Rheumatic Disease Flashcards
A patient with rheumatoid arthritis comes to you for treatment with swollen painful joints. Which stage of the inflammatory disease process are they in?
A. Acute
B. Subacute
C. Chronic
A. Acute
Explanation:
Acute = cardinal signs
Subacute = they would be getting better; decreased pain and swelling, increased ROM
Chronic = disease would be active yet stable; symptoms would be managed
Not all rheumatic diseases are systemic and symmetrical.
A. True
B. False
A. True
Explanation:
All rheumatic diseases ARE SYSTEMIC, however, diseases like ankylosing spondylitis ARE ASYMMETRICAL, some, like psoriatic arthritis, can even BE BOTH.
The next patient on your schedule has osteoarthritis. You would expect to see all but which of the following?
A. Cartilage or ligament degeneration
B. Limited ROM
C. Swelling or inflammation
D. Weakness around affected joints
C. Swelling or inflammation
Explanation:
Inflammation can happen, but not primary. You definitely shouldn’t see swelling.
A. Cartilage or ligament degeneration. Yes, from joint erosion.
B. Limited ROM. Yes, from pain, osteophyte formation, etc.
D. Weakness around affected joints. Yes, common from disuse.
The most common place for osteoarthritis deformity to occur is the:
A. feet
B. knee
C. shoulders
D. hands
D. hands
You’re seeing a patient with volar subluxation this afternoon. You expect to see:
A. The ECU slop volarly. acting as a flexor force.
B. The hand and distal carpals radially deviate while the metacarpals ulnarly deviate.
C. Decreased wrist extension and forearm supination.
D. Ulnar drift of the MCPs
A. The ECU slip volarly, acting as a flexor force.
Explanation:
B. The hand and distal carpals radially deviate while the metacarpals ulnarly deviate; this is ulnar subluxation/radial deviation.
C. Decreased wrist extension and forearm supination; this is DRUJ
D. Ulnar drift of the MCPs; this is ulnar drift
Match the condition to the location of chronic synovitis:
___ Swan neck deformity
___ Boutenniere deformity
___ Mallet finger
___ Zig zag deformity
A. DIP
B. PIP
C. MCP
D. CMC
If your patient has rheumatoid arthritis and has more pain with compression, you would know they were in more of a/an _________ stage of their illness.
A. acute
B. subacute
C. chronic
C. chronic
Explanation:
A. acute; you would see pain and swelling.
B. subacute; you would see pain with movement.
Osteophytes are only indicative of osteoarthritis.
A. True
B. False
A. True
Explanation:
A. True; osteophytes are bony outgrowth (bone spurs) associated with bony degeneration.
Which two tests would you use to evaluate the CMC joint of the thumb?
A. Pinch test
B. Crepitus
C. Grind test
D. Finkelstein’s test
B. Crepitus & C. Grind test
Explanation:
A. Pinch test; tests pinch strength
B. Crepitus; yes, if cracking during ranging, its a positive sign
C. Grind test; yes, if pain, it is a positive test
D. Tests for DeQuervainne’s
Your patient is complaining of “tightness” in their hand. You ask the patient to extend their wrist, then straighten their fingers. They are unable to do so in extension or neutral. The cause of the tightness is:
A. Extrinsic tightness of the flexors
B. Extrinsic tightness of the extensors
C. A joint issue
D. Intrinsic tightness
C. A joint issue
Explanation:
A. Extrinsic tightness of the flexors; the laxity didn’t improve the outcome.
B. Extrinsic tightness of the extensors; you aren’t testing these
D. Intrinsic tightness; you would see MP, PIP, and DIP flexion.
Which of the following would not be an appropriate approach?
A. Theraputty
B. Lever door handles
C. Using a rubberband around cups for easy grasp
D. Adaptive jar openers
A. Theraputty
Explanation:
You don’t want to be doing biomechanical strength.
Answers B (lever door handles), C (using a rubberband around cups for easy grasp), and D (adaptive jar openers) are all rehab strategies.
Which of the following are not goals of the acute stage of rheumatic disease?
A. pain reduction
B. rest
C. heat
D. ice
E. ROM
F. activity modification
G. strength
H. posture/immobilization
C. heat, E. ROM, G. strength
Explanation:
C. heat; subacute/chronic
E. ROM; chronic
G. strength; chronic
Also, F. activity modification is work simplification.
A resting wrist hand orthosis (WHO) immobilizes…
A. wrist
B. wrist and MPs
C. wrist, MPs, and PIPs
D. wrist, MPs, PIPs, & DIPS
D. Wrist, MPs, PIPs, & DIPs
Explanation:
(D) is the answer because WHO rests the whole wrist and hand.
In a resting wrist hand orthosis, the wrist is ________ and the digits are ________.
A. flexion; ~ / 0 degrees extension
B. neutral; ~ 30 degrees flexion
C. extension; ~ 30 degrees flexion
D. extension; ~ / 0 degrees extension
B. neutral; ~ 30 degrees flexion
Explanation:
A. flexion; ~ / 0 degrees extension is not the answer because typically the wrist is extended or neutral.
C. Extension; ~ 30 degrees flexion is not the answer because extension of the wrist isn’t resting posture.
D. extension; ~ / 0 degrees extension is not the answer because extension of the wrist isn’t resting posture, and you don’t hyperextend digits.
A resting wrist orthosis (for volar subluxation) leaves what aspects of the hand free to function?
A. CMCs, MCPs, PIPs, DIPs, thumb
B. MCPs, PIPs, DIPs
C. MCPs, PIPs, DIPs, thumb
D. PIPs, DIPs
C. MCPs, PIPs, DIPs, thumb
Explanation:
(C) is the answer because only the wrist needs to be immobilized.
