Joints from gout to septic.

/10

This Xray shows a characteristic sign seen in Ankylosing Spondylitis. What is it called?

It results from vertebral body fusion by marginal syndesmophytes (extra bone). Krebs first described the radiographic appearance in 1930.

Beanstalk sign.

Ladder spine.

Bamboo spine.

Bone tube spine.

/10

"Swan neck" and "Boutonniere" deformity are usually described in which type of arthritis?

Boutonniere or button hole deformity is where the proximal interphalangeal joint (PIPJ) is fixed and the distal interphalangeal joint hyperextended (DIPJ). In a Swan neck deformity there is hyperextension at the PIP joint and flexion at the DIP joint.

Rheumatoid arthritis.

Psoriatic arthritis.

Oseoarthritis.

Reactive arthritis.

/10

Which of these responses best describes the crystals found in gout?

Option 3 is a description of the crystals found in pseudogout.

Monosodium urate, rhomboid, yellow, negatively birefringent.

Monosodium urate, blue, needle shaped, negatively birefringent.

Calcium pyrophosphate, rhomboid shaped, yellow, positively birefringent.

Calcium pyrophosphate, blue, needle shaped, negatively birefingent.

/10

What component of this brief video of a knee aspiration under ultrasound guidance could be improved?

All reasonable options to improve the aspiration but in terms of an ultrasound guided procedure you should get the ultrasound machine in line with your eyesight and not keep turning your head.

The betadine needs to cover a greater area of the knee.

Use a cannula not a large needle.

Remove your tie if you are doing an aseptic procedure.

The position of the ultrasound machine.

/10

In an acute flare up of gout what is a reasonable dose of colchicine to use?

It reduces the pain and inflammation in about 12 to 24hours but can be a dangerous drug at higher doses. Used also in pericarditis. Well absorbed orally.

1mg orally followed by 0.5mg orally 12hours later.

A single oral dose of 0.5mg.

0.5mg orally twice a day for 1 week.

1.2mg deep IM injection (lateral right buttock).

/10

What sort of arthritis is "Still's" disease?

(JIA) juvenile idiopathic arthritis is the most common type of arthritis in kids and teens. About 10 to 20% have a much more serious variant called systemic juvenile idiopathic arthritis (SJIA) which can also affect the liver, lungs and heart. This is sometimes referred to as Still's disease.

End stage Ankylosing arthritis.

A form of psoriatic arthritis.

Reactive arthritis (post viral).

Systemic juvenile idiopathic arthritis.

/10

When aspirating a joint which of the following is UNTRUE?

In an inflammed gouty joint expect a WCC of around 20,000mm3 with 70% neutrophils which would be similar to a joint with rheumatoid arthritis.

WCC of 700mm3 with 25% neutrophils would be in a normal joint.

WCC of 1000mm3 would support an inflammed gouty joint.

WCC of 90,000mm3 with 90% neutrophils would support a septic joint.

Expect WCC 20,000mm3 with 70% neutrophils in a joint with rheumatic arthritis.

/10

One of the following statements are false when speaking of gonoccocal arthritis.

The word gonorrhea comes from the Greek words---seed, flow--- because the Greek physicians incorrectly mistook the urethral discharge as semen.

Occurs in men more than women.

Disseminated gonococcus occurs in about 3% of patients with gonorrhoea.

Is less destructive to the joints than Staph.

Tends to affect large joints like knees and ankles.

/10

How many types of arthritis are generally recognised in psoriasis?

Tough question. 1/ Symmetric, 2/ Asymmetric, 3/ Mainly DIP, nails, 4/ Arthritis mutilans, 5/ Spondylitis.

Treatment is a cascade---NSAIDs, DMARDS (Methtrexate, Sulphasalazine,Leflunomide), AntiTNF ( Etanercept, Infliximab, Adalimumab), Monoclonal Ab (Ustekinumab).

All those drugs always sound to me like Illhaveakebab.

/10

Which of the following celebrities did/does NOT have rheumatoid arthritis?

Shaq O'Neil is a very large person so it not surprising that he has osteoarthritis. However he does not not have rheumatoid arthritis.

Edith Piaf (Legendary French singer).

Shaquille O'Neil (Retired basketball player and BET 365 guy on TV).

Paula Abdul (Singer--see video clip).

Pierre August Renoir (Dead painter).

You got {number correct}/{number of questions} correct answers