NBME Answers : dlw's page

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+0 visit this page (step2ck_form7#39)

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I totally thought this guy had Huntington's possibly.

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happyyoyo that would be really young, but we also don't have a family history, and he doesn't have the choreiform movements seen in Huntingtons, and those pts also tend to have depression. +

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submitted by step_prep2(66), visit this page

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Presentation most consistent with osteoarthritis because the woman is heavy, the stiffness resolves quickly upon waking, the joint pain is asymmetric and, most importantly, it involves the DIP joints of the hand. The only two diseases that will involve the DIP joints are osteoarthritis and psoriatic arthritis. It is weird that it gets better as the day progresses, but the overall picture is most consistent with OA
Key idea: Osteoarthritis characterized by osteophytes, joint space narrowing, subchondral sclerosis and cysts

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dlw Also, Q stem specifically states most likely to find on imaging of her KNEES, not her hands. The hands improve with movement but the knees worsen on walking. +3

cbreland What would "subchondral lucency" reference?? I was assuming that it would be OA as well so that's why I didn't pick osteophytes. That being said, I chose erosions... but not for a good reason +

namesthegame22 I think "subchondral lucency" is osteonecrosis +

namesthegame22 Osteophytes can be causing the crepitus +