- Email: [email protected]
Rheumatology Quiz
Indian Journal of Rheumatology 2010 March Volume 5, Number 1; p. 45
PG Forum
Rheumatology Quiz V Arya1, V Dhir2
1. All of the following are true of DILS (Diffuse Infiltrative Lymphocytosis Syndrome) except (a) bilateral submandibular gland enlargement is common (b) negative for anti-Ro and anti-La antibodies (c) CD8+ lymphocyte predominance in biopsy of affected glands (d) typically starts after initiation of HAART (Highly Active Anti Retroviral Therapy) 2. Which of the following is not true of licofenole, a newly tested drug (a) competitive inhibitor of cyclo-oxygenase and 5lipo-oxygenase (b) useful in preventing relapses in Wegener’s granulomatosis (c) shown to be disease modifying in osteoarthritis (d) dyspepsia is the commonest adverse effect reported 3. “CSULGIE” is (a) a reporting system for anti-TNF adverse effects (b) a disease activity assessment score for psoriatic arthritis (c) a new classification of vasculitis (d) a composite end point for gut toxicity of drugs 4. Which of the following antibiotics has been shown to slow down the progression of knee osteoarthritis? (a) clarithromycin (b) ciprofloxacin (c) doxycycline (d) rifampicin 5. Which of the following is not true of osteitis condensans ilii? (a) common in obese multipara (b) back pain relieved by activity and worsened by rest
1
(c) may resolve spontaneously (d) triangular iliac sclerosis seen on pelvic radiographs 6. Levels of anti-CRP antibodies reflect disease activity in (a) rheumatoid arthritis (b) fibromyalgia (c) lupus nephritis (d) dermatomyositis 7. Which of the following is not true of soluble human leucocyte antigen-G (sHLA-G)? (a) gene polymorphism is high (b) levels are low in RA (c) low levels predispose to ankylosing spondylitis (d) low levels predispose to poor spinal mobility 8. Compared with adult ankylosing spondylitis, patients with juvenile onset AS have all the following except (a) a greater delay in diagnosis (b) more severe axial involvement (c) less radiological damage (d) more peripheral arthritis 9. Cranial nerve involvement in Mixed Connective Tissue Disease most often takes the form of (a) lower motor neuron seventh nerve palsy (b) unilateral sixth nerve palsy (c) trigeminal neuralgia (d) internuclear ophthalmoplegia 10. Patients with SLE myelitis who have predominantly grey matter dysfunction are more likely to have which of the following features? (a) progression to irreversible paraplegia (b) a polyphasic course (c) lower disease activity (d) normal CSF findings For answers refer to page 15
Department of Medicine, PGIMER and Dr R.M.L. Hospital, New Delhi and 2Department of Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India. Correspondence: Dr. V Arya, email: [email protected]
Relating bone marrow oedema to hs-CRP in knee osteoarthritis
11. Kellgren JK, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis 1957; 16: 494–501. 12. Larry, J., Kricka, D. Principles of immunochemical techniques. In: Tietz WW (ed.), Fundamentals of Clinical Chemistry, 4th ed. W.B. Saunders: Philadelphia, 1996; 10: 144–69. 13. Kumon Y, Suehiro T, Nishiya K, Hashimoto K, Nakatani K, Sipe JD. Ferritin correlates with C-reactive protein and acute phase serum amyloid A in synovial fluid, but not in serum. Int J Exp Clin Invest 1999; 6: 130–5. 14. Shine B, Bourne JT, Begum Baig F, Dacre J, Doyle DV. C reactive protein and immunoglobulin G in synovial fluid and serum in joint disease. Annal Rheum Dis 1991; 50: 32–5. 15. Bassiouni M, Bassiouni H, El-Dahan M. Measurement of immunoglobulins G, M and A in idiopathic osteoarthrosis: a suggested explanation for their production. Ann Saudi Med 1991; 11. 16. Wluka AE, Hanna F, Davies-Tuck M, Wang Y, Bell RJ, Davis SR, Adams J, Cicuttini FM. Bone marrow lesions predict
ANSWERS TO THE RHEUMATOLOGY QUIZ (page 45) 1d*, 2b, 3d**, 4c, 5b***, 6c†, 7a††, 8b†††, 9c, 10a§ *DILS occurs with profound immunosuppression and resolves rapidly with HAART. **Stands for: Clinically Significant Upper and Lower GI Events. J Rheumatol 2010;37:167–74
Original Article
17.
18.
19.
20.
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increase in knee cartilage defects and loss of cartilage volume in middle-aged women without knee pain over 2 years. Ann Rheum Dis 2009; 68: 850–5. Spector TD, Hart DJ, Nandra D, Doyle DV, Mackillop N, Gallimore JR, et al. Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum 1997; 40: 723–7. Zanetti M, Bruder E, Romero J, Hodler J. Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 2000; 215: 835–40. [PMID: 10831707] Bergman AG, Willen HK, Lindstrand AL, Pettersson HT. Osteoarthritis of the knee: correlation of subchondral MR signal abnormalities with histopathologic and radiographic features. Skeletal Radiol 1994; 23: 445–8. Kesemenli, Memisoglu K, Muezzinoglu US. Bone marrow edema seen in MRI of osteoarthritic knees is a microfracture. Med Hypotheses 2009; 72(6): 754–5. Epub 2009 Feb 27
***Back pain is worsened by activity and relieved by rest † this marker has been shown to correlate very closely with the activity of nephritis in SLE †† unlike other MHC class I genes, gene polymorphism is low ††† peripheral arthritis is more common and axial involvement is less severe § progression often heralded by fever and urinary retention; monophasic course; disease activity high; CSF findings like those of pyogenic meningitis.
PG Forum
Rheumatology Quiz V Arya1, V Dhir2
1. All of the following are true of DILS (Diffuse Infiltrative Lymphocytosis Syndrome) except (a) bilateral submandibular gland enlargement is common (b) negative for anti-Ro and anti-La antibodies (c) CD8+ lymphocyte predominance in biopsy of affected glands (d) typically starts after initiation of HAART (Highly Active Anti Retroviral Therapy) 2. Which of the following is not true of licofenole, a newly tested drug (a) competitive inhibitor of cyclo-oxygenase and 5lipo-oxygenase (b) useful in preventing relapses in Wegener’s granulomatosis (c) shown to be disease modifying in osteoarthritis (d) dyspepsia is the commonest adverse effect reported 3. “CSULGIE” is (a) a reporting system for anti-TNF adverse effects (b) a disease activity assessment score for psoriatic arthritis (c) a new classification of vasculitis (d) a composite end point for gut toxicity of drugs 4. Which of the following antibiotics has been shown to slow down the progression of knee osteoarthritis? (a) clarithromycin (b) ciprofloxacin (c) doxycycline (d) rifampicin 5. Which of the following is not true of osteitis condensans ilii? (a) common in obese multipara (b) back pain relieved by activity and worsened by rest
1
(c) may resolve spontaneously (d) triangular iliac sclerosis seen on pelvic radiographs 6. Levels of anti-CRP antibodies reflect disease activity in (a) rheumatoid arthritis (b) fibromyalgia (c) lupus nephritis (d) dermatomyositis 7. Which of the following is not true of soluble human leucocyte antigen-G (sHLA-G)? (a) gene polymorphism is high (b) levels are low in RA (c) low levels predispose to ankylosing spondylitis (d) low levels predispose to poor spinal mobility 8. Compared with adult ankylosing spondylitis, patients with juvenile onset AS have all the following except (a) a greater delay in diagnosis (b) more severe axial involvement (c) less radiological damage (d) more peripheral arthritis 9. Cranial nerve involvement in Mixed Connective Tissue Disease most often takes the form of (a) lower motor neuron seventh nerve palsy (b) unilateral sixth nerve palsy (c) trigeminal neuralgia (d) internuclear ophthalmoplegia 10. Patients with SLE myelitis who have predominantly grey matter dysfunction are more likely to have which of the following features? (a) progression to irreversible paraplegia (b) a polyphasic course (c) lower disease activity (d) normal CSF findings For answers refer to page 15
Department of Medicine, PGIMER and Dr R.M.L. Hospital, New Delhi and 2Department of Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India. Correspondence: Dr. V Arya, email: [email protected]
Relating bone marrow oedema to hs-CRP in knee osteoarthritis
11. Kellgren JK, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis 1957; 16: 494–501. 12. Larry, J., Kricka, D. Principles of immunochemical techniques. In: Tietz WW (ed.), Fundamentals of Clinical Chemistry, 4th ed. W.B. Saunders: Philadelphia, 1996; 10: 144–69. 13. Kumon Y, Suehiro T, Nishiya K, Hashimoto K, Nakatani K, Sipe JD. Ferritin correlates with C-reactive protein and acute phase serum amyloid A in synovial fluid, but not in serum. Int J Exp Clin Invest 1999; 6: 130–5. 14. Shine B, Bourne JT, Begum Baig F, Dacre J, Doyle DV. C reactive protein and immunoglobulin G in synovial fluid and serum in joint disease. Annal Rheum Dis 1991; 50: 32–5. 15. Bassiouni M, Bassiouni H, El-Dahan M. Measurement of immunoglobulins G, M and A in idiopathic osteoarthrosis: a suggested explanation for their production. Ann Saudi Med 1991; 11. 16. Wluka AE, Hanna F, Davies-Tuck M, Wang Y, Bell RJ, Davis SR, Adams J, Cicuttini FM. Bone marrow lesions predict
ANSWERS TO THE RHEUMATOLOGY QUIZ (page 45) 1d*, 2b, 3d**, 4c, 5b***, 6c†, 7a††, 8b†††, 9c, 10a§ *DILS occurs with profound immunosuppression and resolves rapidly with HAART. **Stands for: Clinically Significant Upper and Lower GI Events. J Rheumatol 2010;37:167–74
Original Article
17.
18.
19.
20.
15
increase in knee cartilage defects and loss of cartilage volume in middle-aged women without knee pain over 2 years. Ann Rheum Dis 2009; 68: 850–5. Spector TD, Hart DJ, Nandra D, Doyle DV, Mackillop N, Gallimore JR, et al. Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum 1997; 40: 723–7. Zanetti M, Bruder E, Romero J, Hodler J. Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 2000; 215: 835–40. [PMID: 10831707] Bergman AG, Willen HK, Lindstrand AL, Pettersson HT. Osteoarthritis of the knee: correlation of subchondral MR signal abnormalities with histopathologic and radiographic features. Skeletal Radiol 1994; 23: 445–8. Kesemenli, Memisoglu K, Muezzinoglu US. Bone marrow edema seen in MRI of osteoarthritic knees is a microfracture. Med Hypotheses 2009; 72(6): 754–5. Epub 2009 Feb 27
***Back pain is worsened by activity and relieved by rest † this marker has been shown to correlate very closely with the activity of nephritis in SLE †† unlike other MHC class I genes, gene polymorphism is low ††† peripheral arthritis is more common and axial involvement is less severe § progression often heralded by fever and urinary retention; monophasic course; disease activity high; CSF findings like those of pyogenic meningitis.