Rheumatoid Arthritis Flashcards
True for the laboratory fratures of RA
A. Serum Igg rf has been found in 75-80%
B. The presence of serum anti ccp AB has the same sensitivity as serum RF
C. Synovial fluid WBC usually id <2000
D. Periarticular osteopenia is a classic late finding on plain radiograph
Answer: B
A. Should be IgM RF
C. This level is found on osteoarthritis.. in RA level is usually 5,000 to 50,000
D. This id an early finding
Which of the ff statement is correct with regards to the management of rheumatoid arthritis?
A. Nsaids are considered as the core of treatment at present
B. Methotrexate is the DMARD of choice as to its treatment
C. Most cases respond to monotherapy using methotrexate
D. Low dose glucocorticoids for severe extraarticulat RA
Answer: B
A. Formerly the core but now treated as adjunctive therapy
C. Usually needs multiple drugs
D. High dose dapat
The following are extraarticular manifestations of RA except
A. Thrombocytopenia
B. Pleuritis
C. Vasculitis
D. Pericarditis
Answer: A
Usually will present with thrombocytosis
Immune mediated thrombocytopenia is rare
A 30 yr old pregnant female on 20 weeks AOG came in due to joint pains diagnosed with RA. Which DMARDs is appropriate for the patient?
A. Methotrexate
B. Leflunomide
C. Hydroxycloroquine
D. Etanercept
C. Hydroxychloroquine along eith Sulfasalazine
A 20/F came in due to wrist pain and PIP joint swelling for 2 weeks. Famliy hx revealed RA on maternal side. What diagnostic is appropriate to confirm your diagnosis?
A. ESR
B. ANA
C. CRP
D. Anti CCP
D
Which of the ff biologic DMaRDs is a humanized MAB directed against IL 6 receptir and has been shown to increase LDL cholesterol?
A. Anti TNF
B. Rituximab
C. Anakinra
D. Tocilizumab
D
What is the most common cause of death in RA?
Ischemic heart disease
In the new classification criteria for RA, it should have a score of ____ to fulfill the requirements for definite RA
More than or equal to 6
True for the DMARDs used in the tx of RA
A. Anakinra is a tnf alpha inhibitor administered subcutaneously
B. Liver function tests are measured every 2-3 months when using hydroxychloroquine
C. Eye exam if > 40 yrs old or with previous eye disease is warranted when using rituximab
D. Leflunomide and methotrexate are contraindicated in pregnancy
D
A. Anakinra = 1L1 antagonist
LFTs measured during methotrexate therapy
Eye exam warranted during tx with hydroxychloroquine
A 40 yr old female came in for consult due to joint pains localized at MCP, PIP and wrists with symmetrical involvement for 2 months. Labs revealed high positive RF and high ESR. You are considering RA, the ff are pathologic hallmarks except?
A. Formation of pannys
B. Synovial inflammation and proliferation
C. Synovial lining hyperplasia
D. Double contour sign on articular cartilage
D
Seen on Goit
True for the clinical features of RA
A. Established RA mostly involves the distal interphalangeal joints (DIP)
B. Trigger finger is due to flexor tendon tenosynovitis
C. Boutonniere deformity is due to flexion of DIP joint and hyperextension of PIP joint
D. Swan neck deformity is due to hyperextension of PIP joint and flexion of DIP joint
D
A. Usually involves the PIP
B. True but not sure if this is the answer
Boutonniere - flexion of PIP, hyperextension of DIP
A rare subset of pulmonary nodulosis characterized by the development of nodules and pneumoconiosis following silica exposure
Caplan’s syndrome
True for the extraarticular conditions assoc with RA
A. Osteoporosis is least common in RA
B. Most common cause of death is cardiovascular disease
C. Hyperandrogenism is common in males
D. Postmenopausal women have higher LH levels than control
B
A. Osteoporosis common
Hypoandrogenism
What is the most common cardiac manifestation of RA?
Pericarditis
A 30 yr old female consult at your clinic with flexion of PIP joint with DIP hyperextension. RA is considered. This clinical presentation is consistent with what joint findings?
Boutonniere deformity