Rheumatoid Arthritis-202 Module

Question 1

A clinical diagnosis of RA relies on a confluence of factors such as:

Answer 1

History of joint pain and stiffness
Findings on physical examination
Documentation of symmetric polyarticular joint swelling (synovitis)
Results of laboratory tests
X-ray images

Question 2

RF and ACPA are routinely included in the diagnosis of RA in clinical practice. However, about__________ of patients with RA test negative for RF and ACPA (seronegative). This is why a diagnosis of RA presents a clinical challenge.[26]

Answer 2

15%

Question 3

The overarching principles of RA management, which have changed minimally since 2010, now include:

Answer 3

Shared decision making
Maximize health-related quality of life (HRQOL)
Reversal of inflammation is uppermost in achieving treatment goals
Treatment to target, which is informed by measurement of disease activity with consequent adjustment in treatment to optimize outcomes

Question 4

Both _____ and ____ are commonly monitored to assess RA disease activity and response to therapy.

Answer 4

ESR, CRP

Question 5

The JAK enzyme family is a group of ______________.

Answer 5

Signal transducers

Question 6

In the first step of JAK/STAT pathway mediation, after a cytokine binds to its receptor, a pair of JAKs is recruited to _______________ and activate each other.

Answer 6

Phosphorylate

Question 7

Which of the following was the first instrument to incorporate scoring for bone and cartilage damage, and evaluates joints of the hands and wrists?

Answer 7

Sharp Score

Question 8

Which of the following systemic manifestations of RA appears more frequently in the early stage of the disease, and can be a presenting factor in RA?

Answer 8

Anemia

Question 9

Chronic inflammation in the synovial joint results in __________ of the synovial lining.

Answer 9

Hyperplasia

Question 10

In the first step of joint damage in RA, immune-mediated activation of _______________ stimulates an autoimmune inflammatory response.

Answer 10

Synoviocytes

Question 11

The three key modulators of cell migration and inflammation in RA are

Answer 11

TNFα, IL-6, and IL-1

Question 12

Along with the SDAI, which of the following clinical tools for goal-directed treatment is limited by the requirement that a patient must have a blood draw, which can delay a clinician’s ability to score disease activity or response to treatment and thus delay treatment modifications?

Answer 12

DAS28

Question 13

In the third step of JAK/STAT pathway mediation, STAT dimers enter the cell’s nucleus, bind to DNA, and _____________________ that mediate the inflammatory process.

Answer 13

Regulate the expression of proteins