Rheumatology

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Fibromyalgia

Which one of the following treatments has not been shown to be an effective treatment for fibromyalgia?

  • Pregabalin
  • Duloxetine
  • Desvenlafaxine
  • Pramipexole
Volume 41.2 - Question 33

Glucocorticoid-Induced Adrenal Insufficiency

Which one of the following statements concerning glucocorticoid-induced adrenal insufficiency is false?  

  • It is the most common form of adrenal insufficiency.  
  • It can be induced by the use of inhaled steroids.  
  • It can result in an adrenal crisis if steroid treatments are weaned too rapidly.  
  • These patients commonly develop mineralocorticoid deficiency.  
Volume 41.2 - Question 2

Cardiovascular Events in Patients with Gout

In patients with gout initiating urate-lowering therapy, gout flare prophylaxis with colchicine is associated with a lower rate of cardiovascular events for up to the next 180 days compared with no prophylaxis.

  • True
  • False
Volume 40.5 - Question 31

Axial Spondyloarthritis

A 34-year-old female patient presents with chronic low back pain for the past four years. The pain is worse with rest and improves with activity. After taking a history and performing an examination, you consider the diagnosis of axial spondyloarthritis.
Volume 40.4 - Question 39

Axial Spondyloarthritis

A 34-year-old female patient presents with chronic low back pain for the past four years. The pain is worse with rest and improves with activity.  After taking a history and performing an examination, you  consider the diagnosis of axial spondyloarthritis.
Volume 40.3 - Question 40

Knee Joint Injection

Patients should be advised that a steroid flare-up may occur in the first 24 to 48 hours after knee joint injection.

  • True
  • False
Volume 39.6 - Question 27

Drugs for Rheumatoid Arthritis

Which one of the following statements about treatment for Rheumatoid Arthritis (RA) is false?

  • Disease-modifying anti-rheumatic drugs should be used for initial treatment of RA.
  • Methotrexate is the drug of choice for initial treatment of patients with moderate-to-high disease activity.
  • Triple therapy with methotrexate, hydroxychloroquine, and sulfasalazine is not an alternative to addition of a biologic drug.
  • If maximally tolerated doses of methotrexate are not adequately effective, a biologic drug, such as a tumor necrosis factor inhibitor, should be added.
Volume 37.3 - Question 38

Treatment of Osteoporosis with Denosumab

Which one of the following statements about denosumab treatment for osteoporosis is false?

  • It is important to correct severe vitamin D deficiency before treatment.
  • Denosumab should not be used in patients with an eGFR of less than 30 mL/min.
  • Treatment effects have a rapid offset following discontinuation of denosumab.
  • There is an increased risk of vertebral fractures in the 12 months after the drug is discontinued
Volume 37.6 - Question 32

Treatment of Osteoporosis

Which one of the following statements about osteoporosis prevention and treatment is false?

  • Vitamin D supplementation greater than 1000 units per day can accelerate bone loss.
  • Calcium supplements in community-dwelling adults prevent fractures.
  • An acute phase response (flu-like illness) occurs in about a third of patients receiving their first intravenous bisphosphonate treatment.
  • A 1-to-2-year drug holiday should be considered after 5 years of treatment with alendronate.
Volume 37.6 - Question 31

SAMP Ankylosing Spondyloarthropathy

A 37-year-old woman presents to your office after attending the ER with acute unilateral eye pain, redness, photophobia, and blurred vision. She was diagnosed with anterior uveitis. Screening blood tests included a positive HLA-B27.  
Volume 36.5 - Question 42

PoCUS vs Landmarks for Arthrocentesis

Ultrasound guidance improves overall successful arthrocentesis of medium sized joint effusions (elbow, wrist or ankle).

  • True
  • False
Volume 37.6 - Question 19

Opioid Treatment for Osteoarthritis

The clinical benefit of opioid treatment, regardless of preparation or dose, outweighs the harm it could cause in patients with osteoarthritis. 

  • True
  • False
Volume 37.4 - Question 29

Viscose Supplementation for Knee Osteoarthritis

Intra-articular hyaluronic acid for knee osteoarthritis results in a small, non-clinically important reduction in pain intensity. 

  • True
  • False
Volume 38.1 - Question 20

Thumb Carpal Metacarpal Arthritis

Which one of the following statements about thumb carpometacarpal joint arthritis is false? 

  • It is associated with female sex. 
  • The “traction shift” test is highly specific. 
  • Corticosteroid injection improves function with activity. 
  • Trapeziectomy with ligament reconstruction and tendon interposition is a common surgical treatment. 
Volume 38.1 - Question 19

Systemic Sclerosis Organ Involvement

Which one of the following statements about organ involvement in systemic sclerosis is false?

  • Interstitial lung disease is the leading cause of death in systemic sclerosis..
  • Involvement of the lower gastrointestinal tract rarely occurs.
  • Anemia can indicate the presence of gastric antral vascular ectasias.
  • Measurement of systolic blood pressure is important for early detection of renal crisis.
Volume 38.4 - Question 34

Systemic Sclerosis Early Diagnosis

Which one of the following statements about systemic sclerosis (SS) is false?

  • Most patients have negative antinuclear antibodies.  
  • Raynaud phenomenon is one of the earliest signs.
  • Scleroderma-type changes on nailfold capillaroscopy can help to diagnose early disease.
  • In patients with SSc-specific autoantibodies and puffy fingers, over 90% develop definite SSc at 5 years.
Volume 38.4 - Question 33

Topical Nonsteroidal Anti-Inflammatory Drugs

Which one of the following statements about topical NSAIDS is false? 

  • They provide effective pain relief for acute strains and sprains. 
  • They are safer than oral NSAIDS. 
  • Systemic uptake is limited to around 5% 
  • They provide inferior pain relief to oral NSAIDS for patients with chronic osteoarthritis. 
Volume 39.1 - Question 38

Glucocorticoids for Rheumatoid Arthritis

Over a 2-year treatment period, low-dose (≤7.5mg/day) prednisone for the treatment of rheumatoid arthritis does not increase blood pressure.  

  • True
  • False
Volume 39.1 - Question 33

Gout

Which one of the following statements about gout is false?

  • Women are more likely to have atypical joint involvement.
  • Sodium-glucose transport protein 2 (SGLT-2) inhibitors lower serum urate concentrations.
  • Allopurinol hypersensitivity syndrome is a potentially life-threatening treatment complication.
  • Patients who receive beta-blockers are at decreased risk for gout.
Volume 38.3 - Question 31

Sjogren's Syndrome

Interstitial lung disease is the most frequent pulmonary complication of Sjogren’s Syndrome.

  • True
  • False
Volume 39.2 - Question 39

Fibromyalgia

A 45-year-old female patient comes to see you in follow-up. She is known for arthrosis and a long-standing issue with chronic pain. She states today that she feels exhausted and has pain “all over”. Her physical exam doesn’t reveal any sign of inflammation. You are considering a diagnosis of fibromyalgia.
Volume 38.6 - Question 43

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