Rheumatology – Exam Review Set 3

What this deck covers

Rheumatology – Exam Review Set 3 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Two years on, no eye check yet
2. Sick every Sunday
3. Cleared before he started
4. Ulcers, fever, six weeks in
5. Seven doses in seven days
6. A first seizure at midnight
7. Hearing voices on high doses
8. Bright girl, falling marks
9. Double vision, then a stumble
10. A dropped foot, then a wrist
11. Three years old, and his father too
12. Two strokes before school ends
13. Three years of drugs, no change
14. Sore bones, and a low blood count
15. Well now, after two years off
16. A dusky digit in January
17. Chalk under the skin
18. Her cheeks have hollowed
19. Two fingers of mouth opening
20. Strong again, but still purple
21. Quiet joints, breathless on stairs
22. What lies ahead, at diagnosis
23. A line up from the eyebrow
24. Six times, and one scar already
25. Three courses for her ears
26. Nobody told her it was changing
27. Two hours, and nobody to inject
28. A month of daylight hours
29. Nobody there will give the dose
30. Twenty minutes and tears, nightly
31. A swollen knee, and no fever
32. Arrived with nothing written down
33. He will not say where it hurts
34. Will the next child have it?
35. Two years without a flare
36. She has already booked it
37. Five weeks away, two doses due
38. The grandmother wants it gone
39. Needles in a drinks bottle
40. A week at the coast
41. Four joints, one frightened child
42. Comfortable bent, and staying that way
43. Four hours each way
44. She has stopped raising it
45. A year of normal clinic letters
46. They apologise for asking
47. She has seen this before
48. Nobody has ever told him
49. Her mother does all of it
50. Three weeks until the papers

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: No monitoring beyond the blood tests, Prescribe an antibiotic and review in two days, Stop the steroid at once, A peripheral neuropathy from the drug he is taking, An inherited arthropathy in, Advise gloves and review at her next appointment, Nothing beyond the routine day-case checks, Serial muscle enzymes alone, Glue ear, Suspend his treatment for the month, Inject the joint with steroid today, That it is not inherited at all, Simple sunburn from an unusually sunny week, By telephone as requested, arranging tests locally.

Clinical pearls from this deck

• A drug nobody intends to stop needs the monitoring that matches its own toxicity, and here that is the eye.
• Ask why a working drug is being missed. Intolerance you do not treat becomes non-adherence you never hear about.
• A screen before the first dose is not a screen for the fourth year. Exposure since is the question nobody asked.
• Scheduled monitoring is for the child with no symptoms. The child who telephones has already outrun it.
• The weekly tablet is dangerous because everything else in the cupboard is daily. Say so to whoever gives it next.
• Two diagnoses, opposite treatments. When immunosuppression is one of them, exclude the infection before you add more.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all rheumatology case decks · pediatric reference values.