Musculoskeletal/Rheum - Primary Care Review
A 75 year-old female presents with complaints of stiffness, aching, and pain in the muscles
... [Show More] of her neck, shoulders, lower back, hips, and thighs. There is no associated weakness associated with the stiffness and achiness. Laboratory evaluation shows an elevated C reactive protein and erythrocyte sedimentation rate. Which of the following medications is used to treat this condition immediately and will also serve to prevent a known complication from this disorder?
Methotrexate (Rheumatrex)
Azathioprine (Imuran)
Cyclophosphamide (Cytoxan)
Glucocorticoids - answers Glucocorticoids
A 51- year-old man recently underwent a physical examination during which you obtained a routine chemistry profile. All values were normal except for a serum uric acid of 7.5 mg /dL. He has no history of gouty arthritis, renal disease, or urolithiasis. The most appropriate management of this problem would be to:
Begin Probenecid therapy to prevent renal stone formation
Initiate therapy with Allopurinol to prevent urate nephropathy
Follow the patient expectantly without pharmacologic intervention
Treat the patient with prophylactic indomethacin to prevent gout
None of the above - answers Follow the patient expectantly without pharmacologic intervention
A 52 year-old male presents with a severely painful, swollen right great toe. He denies recent trauma, but reports several similar episodes of toe pain and swelling over the past two to three years. He has a history of alcohol abuse and hypertension, for which he "takes medication" of unknown type. Examination reveals bright erythema and edema associated with the right first MCP joint. Which of the patient's antihypertensive medications may be contributing to this condition?
Hydrochlorothiazide (HCTZ)
Lisinopril (Prinivil)
Metoprolol (Lopressor)
Diltiazem (Cardizem) - answers Hydrochlorothiazide (HCTZ)
Disease-modifying antirheumatic drugs(DMARDS) include all of the following EXCEPT?
Hydroxychloroquine
NSAID's
Methrotrexate
Sulfasalazine
D-penicillamine - answers NSAID's
A 56 year-old white post-menopausal female had a recent surveillance DEXA bone densitometry. The T-score is -2.7 for her right hip. In counseling this patient, in addition to medications, which of the following would you recommend?
Weight bearing exercises
Daily red wine consumption
Limit sun exposure
Water aerobics - answers Weight bearing exercises
Which of the following medications is the initial treatment of choice for suppressing the progression of rheumatoid arthritis (RA)?
Gold salts
Methotrexate (Rheumatrex)
Prednisone
Naproxen sodium (Naprosyn) - answers Methotrexate (Rheumatrex)
A 34 year-old female, with a past medical history of irritable bowel syndrome and migraines, presents with fatigue, generalized aching and stiffness of the trunk, hip, and shoulder girdles. She complains of pain and tightness in the neck and across the upper posterior shoulders. She complains of poor sleep, but denies depression. Physical examination is unremarkable except for numerous tender points on palpation. Laboratory evaluation was unremarkable. Which of the following is the best intervention for this patient?
Corticosteroids
Supervised exercise program
Hydrocodone (Vicodin)
Refer to endocrinologist - answers Supervised exercise program
What is the first DOC for the suppression of inflammation in a patient with RA?
Hydroxychloroquine
Oral prednisone
NSAID's
D-penicillamine
Methotrexate - answers NSAID's
A 70-year-old man with renal insufficiency and recurrent attacks of proven gouty arthritis has elevated serum and urine uric acid levels. He is now asymptomatic. The most appropriate approach is
Chronic allopurinol
Chronic celecoxib
Chronic probenecid
Chronic colchicine
No chronic therapy - answers Chronic allopurinol
An elderly woman slipped in her driveway, injuring her right wrist. Radiographs show a Colles fracture. Before sending the patient to orthopedics, intervention should include immobilization with which splint
...............................................................................continued....................................................................... [Show Less]