasculitis that is associated
with new onset of headache and
elevated ESR levels"

Answer 3

Giant cell (temporal) arteritis

Question 4

What two extra-intestinal manifestations

of IBD will mirror the GI condition?

Answer 4

Erythema nodosum and arthritis

Question 5

Thougn not used in diagnosis, what HLA

marker can often be seen in
seronegative spondyloarthropathies?

Answer 5

HLA-B27

Question 6

Foamy macrophages on PAS stain is

often seen in what condition?

Answer 6

Whipple's Disease

Question 7
A patient suffering from renal crisis
because of diffuse cutaneous systemic
sclerosis (scleroderma) typically develops
this condition within ____ months after
systemic sclerosis is first diagnosed.

Answer 7

48

Question 8

True or False: Captopril is commonly

used for patients with scleroderma renal
crisis.

Answer 8

True

Question 9

True or False: Steroids are useful in

treating scleroderma renal crisis

Answer 9

False. Steroids can exacerbate

scleroderma renal crisis

Question 10

What are the two major forms of

scleroderma?

Answer 10

Diffuse and Limited scleroderma

Question 11
What type of scleroderma is this
describing? "Large areas of the skin are
rapidly affected and thickened. In some
case, internal organs are affected as
well."

Answer 11

Diffuse scleroderma

Question 12

What is the initial step for a patient

symptomatic for atlanto-odontoid
subluxation?

Answer 12

Cervical spine xray with flexion and

extension views

Question 13
In a patient symptomatic for atlantoodontoid subluxation, what is the level
of potential compression on a cervical
xray that would indicate surgery?

Answer 13

8mm

Question 14

True or False: Carpal Tunnel Syndrome

can result as a cause of Rheumatoid
Arthritis

Answer 14

True

Question 15

True or False: Multiple sexual partners is

a risk factor for osteoarthritis and septic
arthritis

Answer 15

False; Multiple sexual partners is not a

risk factor for osteoarthritis. It is,
however, a risk factor for septic arthritis.

Question 16

The rotator cuff is a group of four

muscles that support the shoulder joint.
What are the four muscles?

Answer 16

Supraspinatus, Infaspinatus, Teres minor,

Subcapularis

Question 17
Pain upon abduction of left shoulder and
pain and tenderness over the anterior
bicipital grove is a description of what
condition?

Answer 17

Bicipital tendinitis

Question 18

True or False: Apical pulmonary fibrosis

is a late and rare manifestation of
ankylosing spondylitis.

Answer 18

True

Question 19

What is the treatment for Relapsing

Polychondritis?

Answer 19

Corticosteroids, Dapsone or Colchicine

Question 20
___________ is bone death due to a lack
of blood supply. It can affect any bone
though it primarily affects the joints at
the hip, shoulder and knee.

Answer 20

Avascular necrosis

Question 21
True or False: Rheumatoid arthritis has
many extra-articular manifestations as it
is a systemic disease but is usually not
directly associated with avascular
necrosis.

Answer 21

True

Question 22
Which test is performed by the examiner
placing one hand at the lateral knee joint
and the other at the medial aspect of the
distal tibia. Stress is applied at the knee.

Answer 22

Valgus Test

Question 23
Which test is performed by the examiner
placing one hand at the medial knee
joint and the other at the lateral aspect
of the distal fibula. Stress is applied at
the knee.

Answer 23

Varus Test

Question 24
Which test is performed by the physician
grasping the patients heel with one
hand and the knee with the other hand.
The tibia is rotated internally to assess
the lateral meniscus.

Answer 24

McMurray Test

Question 25
True or False: A patient with
osteoarthritis interested in using a cane
should place it on the same side as the
affected joint - generally the hips, hands,
neck and lower back.

Answer 25

False; A patient interested in using a

cane should place it on the opposite side
of the affected joint

Question 26

What supplements should patients with

osteoporosis continue taking indefinitely
to build stronger and denser bones?

Answer 26

Vitamin D and Calcium

Question 27
What condition is described here?
"Condition that produces a negative
birefringence and monosodium urate
crystals when arthrocentesis is
performed"

Answer 27

Gout

Question 28
With what condition would a patient
have pain in the heel and which is usually
worse in the morning than when the
individual takes his or her first steps?

Answer 28

Plantar fasciitis

Question 29
What common sports injury comes from
the inside portion of the knee, and one
in which you would not expect to hear
any popping sounds?

Answer 29

Lateral collateral ligament (LCL) tear

Question 30
What condition, more likely to be seen in
individuals with multiple sexual partners,
results in an inflamed joint (often the
knee)?

Answer 30

Septic arthritis

Question 31

Antibody that is involved in cold

agglutinin hemolytic anemia

Answer 31

IgM

Question 32

Antibody that is involved in warm

agglutinin hemolytic anemia

Answer 32

IgG

Question 33

Antibody that is associated with type 1

hypersensitivity reactions

Answer 33

IgE

Question 34

True or False: Lisinopril is often used to

control hypertension in pregnant
patients

Answer 34
False: Lisinopril, like all ACE inhibitors
and angiotensin receptor blockers, is
absolutely contraindicated to control
blood pressure in pregnancy due to
teratogenic effects.

Question 35

What condition is described? "Condition

that reveals bronchoalveololar lavage
(BAL) CD4/CD8 ratio of 4:1 or greater"

Answer 35

Sarcoidosis

Question 36

Do pre-menopausal women have an

increased or decreased risk of
developing gout?

Answer 36

Decreased risk

Question 37

24-hour urine uric acid levels greater

than what level indicates overproducers?

Answer 37

Greater than 600 mg/dl

Question 38

In addition to allopurinol, what is

another medication that is a xanthine
oxidase inhibitor?

Answer 38

Febuxostat

Question 39

What is the goal uric acid level to

prevent further gouty attacks?

Answer 39

Less than 6 mg/dl

Question 40

What agent is used to prevent further

gouty attacks in under-excreters of uric
acid?

Answer 40

Probenecid

Question 41

What is the most common joint affected

in pseudogout?

Answer 41

Knee

Question 42

Which medication should not be given

concurrently with allopurinol to prevent
blood dyscrasias?

Answer 42

Azathioprine

Question 43

What type of medication is allopurinol?

Answer 43

Xanthine oxidase inhibitor

Question 44

If patient has normal renal function,

what is the drug of choice for acute
gouty attack in the first 24 hours?

Answer 44

Colchicine

Question 45

What is the most common cause of

pseudogout?

Answer 45

Hyperparathyroidism

Question 46

What kind of birefringence would you

see in pseudogout?

Answer 46

Positive birefringence

Question 47

What kind of crystals would you expect

to see with pseudogout?

Answer 47

Rhomboid shaped crystals

Question 48

What would the WBC range be if

arthrocentesis was done for
pseudogout?

Answer 48

5,000-50,000/microliter

Question 49
What condition is often caused by
compression of the cutaneous femoral
nerve seen in overweight individuals
with tight-fitting clothes?

Answer 49

Meralgia paresthetica

Question 50

What condition is associated with

decreased TSH and increased free T4
index?

Answer 50

Primary hyperthyroidism

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