Rheumatoid Arthritis

Question 1

Predominant source of proinflammatory cytokines; major drive for RA

Answer 1

Macrophages

Question 2

Frequent hallmark of RA

Answer 2

Flexor Tendon Synovitis

Question 3

Major genetic risk factor for RA

Answer 3

HLA DRB1

Question 4

Predicts worse outcomes in RA

Answer 4

Presence of anti-CCP antibodies

Question 5

DMARD of choice

Answer 5

Methotrexate

avoided in crea >2mg/dL

Question 6

MCC of death among RA

Answer 6

Cardiovascular disease

Question 7

Pattern of RA

Answer 7

symmetric
peripheral polyarthritis (initially monoarthritic)

Question 8

MC form of chronic inflammatory arthritis

Answer 8

RA

Question 9

Valuable biomarker of diagnostic and prognostic significance

Answer 9

Anti-CCP (Higly specific)

Question 10

Presenting symptom of RA

Answer 10

Early morning joint stiffness at least for 1 hour, improves with physical activity

Question 11

May indicate coexistence with OA

Answer 11

DIP joint involvement

Question 12

Subluxation of MCP joints + subluxation of proximal phalanx to volar side if the hand

Answer 12

Ulnar deviation

Question 13

Hyperextension of the PIP joint + Flexion of DIP joint

Answer 13

Swan neck deformity

Question 14

Flexion of the PIP + Hyperextension of the DIP

Answer 14

Buttonniere deformity

Question 15

Subluxation of the first MCP joint + Hyperextension of the first IP joint

Answer 15

Z-line deformity

Question 16

Inflammation if the ulnar styloid + Tenosynovitis of the extensor carpi ulnaris causing subluxation of the distal ulna

Answer 16

Piano key movement

Question 17

Most common pulmonary manifestation

Answer 17

Pleural disease

Question 18

Pulmo finding portends a poor prognosis

Answer 18

ILD but responss to immunosuppressive therapy

Diagnosis: HRCT, PFT: restrictive

Question 19

Most frequent site of caridac involvement

Answer 19

Pericardium

Question 20

Most common hematologic abnormality

Answer 20

Normochromic, normocytic anemia

Question 21

Neutropenia + splenomegaly + RA

Answer 21

Felty’s syndrome

Question 22

MCC of death in RA

Answer 22

Cardiovascular disease

Question 23

Pathologic hallmarks of RA

Answer 23

Synovial inflammation and proliferation, focal bone erosions, articular cartilage thinning

Question 24

Most sensitive diagnostic to detect synovitis

Answer 24

MRI

Question 25

DMARD which decreases the radiographic progression of disease

Answer 25

Sulfasalazine

Question 26

Safest DMARDs in pregnancy

Answer 26

Hydroxychloroquine
Sulfasalazine
Flares: Prednisone

Question 27

Likelihood of extraarticular manifestations in RA

Answer 27

smoking
(+) RF
early onset of physical disability

Question 28

Primary treatment of RA

Answer 28

DMARDS

Methotrexate-1st line
Hydroxychloroquine
Sulfasalazine

Question 29

MCC of death in RA

Answer 29

IHD