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Rheumatology Flashcards

7 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Rheumatology flashcards as text

  1. A 65-year-old woman presents with bilateral aching in her shoulders and hips, an ESR of 85 mm/hr, markedly elevated CRP, but no true synovitis on examination. What is the most likely diagnosis?

    Answer: Polymyalgia rheumatica

    Polymyalgia rheumatica typically presents in patients over 50 with bilateral proximal girdle pain, markedly elevated inflammatory markers, and no true synovitis.

  2. A patient with polymyalgia rheumatica develops new-onset unilateral temporal headache, scalp tenderness, and jaw claudication. What is the most feared complication if giant cell arteritis is not promptly treated?

    Answer: Irreversible blindness

    Giant cell arteritis can cause ischemic optic neuropathy via involvement of the ophthalmic arteries, leading to irreversible blindness if high-dose corticosteroids are not started immediately.

  3. Which antibody is characteristically associated with drug-induced lupus?

    Answer: Anti-histone

    Drug-induced lupus is characteristically associated with anti-histone antibodies; common culprits include hydralazine, procainamide, isoniazid, and minocycline.

  4. A 40-year-old woman presents with proximal muscle weakness, heliotrope rash over the eyelids, and Gottron papules on her knuckles. Which laboratory finding most supports the diagnosis of dermatomyositis?

    Answer: Elevated creatine kinase (CK)

    Elevated creatine kinase (CK) is characteristic of inflammatory myopathies like dermatomyositis, reflecting ongoing muscle cell injury.

  5. A patient with SLE, lupus anticoagulant, and anticardiolipin antibodies has a history of two miscarriages. What is the recommended anticoagulation strategy during her next pregnancy?

    Answer: Low molecular weight heparin (LMWH) plus low-dose aspirin

    In antiphospholipid syndrome with obstetric complications, low-dose aspirin plus LMWH throughout pregnancy is standard of care; warfarin is teratogenic in the first trimester.

  6. What is the primary mechanism of action of colchicine in the treatment of acute gout?

    Answer: Inhibition of neutrophil microtubule polymerization

    Colchicine works by inhibiting microtubule polymerization in neutrophils, thereby impairing their migration and activation at sites of urate crystal deposition.

  7. A 30-year-old man develops arthritis, urethritis, and conjunctivitis 2-4 weeks after a Salmonella gastroenteritis. What is the most likely diagnosis?

    Answer: Reactive arthritis

    Reactive arthritis presents with the classic triad of arthritis, urethritis, and conjunctivitis following a genitourinary or gastrointestinal infection.