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Rheumatology practice questions
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practice questions- systems based approach(RHEUMATOLOGY)
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Rheumatology1. An 81 year-old female presents with scalp 4. A 56-year-old man presents to the
tenderness and tongue and jaw Emergency Department with an acutely
claudication. All of the following are swollen and warm right wrist. After history
consistent with a diagnosis of Giant Cell and physical exam, the team decides to
Arteritis, EXCEPT: perform a synovial fluid analysis. Analysis
a) Sudden temporal headache of the fluid indicates a yellow, opaque
b) ESR ≥ 50 mm/h fluid with about 10,000 WBC/ mm3 and
c) Painless vision loss and diplopia 250 RBC/ mm3 The most likely etiology
d) Mononuclear cell infiltration on of the wrist is likely:
artery biopsy a) Inflammatory
e) Association with polymyalgia b) Infectious
rheumatica c) Non-inflammatory
d) Hemorrhagic
2. A 31 year-old male has a history of an 5. Hallmarks of osteoarthritis on radiographs
infectious episode with a Shigella include all but:
species. Soon after this GI infection, he a) Joint space narrowing
presents with a peripheral arthritis and b) Subchondral cysts
uveitis that is most suggestive of reactive c) Subluxation of joints
arthritis. Which of the following is the d) Subchondral sclerosis
most likely to be another manifestation of
reactive arthritis? 6. A 48 year-old construction worker gives
a) Keratoderma blennorrhagicum you a list of symptoms regarding back
b) Cervical immobility pain he has experienced in the past 12
c) Diarrhea months. Which of these symptoms are
d) Urethritis suggestive of a degenerative rather than
e) Plantar fasciitis an inflammatory cause of this back pain?
a) Pain with activity
b) Prolonged morning stiffness
3. A 25 year-old male presents with mid to c) Symmetrical joint involvement
lower back stiffness, morning stiffness > 1 d) Fever and weight loss
hour, and decreased lumbar lordosis. He
also notes tenderness at his Achilles 7. A 50-year-old accountant is referred to
tendon. He does not endorse any rheumatology by her family doctor. She
peripheral arthritis. What is the first line reports a symmetrical distribution of
pharmacological therapy for this polyarthritis for 9 months duration, with
condition? radiographs demonstrating joint space
a) DMARDs (sulfasalazine) narrowing and soft-tissue swelling. Which
b) Acetaminophen would be the most frequently used first
c) Anti-TNF agent (infliximab) line therapy for this patient?
d) Prednisone a) Leflunomide
e) NSAIDs b) Methotrexate
c) Naproxen
d) Etanercept
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