RA quiz 3

Question 1

RA definition

Answer 1

Autoimmune disease w/predilection for synovial tissue &
associated tendon sheath

Question 2

RA onset

Answer 2

May
follow
viruses,
stress,
surgery,
infection,
trauma,
pregnancy

Question 3

RA course

Answer 3

Highly variable
• 50% have progressive disease
• 3% have erosive arthritis

Question 4

RA prognosis

Answer 4

Better in men than women.
Patients
>50 at time of onset have poorer prognosis
• Poor prognosis =early age,
high RF titer,
high ESR,
swelling>20joints
&
extracurricular manifestations

Question 5

RA stages

Answer 5

1. Disease present , asymptomatic
2. Disease interfering w/ADLs
3. Major compromise in function
4. incapacitation, confine to bed or w/c

Question 6

RA is a

Answer 6

autoimmune disease

Question 7

RA cartilage loss is

Answer 7

symmetrical

Question 8

RA HPI ask

Answer 8

1. Location, duration & characteristics of pain.
2. Tenderness, inflammation and morning stiffness
3. systemic fatigue, associated symptoms

Question 9

RA FH; ID genetic markers

Answer 9

Id
genetic markers for RA
(class 2 human leukocyte antigen {HLA} w/an identical 5-­‐amino-­‐acid sequence

Question 10

RA History could sound like

Answer 10

1. Am stiffness several hours
2. Arthritis of 3 or more joints
3. Arthritis of the hands ( Metacarpal)
4. Symmetric arthritis
5. Rheumatoid nodules
6. • RF
7. Radiological changes

Question 11

Diagnosis RA with

Answer 11

presence of 4-7 and 1-4 present for 6 weeks

Question 12

2010 ACR/EULAR

Answer 12

score of >6/10 to classify as RA

Question 13

RA Constitutional symptoms

Answer 13

fatigue
low grade fever
Malaise
wt. Loss

Question 14

RA extra-articular symptoms

Answer 14

Sjogren’s syndrome,
vasculitis,
pulmonary nodules,
Felty’s Syndrome
(splenomegaly, anemia,thrombocytopenia)

Question 15

RA S/S

Answer 15

soft tissue swelling and tenderness
spongy joints warm to touch/tender
gelling

Question 16

RA need to preform a full and total PE T/F

Answer 16

True

Question 17

Physical Findings with RA

Answer 17

Febrile
• Soft tissue swelling
• Muscle atrophy
• Effusions
• Decreased ROM
• Decreased strength
• Thickening of the volar aspect of the wrist
• Symmetry in changes
• Soft  tissue nodules
• Popliteal (Baker’s) cysts
–\behind the knees

Question 18

RA deformity of the neck

Answer 18

Swan neck

Question 19

RA deformity of the fingers

Answer 19

Mallet and Boutonniere

Question 20

RA diagnosis you need to R/O

Answer 20

Reiters, SLE, gouty/GN/ psoriatic arthritis,
lyme disease
acute rheumatic fever

Question 21

RA what would you expect to see on the CBC

Answer 21

Mild to moderate anemia

Question 22

RA whattype of anemia is present

Answer 22

normochromic, normocystic

Question 23

RA what would you expect the ESR to be

Answer 23

elevated

Question 24

RA the RF level

is elevated with

Answer 24

Age and progression of disease

Question 25

RA the C- reactive protein level is

Answer 25

Elevated

Question 26

Why would you draw a LFT with suspected RA

Answer 26

R/O hepatitis

Question 27

RA synovial fluid aspiration is

Answer 27

>WBC, crystal search and C&S

Question 28

RA X-rays help determine

Answer 28

early changes Progression detect damage after 3 years into the disease

Question 29

Are wrist ankles and toes involved in RA | t/f

Answer 29

False

Question 30

Best description RA presentation

Answer 30

symmetrical early Am stiffness

Question 31

On an x-ray or MRi you would expect o see with RA

Answer 31

Joint erosions

Question 32

Which of the following hemograms would be expected for a 46-year-old woman with poorly controlled RA?

Answer 32

Hg = 9.7 g/dL (12–14 g/dL); MCV = 87 fL (80–96 fL); reticulocytes = 0.8% (1%–2%). Hg = 11.1 g/dL (12–14 g/dL); MCV = 66 fL (80–96 fL); reticulocytes = 0.8% (1%–2%). Hg = 10.1 g/dL (12–14 g/dL); MCV = 103 fL (80–96 fL); reticulocytes = 1.2% (1%–2%). Hg = 11.4 g/dL (12–14 g/dL); MCV = 84 fL (80–96 fL); reticulocytes = 2.3% (1%–2%).

Question 33

Which of the following is not characteristic of rheumatoid arthritis (RA)?

Answer 33

It is more common in women at a 3:1 ratio. B. Family history of autoimmune conditions often is reported. C. Peak age for disease onset in individuals is age 50 to 70 years. D. Wrists, ankles, and toes often are involved

Question 34

5. RA disease progression is typically evaluated using all of the following approaches except:

Answer 34

A. x-ray. B. MRI. C. echosonography. D. ultrasound.

Question 35

``` 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 ```

Answer 35

A. elevated levels of rheumatoid factor

Question 36

``` A 52-year-old woman has RA. She now presents with decreased tearing, "gritty"-feeling eyes, and a dry mouth. You consider a diagnosis of: systemic lupus erythematosus. B. vasculitis. C. Sjögren syndrome. D. scleroderma. ```

Answer 36

C. Sjögren syndrome.

Question 37

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

Answer 37

. 30% B. 50% C. 75% D. 95%

Question 38

Which test is specific to RA

Answer 38

elevated RF

Question 39

Hemogram in RA

Answer 39

reveals Normocytic, normochromic

Question 40

RA diagnostic test CBC

Answer 40

Mild to moderate anemia

Question 41

RA Mild to moderate anemia is

Answer 41

Normochromic, normocytic

Question 42

RA ESR

Answer 42

elevated

Question 43

RA the C reactive protein is

Answer 43

elevated