Practice Question, Musculoskeletal Pathology - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 04-03-2011
USMLE Forums Guru
 
Steps History: Not yet
Posts: 298
Threads: 45
Thanked 718 Times in 210 Posts
Reputation: 728
Arrow Practice Question, Musculoskeletal Pathology

  • A 65 year old male presents to your office with complaints of joint pain in his right knee. Upon further questioning, you find out that the knee is stiff for over an hour in the morning and gets better with exercise. You also notice that he has a silvery rash on his elbows. You take a sample of synovial fluid from his knee. You would expect the synovial fluid to be most similar to that found in which of the following?
A. Osteoarthritis
B. Gout
C. Rheumatoid Arthritis
D. Systemic Lupus Erythematosus
E. Septic Arthritis
Reply With Quote Quick reply to this message
The above post was thanked by:
aktorque (04-03-2011), bronchiole (04-03-2011), doc_study (04-05-2011), harlesmd (04-03-2011), Mondoshawan (04-03-2011)



  #2  
Old 04-03-2011
harlesmd's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 390
Threads: 40
Thanked 365 Times in 144 Posts
Reputation: 375
Default

C. Rheumatoid arthritis
__________________
Time is immortal when you believe on something...
Reply With Quote Quick reply to this message
  #3  
Old 04-03-2011
bronchiole's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 121
Threads: 18
Thanked 66 Times in 37 Posts
Reputation: 76
Help

c is the answer(rheumatoid nodules on elbow??)
Reply With Quote Quick reply to this message
 
  #4  
Old 04-03-2011
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 590
Threads: 31
Thanked 1,232 Times in 411 Posts
Reputation: 1256
Default

I agree C - RA...

...but I think those are psoriatic plaques rather than rheumatic nodules. Psoriatic arthritis is inflammatory like RA (though usually RF-negative), so the synovial fluid would look similar.
Reply With Quote Quick reply to this message
The above post was thanked by:
doc_study (04-05-2011), nirmal pudota (10-14-2014)
  #5  
Old 04-03-2011
USMLE Forums Guru
 
Steps History: Not yet
Posts: 298
Threads: 45
Thanked 718 Times in 210 Posts
Reputation: 728
Correct Answer C is correct!

Quote:
Originally Posted by Mondoshawan View Post
I agree C - RA...

...but I think those are psoriatic plaques rather than rheumatic nodules. Psoriatic arthritis is inflammatory like RA (though usually RF-negative), so the synovial fluid would look similar.
Yup, you are exactly right. This is a case of psoriatic arthritis, an inflammatory process. Note that these patients are RF positive in up to 10% of cases though (RF is not a very specific test). Further explanation below:

This patient presents with signs of psoriatic arthritis. This is indicated by the silvery rash (psoriasis) + asymmetrical joint pain. This type of arthritis is most closely related to Rheumatoid Arthritis. Both of these processes are inflammatory, so you would expect to have prolonged morning stiffness and relief of symptoms with use. Osteoarthritis is not inflammatory so morning stiffness would most likely be less than 30 minutes. Gout would show crystals, which would not be expect in psoriatic arthritis. SLE does not have the same extent of inflammation as RA or Psoriatic (I dont blame you if you answered SLE but RA is a better answer). Septic arthritis would have >100,000 WBCs, but here we would expect less (2,000-75,000).

Good job guys!
Reply With Quote Quick reply to this message
The above post was thanked by:
bronchiole (04-03-2011), doc_study (04-05-2011), donofitaly (04-12-2011), Fazle rabbi (09-12-2011), harlesmd (04-03-2011), kumar11 (10-17-2014), mayeli (04-05-2011), Mondoshawan (04-03-2011), noothan (04-12-2011)
  #6  
Old 04-12-2011
USMLE Forums Newbie
 
Steps History: CK+CS
Posts: 1
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default RA

Rheumatoid Arthritis...R/t psoriasis
Reply With Quote Quick reply to this message



Reply

Tags
Musculoskeletal-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Practice Question: Biochemistry apx85 USMLE Step 1 Forum 10 09-14-2016 10:40 AM
Practice Question: Microbiology #2 apx85 USMLE Step 1 Forum 12 10-01-2014 03:48 AM
Practice Question, Microbiology #3 apx85 USMLE Step 1 Forum 16 04-09-2011 12:25 PM
Practice Question: Pharmacology apx85 USMLE Step 1 Forum 11 03-28-2011 05:33 PM
Practice Question: Reproductive pathology apx85 USMLE Step 1 Forum 5 03-15-2011 10:08 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)