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Fall Y3 > Rheum Exam 5 > Flashcards

Rheum Exam 5 Flashcards

1
Q

What dose the RAPID 3 score contain?
a. subjective sx
b. subjective sx and objective findings
c. objective findings
d. all of the above

A

subjective sx

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2
Q

What is included in DAS 28?
a. subjective sx
b. objective sx
c. ESR +PGA and 28 joints assessed for swelling and tenderness
d. all of the above

A

all of the above

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3
Q

What are used to asess disease progression?

A

Rapid 3
DAS 28
SDAI
CDAI

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4
Q

What is the disease activity monitoring tool for ankylosing spondylitis?
a. rapid 3
b. DAS 28
c. BASDAI
d. SDAI

A

BASDAI

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5
Q

What is the disease activity monitoring tool for SLE?
a. rapid 3
b. DAS 28
c. BASDAI
d. none of the above

A

none of the above

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6
Q

Which of the following are true of psoriatic arthritis?
a. RF is always negative in individuals with PsA
b. Onset occurs simultaneously with psoriasis of the skin
c. The peak symptom onset is 30-55 years of age
d. Affects females and males equally

A

c. The peak symptom onset is 30-55 years of age
d. Affects females and males equally

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7
Q

Which HLA is associated with psoriatic arthritis (though not as strongly as with other spondyloarthropathies)?
a. HLA-DR4
b. HLA-B27
c. HLA-DR2
d. HLA-DQ

A

HLA-B27

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8
Q

Stress is considered a risk factor for developing psoriatic arthritis.

Select one:
True
False

A

T

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9
Q

Peripheral joint involvement in PsA is more common in
a. Females
b. Males

A

F

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10
Q

Axial involvement of PsA is more common in
a. Males
b. Females

A

m

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11
Q

Which patterns are generally seen in PsA?
a. Morning stiffness lasting greater than 30 minutes
b. Joint pain worse with activity and better with immobility
c. Morning stiffness lasting less than 30 minutes
d. Joint pain worse with immobility and better with activity

A

Joint pain worse with immobility and better with activity
Morning stiffness lasting greater than 30 minutes

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12
Q

Which is the most predominant subgroup of PsA?
a. Polyarthritis
b. Asymmetrical oligoarthritis
c. Distal interphalangeal joint disease
d. Arthritis mutilans
e. Spondylitis

A

Asymmetrical oligoarthritis

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13
Q

“Sausage digit” occurs in about 50% of patients with psoriatic arthritis, What is the medical term for this symptom?
a. Dactylitis
b. Tenosynovitis
c. Kielbasa digit
d. Sclerodactyly

A

Dactylitis

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14
Q

Approximately, which percentage of patients with PsA develop arthritis mutilans?
a. 25%
b. 1%
c. 5%
d. 15%

A

5%

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15
Q

Enthesitis is defined as inflammation at the site of the insertion of tendons, ligaments and synovium into bone. Which tendon is most commonly affected in PsA?
a. Biceps tendon
b. Achilles tendon
c. Patellar tendon
d. Extensor hallucis longus tendon

A

Achilles tendon

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16
Q

Which should be included in the workup for psoriatic arthritis?
a. Deep tendon reflexes (DRTs)
b. Eye exam
c. Depression screening
d. Musculoskeletal exam
e. Skin and nail exam

A

b. Eye exam
c. Depression screening
d. Musculoskeletal exam
e. Skin and nail exam

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17
Q

Which differential diagnoses should be considered in the workup for PsA?
a. Hemochromatosis
b. Osteoarthritis
c. Trauma
d. Ankylosing spondylitis
e. Rheumatoid arthritis

A

Hemochromatosis
Ankylosing spondylitis
Rheumatoid arthritis

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18
Q

How is septic arthritis ruled out?
a. Physical exam
b. ESR/CRP
c. History alone
d. Joint aspiration and culture

A

Joint aspiration and culture

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19
Q

Individuals with PsA are at higher risk for cardiovascular disease
Select one:
True
False

A

T

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20
Q

Pencil-in-cup findings on imaging may be observed in which pathologies?
a. Osteoarthritis
b. Reactive Arthritis
c. Psoriatic arthritis
d. Rheumatoid arthritis

A

Psoriatic arthritis
Rheumatoid arthritis

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21
Q

Which joints are most commonly affected by pencil-in-cup deformity?
a. DIPs
b. Hips
c. PIPs

A

DIPs

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22
Q

Which osseous change observed on imaging is specific to PsA?
a. Cloudy opacity
b. Swan neck deformity
c. Subcortical cysts
d. Ivory phalynx

A

Ivory phalynx

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23
Q

What is the first-line pharmaceutical therapy for mild peripheral PsA arthritis?
a. Biologic DMARDs (TNF inhibitors)
b. Synthetic DMARDs (Methotrexate)
c. NSAIDs
d. Vitamin D

A

NSAIDs

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24
Q

What is the standard of care for severe psoriatic arthritis?
a. NSAIDs
b. Synthetic DMARDs (Methotrexate)
c. Biologic DMARDs (TNF inhibitors)
d. Vitamin D

A

Biologic DMARDs (TNF inhibitors)

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25
Q

What is the primary initial pharmaceutical intervention for axial psoriatic arthritis?
a. Biologic DMARDs (TNF inhibitors)
b. Synthetic DMARDS (methotrexate)
c. Intra Articular steroid injections
d. NSAIDs

A

NSAIDs

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26
Q

What daily dose of curcumin has been shown to improve symptoms of RA (and potentially PsA?
a. 1000mg
b. 300mg
c. 10g
d. 100mg

A

1000mg

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27
Q

Celiac disease is more prevalent in individuals with PsA

Select one:
True
False

A

T

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28
Q

Individuals with psoriasis and PsA should avoid even mild amounts of UV radiation and sun exposure

Select one:
True
False

A

F

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29
Q

Which vitamin deficiency has been noted in psoriasis and PsA patients?
a. Vitamin C
b. Vitamin D
c. B12
d. Vitamin E

A

Vitamin D

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30
Q

How often should a patient with active psoriatic arthritis or whos treatment is being adjusted be reassessed?
a. Every 6 months
b. Annually
c. Every 3 months
d. At least every month

A

Every 3 months

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31
Q

How often should a patient with stable psoriatic arthritis be reassessed?
a. Every 6 months
b. Every 3 months
c. Annually
d. At least once a month

A

Every 6 months

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32
Q

This remedy is indicated for sprains with boggy swelling.
a. Carbo animalis
b. Rhus tox
c. Ledum
d. Colchicum

A

ledum

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33
Q

80% of sarcoidosis cases present within this age range.
a. 15-20
b. >50
c. 45-60
d. 20-50

A

20-50

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34
Q

About half the individuals in whom sarcoidosis is identified are asymptomatic.

Select one:
True
False

A

T

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35
Q

In sarcoidosis, remission generally occurs
a. In black individuals more often than in white individuals
b. if there are no extra thoracic manifestations
c. Within the first two years of diagnosis
d. In individuals who are younger at diagnosis

A

Within the first two years of diagnosis

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36
Q

The most common systems involved in sarcoidosis include
a. Heart and lungs
b. Lymphatics and GI
c. Lungs and lymphatics
d. Lungs and GI

A

Lungs and lymphatics

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37
Q

Select the environmental exposures linked to increased risk of developing sarcoidosis.
a. Zirconium
b. Lithium
c. Zinc
d. Lead
e. Beryllium
f. Mercury
g. Aluminum

A

Aluminum
Beryllium
Zirconium

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38
Q

Mycobacterium tuberculosis is histologically similar to sarcoidosis with the major difference being that the granuloma in tuberculosis is _ whereas in sarcoidosis it is _
a. Caseating; non-caseating
b. Non-caseating; caseating

A

Caseating; non-caseating

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39
Q

The center of a sarcoid granuloma is filled with
a. Dead epithelial cells
b. bacteria
c. specialized macrophages called epithelioid cells
d. mast cells

A

specialized macrophages called epithelioid cells

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40
Q

Interstitial lung disease is defined as
a. A disorder resulting in airflow obstruction and reduction
b. As acute, inflammatory reaction in the lungs
c. A disorder causing fibrosis or scarring of the lugs
d. A disease only occurring in the interstitium of the lungs

A

A disorder causing fibrosis or scarring of the lungs

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41
Q

Which of the following is associated with chronic sarcoidosis and therefore likely to require systemic treatments?
a. Lupus pernio
b. Papular sarcoidosis
c. Plaque-like lesions

A

Lupus pernio

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42
Q

It is imperative to recommend patients with sarcoidosis to follow up with an ophthalmologist annually because
a. they are at increased risk of developing anterior uveitis leading to blindness
b. development of keratoconjunctivitis sicca is associated with higher mortality
c. They’re more likely to develop Sjogren’s syndrome, leading to dry eyes
d. They may develop glaucoma leading to impaired vision

A

they are at increased risk of developing anterior uveitis leading to blindness

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43
Q

Cardiovascular manifestations of sarcoidosis are
a. only addressed in someone with chest pain
b. rare and easily treated
c. Common in older individuals
d. Uncommon and serious

A

Uncommon and serious

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44
Q

In individuals with sarcoidosis, hilar involvement with lymphadenopathy is seen in _________ % of cases.
a. 90
b. 60
c. 30
d. 5

A

90

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45
Q

What helps differentiate the MSK symptoms of RA from sarcoidosis?
a. The radial deviation of RA is correctable but with sarcoidosis it is not
b. RA polyarthritis in symmetrical; sarcoidosis is asymmetrical
c. The ulnar deviation in correctable by patients with sarcoidosis but not by those with RA
d. RA will present with ulnar deviation; sarcoidosis presents with radial deviation

A

The ulnar deviation in correctable by patients with sarcoidosis but not by those with RA

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46
Q

Choose the symptom cluster described by Lofgren syndrome.
a. Uveitis + papular sarcoidosis + fever + lymphadenopathy
b. Erythema nodosum + polyarthritis + fatigue + glossitis
c. Erythema nodosum + hilar adenopathy + migratory polyarthralgia + fever
d. Hilar adenopathy + heart failure + erythema nodosum + glossitis

A

Erythema nodosum + hilar adenopathy + migratory polyarthralgia + fever

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47
Q

This is the most common presenting symptom in individuals with sarcoidosis.
a. fatigue
b. Polyarthralgia
c. Hilar adenopathy
d. fever

A

fatigue

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48
Q

Which bloodwork is likely to come back elevated in sarcoidosis patients.
a. RBC count
b. ESR and CRP
c. Eosinophils
d. Liver enzymes

A

ESR and CRP

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49
Q

A diagnosis of sarcoidosis requires this in the absence of lofgren syndrome
a. Fatigue as a clinical symptom
b. Migratory polyarthralgia
c. An X-ray demonstrating hilar adenopathy
d. A biopsy detecting noncaseating granulomas

A

A biopsy detecting noncaseating granulomas

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50
Q

For which stages of sarcoidosis is prednisone recommended?
a. Stages 3 and 4
b. Stages 2 and 3
c. Stages 1 and 2
d. Stages 0 and 1

A

Stages 3 and 4

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51
Q

Which dose of melatonin has been shown to resolve dyspnea and skin lesions in sarcoidosis patients in whom glucocorticoids have failed?
a. 10 mg/day
b. 1 mg/day
c. 5 mg/day
d. 20 mg/day

A

20 mg/day

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52
Q

Infections leading to Reactive arthritis are typically
a. Chronic
b. Upper respiratory infections
c. GI or GU infections
d. Severe and debilitating
e. Associated with septic arthritis

A

GI or GU infections

53
Q

Around ___________% of individuals with Reactive arthritis are HLA B27 positive.
a. 50
b. 25
c. 75
d. 10

A

75

54
Q

Which of these Reactive arthritis differentials must be ruled out quickly with arthrocentesis?
a. Rheumatoid arthritis
b. Ankylosing spondylitis
c. Septic Arthritis
d. Psoriatic arthritis

A

Septic Arthritis

55
Q

Which of the following is true concerning the classic triad of conjunctivitis, urethritis and arthritis for reactive arthritis?
a. It is pathognomonic but extremely rare
b. It is specific but not sensitive for reactive arthritis
c. It is found in many inflammatory conditions
d. It is sensitive but not specific for reactive arthritis

A

It is specific but not sensitive for reactive arthritis

56
Q

This joints are most often affected by reactive arthritis.
a. Knees and shoulders
b. PIPs and DIPs
c. Lower limb joints
d. Neck and spine

A

Lower limb joints

57
Q

Which of the following is NOT a typical digital finding associated with reactive arthritis?
a. Subungual keratosis
b. Clubbing
c. Onycholysis
d. Dactylitis

A

Clubbing

58
Q

Which of the following is true about the mucous membrane ulcers of reactive arthritis?
a. They are generally painless
b. They are extremely painful

A

They are generally painless

59
Q

What helps distinguish nail manifestations of reactive arthritis from those of psoriatic arthritis?
a. Reactive arthritis typically only affects the toenails
b. In reactive arthritis the skin peels around the nails (subungual keratosis), in psoriatic arthritis the skin around the nails is typically unaffected
c. Psoriatic arthritis presents with pitting, reactive arthritis typically doesn’t have pitting
d. Reactive arthritis does not present with subungual keratosis

A

In reactive arthritis the skin peels around the nails (subungual keratosis), in psoriatic arthritis the skin around the nails is typically unaffected
Psoriatic arthritis presents with pitting, reactive arthritis typically doesn’t have pitting

60
Q

Circinate balanitis is
a. All of these are true
b. Painless
c. Highly suggestive for reactive arthritis when presenting with joint pain in a male
d. Characterized by small, shallow ulcers

A

All of these are true

61
Q

In reactive arthritis rheumatoid factor is
a. Negative
b. Positive as often as in the general population
c. Positive

A

Positive as often as in the general population

62
Q

The prognosis for reactive arthritis is
a. The prognosis is highly variable and unpredictable.
b. Poor. The disease progresses with treatment aimed at symptomatic relief
c. Good. It resolves in 70-80% of cases

A

Good. It resolves in 70-80% of cases

63
Q

Exercise is contraindicated in reactive arthritis.

Select one:
True
False

A

F

64
Q

Dietary recommendations for reactive arthritis
a. Are specific for reactive arthritis
b. Are well researched
c. Can decrease overall inflammation
d. Are not advised due to lack of research

A

Can decrease overall inflammation

65
Q

Reactive arthritis is a clinical diagnosis.

Select one:
True
False

A

T

66
Q

Which of the following are key notes of ledum?
a. Cold to the touch
b. All of these are key notes of ledum
c. Black eyes
d. Better from cold applications

A

All of these are key notes of ledum

67
Q

Which of the following remedies is/are indicated for podagra/gouty attacks
a. Rhus tox
b. Ledum
c. Colchicum
d. None of these remedies are indicated

A

Ledum
Colchicum

68
Q

Which remedy has aggravation from drinking coffee?
a. Ledum
b. Rhus tox
c. Colchicum
d. Coffea

A

Colchicum

69
Q

What is rhus tox derived from?
a. Poison oak
b. Dog saliva
c. Mercury
d. Poison ivy

A

Poison ivy

70
Q

Which of the following is an indication for rhus tox?
a. Testicular pain
b. Craving milk
c. Arthritis
d. Suicidality

A

Arthritis

71
Q

Tuberculinum is considered a miasm by some individuals.

Select one:
True
False

A

T

72
Q

Tuberculinum is commonly used to treat
a. Arthritis
b. Flus
c. Colds
d. Each of these are possible indications for its use.

A

Each of these are possible indications for its use.

73
Q

Which of the following best describes the emotional state associated with tuberculinum?
a. Happy
b. Discontent
c. Content
d. Lazy

A

Discontent

74
Q

Individuals who may benefit from tuberculinum express an underlying weakness and will often overextend themselves triggering discharges and breakdowns.

Select one:
True
False

A

T

75
Q

Tuberculinum is indicated for individuals who stay in the same job and do not travel often.
Select one:
True
False

A

F

76
Q

Select the keynotes for tuberculinum.
a. Content
b. Wants to sleep all the time
c. Desire for travel
d. Allergy to milk
e. Better in mountains

A

Desire for travel
Allergy to milk
Better in mountains

77
Q

Tuberculinum is indicated in individuals prone to recurring colds.

Select one:
True
False

A

T

78
Q

Individuals willingness to travel is factored in their constitutional remedy,

Select one:
True
False

A

T

79
Q

Which remedy is associated with long, fine eyelashes?
a. Ledum
b. Rhus tox
c. Colchicum
d. Tuberculinum

A

Tuberculinum

80
Q

Causticum is a polycrest.

Select one:
True
False

A

T

81
Q

Select the emotions associated with causticum.
a. Sympathetic
b. Pessimists
c. Organized
d. Sensitive

A

Sensitive
Sympathetic

82
Q

Select the keynotes associated with causticum.
a. Constant desire to clear throat
b. Rebellious
c. Skin eruptions or warts on the nose
d. Each of these is a keynote for causticum

A

Each of these is a keynote for causticum

83
Q

Which of the following is the “Portland remedy”?
a. Ledum
b. Colchicum
c. Causticum
d. Tuberculinum

A

Causticum

84
Q

Causticum is a remedy to consider in individuals who often overreact and have outbursts.
Select one:
True
False

A

T

85
Q

Causticum individuals crave sweets.

Select one:
True
False

A

F

86
Q

Causticum individuals prefer cloudy, wet or rainy weather.

Select one:
True
False

A

T

87
Q

Which remedy is associated with a sensitivity to authority?
a. Ledum
b. Tuberculinum
c. Causticum
d. Colchicum

A

Causticum

88
Q

What remedy is Causticum similar to?
a. Ipecac
b. Iris versicolor
c. Ignatia
d. Ledum

A

Ignatia

89
Q

Causticum is indicated for individuals who are closed off and have trouble connecting intimately.
Select one:
True
False

A

T

90
Q

Excessive reactions are commonly associated with causticum.

Select one:
True
False

A

T

91
Q

A causticum picture most often presents after one large grief.

Select one:
True
False

A

F

92
Q

The rheumatic picture most in alignment with cuasticum is
a. Progressive stiffness
b. Sudden stiffness
c. None of these are correct
d. Sudden joint pain

A

Progressive stiffness

93
Q

Causticum is indicated in individuals with a low sex drive.

Select one:
True
False

A

T

94
Q

Causticum is associated with which constitution
a. Warm
b. Wet
c. Dry
d. Damp

A

Dry

95
Q

The pains associated with causticum are generally
a. Tingling pains
b. Stabbing pains
c. Tearing pains
d. Cutting pains

A

Tearing pains

96
Q

Which is the most common of the spondyloarthropathies?
a. Inflammatory bowel disease
b. Ankylosing spondylitis
c. Psoriatic arthritis
d. Reactive arthritis

A

Ankylosing spondylitis

97
Q

Which bacteria is most associated with Ankylosing spondylitis
a. Klebsiella pneumoniae
b. Lactobacillus
c. Bacteroides oralis
d. E. coli

A

Klebsiella pneumoniae

98
Q

Ankylosing spondylitis is more common in females than males.

Select one:
True
False

A

f

99
Q

There is a strong genetic link with Ankylosing spondylitis.

Select one:
True
False

A

T

100
Q

Which of the following is not a classification type of ankylosing spondylitis?
a. Axial AS
b. Peripheral AS
c. Non-radiographic AS
d. Radiographic AS

A

Radiographic AS

101
Q

Which of the following is associated with the low back pain in Ankylosing spondylitis?
a. Evening stiffness
b. Worse with exercise
c. Insidious onset
d. Improvement with rest

A

Insidious onset

102
Q

Which is not a common joint affected in ankylosing spondylitis?
a. Hips
b. Metacarpal joints
c. Costosternal joints
d. Sacroiliac

A

Metacarpal joints

103
Q

Which of the following is not a systemic symptom associated with ankylosing spondylitis?
a. Microscopic colitis
b. Cardiac arrhythmias
c. Hair loss
d. Cauda equina

A

Hair loss

104
Q

What percentage of patients with ankylosing spondylitis present with acute uveitis at some point in their disease?
a. 20-40%
b. 50-60%
c. 10-30%
d. 80-90%

A

20-40%

105
Q

It is common for patients with spondyloarthropathies to have concomitant GI conditions such as Colitis, Crohns or leaky gut.

Select one:
True
False

A

T

106
Q

Which of the following spinal changes is most directly contraindicated for cervical adjustments?
a. Atlantoaxial instability
b. Large joint arthritis
c. Bamboo spine
d. Sacroiliitis

A

Atlantoaxial instability

107
Q

History of back pain is one aspect of the diagnostic criteria for Ankylosing spondylitis.

Select one:
True
False

A

T

108
Q

What purpose does the new diagnostic criteria for Ankylosing spondylitis serve?
a. There is only one diagnostic criteria
b. The lack of treatment goals for the older criteria
c. The need for earlier diagnosis before the radiographic changes.

A

The need for earlier diagnosis before the radiographic changes.

109
Q

Labs and imaging are required for the diagnosis of Ankylosing spondylitis.

Select one:
True
False

A

F

110
Q

Which of the following are diagnostic criteria for Ankylosing spondylitis?
a. Toronto criteria
b. Modified Kane’s criteria
c. Modified New York criteria
d. Assessment in Spondyloarthritis International Society Criteria (ASAS)

A

Modified New York criteria
Assessment in Spondyloarthritis International Society Criteria (ASAS)

111
Q

Which conditions have overlapping symptoms to Ankylosing spondylitis and may be confused with AS?
a. DISH
b. Chronic lower back pain
c. Fibromyalgia
d. All of these are true

A

All of these are true

112
Q

The changes of Ankylosing spondylitis are
a. kyphotic
b. Lordotic

A

kyphotic

113
Q

The diagnosis of Ankylosing spondylitis requires imaging.

Select one:
True
False

A

F

114
Q

Sacroiliitis on plane films may present as all of the following except
a. Blurring of the joint margins
b. Widening of the joint space
c. Microfractures throughout the pelvis
d. Radial opacity in the area around the joint

A

Microfractures throughout the pelvis

115
Q

Plane film changes of Ankylosing spondylitis do not become apparent for
a. 3-7 years
b. 10+ years
c. The course is extremely variable
d. 6 months - 2 years

A

3-7 years

116
Q

Plain film is a more sensitive imaging technique than MRI to detect Ankylosing spondylitis changes.

Select one:
True
False

A

F

117
Q

Whiting on an MRI of the sacroiliac joint of an Ankylosing Spondylitis indicates.
a. Calcification of the joint
b. Bone resorption
c. A bone spur
d. Bone edema

A

Bone edema

118
Q

A plain film finding associated with Ankylosing spondylitis is the
a. stop sign
b. Thumbprint sign
c. Shiny corner sign
d. Steeple sign

A

Shiny corner sign

119
Q

Syndesmophytes refer to
a. Ossification of the spinal ligament
b. Ossification of the annulus fibrosus
c. Osteoporosis of vertebrae
d. Calcification of the SI junction

A

Ossification of the annulus fibrosus

120
Q

Syndesmophytes are distinguished from osteophytes in that
a. syndesmophyte growth is slow and progressive whereas osteophyte growth is fairly acute
b. Findings of syndesmophytes is pathognomonic for AS whereas osteophytes can occur in many conditions
c. Syndesmophyte findings occur in males and osteophytes can occur in both males and females
d. Syndesmophytes run parallel to the spine whereas osteophytes protrude perpendicular to the spine

A

Syndesmophytes run parallel to the spine whereas osteophytes protrude perpendicular to the spine

121
Q

What finding is pathognomonic of Ankylosing spondylitis
a. Shampoo spine
b. Bamboo spine
c. Tree trunk spine
d. Straw spine

A

Bamboo spine

122
Q

What is the first-line pharmaceutical treatment for Ankylosing spondylitis?
a. Corticosteroids
b. TNF inhibitors
c. DMARDs
d. NSAIDs

A

NSAIDs

123
Q

Exercise and cervical spinal adjustments are contraindicated in Ankylosing spondylitis.
a. False. Exercise is recommended for AS patients
b. True. The risks outweigh the benefits

A

False. Exercise is recommended for AS patients

124
Q

The prognosis of Ankylosing spondylitis is
a. Good. This condition has a high likelihood of being self-limiting.
b. Poor. The condition is often caught too late to achieve any benefit through therapy
c. Poor. The disease progresses quickly and therapies are not well matched to the pathophysiology
d. Good. As long as AS is caught early and managed with proper treatment

A

Good. As long as AS is caught early and managed with proper treatment

125
Q

Some of the newer therapies being researched for Ankylosing spondylitis target the
a. Endocrine system
b. Lungs
c. CNS
d. GI tract

A

GI tract

126
Q

What PE do you perform on someone with a possible rheumatic conditon?

A

general
skin/nails
EENT
abdomen
Heart
lungs
psych
MSK (insepct, palpate, ROM)

127
Q

What is included in the SDAI?
a. CRP
b. patient self-assesment of disease activity
c. examiners assesment of diease activity
d. all of the above

A

all

128
Q

What is included in CDAI?
a. pateint self-assesment of disease activity
b. evaluator’s assesment of disease activity
c. ESR
d. a and b

A

a and b

Fall Y3 (10 decks)

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