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NURP 503 Exam 2' > Rheumatoid and SLE Fitzgerald questions > Flashcards

Rheumatoid and SLE Fitzgerald questions Flashcards

1
Q

Which of the following is NOT characteristic of RA?
A. it is more common in women at a 3:1 ratio
B. Family history of autoimmune conditions is often reported
C. Peak age for disease onset in individuals is age 50 to 70 years old
D. wrists, ankles and toes often are involved.

A

C. Peak age for disease onset in individuals is age 50 to 70 years old

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2
Q

Which of the following best describes the presentation of a person with RA?
A. worst symptoms in weight bearing joints later in the day
B. symmetrical early morning stiffness
C. sausage shaped digits with characteristic skin lesions
D. back pain with rest and anterior uveitis

A

B. symmetrical early morning stiffness

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3
Q

NSAIDs cause gastric injury primarily by:
A. direct irritative effect
B. slowing gastrointestinal motility
C. thinning of the protective gastrointestinal mucosa
D. enhancing prostaglandin synthesis

A

C. thinning of the protective gastrointestinal mucosa

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4
Q

Which of the following statements is most accurate concerning RA?
A. joint erosions are often evident on radiographs or MRI
B. RA is seldom associated with other autoimmune diseases.
C. a butterfly shaped facial rash is common
D. parvovirus B19 infection can contribute to its development

A

A. joint erosions are often evident on radiographs or MRI

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5
Q 
X-rays will fail to show changes in affected joints in approximately what percent of patients with RA at disease onset?
A. 30%
B. 50%
C. 75%
D. 95%
A

A. 30%

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6
Q 
RA disease progression is typically evaluated using all of the following approaches except:
A. x-ray
B. MRI
C. echosonography
D. ultrasound
A

C. echosonography

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7
Q 
Mrs. Sanchez is a 42 year old mother of three who reports pain and stiffness in multiple joints that have lasted for more than 6 months.  She is diagnosed with RA.  She has no other clinical conditions of significance.  You recommend which of the following treatments for first line therapy
A. topical analgesics and oral NSAIDs
B. methotrexate plus oral NSAIDs
C. acetaminophen and leflunomide
D. anakinra and systemic corticosteroids
A

B. methotrexate plus oral NSAIDs

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8
Q

You see a 37 year old man with RA who has been treated with hydroxychloroquine and oral NSAIDs for the past 3 months with little improvement in symptoms. X-ray indicates slight progression of RA in several major joints. You recommend:
A. maintaining the current regimen
B. increasing the dose of NSAIDs
C. adding methotrexate to his regimen
D. switching from hydroxychloroquine to a biologic agent

A

C. adding methotrexate to his regimen

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9
Q 
A significant adverse effect of biologic therapy for treating RA is:
A. myopathy
B. infections
C. renal impairment
D. elevated liver enzymes
A

B. infections

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10
Q 
Which of the following tests is most specific to the diagnosis of RA
A. elevated levels of rheumatoid factor
B. abnormally high ESR
C. leukopenia
D. positive ANA titer
A

A. elevated levels of rheumatoid factor

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11
Q 
A positive ANA test is a sensitive marker for the presence of:
A. hyperparathyroidism
B. systemic lupus erythematosus SLE
C. Kawasaki disease
D. leukocytosis
A

B. systemic lupus erythematosus SLE

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12
Q 
A 55 year old woman has RA. She now presents with decreased tearing, "gritty"-feeling eyes and a dry mouth.  You consider a diagnosis of 
A. Lupus
B. vasculitis
C. Sjogren syndrome
D. scleroderma
A

C. Sjogren syndrome

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13
Q 
Which of the following special examinations should be periodically obtained during hydroxychloroquine sulfate use?
A. dilated retinal eye exam
B. bone marrow biopsy
C. pulmonary function tests
D. exercise tolerance test
A

A. dilated retinal eye exam

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14
Q 
Common physical findings of SLE include all of the following except
A. weight gain
B. joint pain and swelling
C. fatigue
D. facial rash
A

A. weight gain

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15
Q 
All of the following diagnostic tests are expected in a patient with SLE except
A. elevated ESR
B. anemia
C. negative ANA test
D. proteinuria
A

C. negative ANA test

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16
Q

First line treatment of SLE in a patient with mild symptoms is
A. systemic corticosteroids
B. hydroxychloroquine (plaquenil) plus NSAIDs
C. anakinra
D. methotrexate

A

B. hydroxychloroquine (plaquenil) plus NSAIDs

17
Q 
Which of the following joints is most likely to be affected by osteoarthritis?
A. wrists
B. elbows
C. metacarpalphalangeal joint 
D. distal interphalangeal joint
A

D. distal interphalangeal joint

18
Q 
Changes to the joint with OA can typically include all of the following EXCEPT
A. widening of the joint space
B. articular cartilage wears away
C. formation of bone spurs
D. synovial membrane thickens
A

A. widening of the joint space

19
Q 
Clinical findings of the knee in a patient with OA include all of the following except
A. coarse crepitus
B. joint effusion
C. warm joint
D. knee often locks or a pop is heard
A

C. warm joint

20
Q

X-ray findings of OA of the knee often reveal
A. microfractures
B. decreased density of subchondral bone
C. osteophytes
D. no apparent changes to the joint structure

A

C osteophyte

21
Q 
Deformity of the proximal interphalangeal (PIPs) joints found in an elderly patient with OA is known as
A. heberden nodes
B. bouchard nodes
C. hallus valgus
D. dupuytren contracture
A

B. bouchard node’s

22
Q

Which of the following best describes the presentation of a patient with OA
A. worst symptoms in weight bearing joints later in the day
B. symmetrical early morning stiffness
C. sausage shaped digits with associated skin lesions
D. back pain with rest and anterior uveitis

A

A. worst symptoms in weight bearing joints later in the day

23
Q 
As part of the evaluation of patients with OA, the NP anticipates finding
A. anemia of chronic disease
B. elevated CRP level
C. no disease specific lab abnormalities
D. elevated ANA titer
A

C. no disease specific lab abnormalities

24
Q

First line pharmacological intervention for milder OA should be a trial of
A. acetaminophen
B. tramadol
C. celecoxib
D. intraarticular corticosteroid injection

A

A. acetaminophen

NURP 503 Exam 2' (23 decks)

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