Rheumatoid Arthritis Flashcards
(10 cards)
Which of the following statements regarding rheumatoid arthritis (RA) is NOT correct?
a. RA has a predilection for cartilaginous joints.
b. RA is categorised as a chronic inflammatory disorder.
c. RA has a predilection for synovial joints.
d. RA is the commonest potentially-reversible cause of physical disability.
Answer: d
RA causes chronic, progressive, and often irreversible joint damage.
While remission is possible, the structural damage to joints is NOT reversible once it occurs.
- (a) RA causes erosion of the articular cartilage.
- (c) RA causes chronic inflammatory synovitis (synovial joints).
Which one of the following statements regarding rheumatoid arthritis (RA) is NOT correct?
a. RA may have a genetic predisposition.
b. Environmental factors have not been found to play a role in the development of RA.
c. Interleukins are involved in the disease process.
d. Tumour necrosis factor is involved in the disease process.
Answer: b
Environmental factors DO play a role in the development of RA.
(e.g. smoking, infections, occupational exposures, microbiome imbalances)
- (a) Certain genes are associated with increased RA risk.
- (c) Interleukins contribute to inflammation and joint damage.
- (d) TNF is a key inflammatory cytokine in RA and a target of may biological treatments.
Which of the following is NOT a key feature of RA?
a. Symptoms include palpable joint swelling.
b. Swelling is symmetrical and poly-articular.
c. Distal interpahlangeal joints of the hands are typically spared.
d. The thoracolumbar spine is involved in >50% of patients.
Answer: d
The CERVICAL spine is frequently involved.
The thoracolumbar spine is generally NOT involved.
Which of the following statements regarding early disease (RA) is NOT correct?
a. Joint damage occurs early and symptoms may progress rapidly.
b. Only 20% of patients have changes on MRI at the onset of the disease.
c. Joint erosions occur within two years of the onset of RA.
d. Early treatment may preserve function.
Answer: b
>90% show MRI abnormalities at or very near disease onset.
Which one of the following is NOT a typical extra-articular manifestation of RA?
a. Cardiac - pericarditis
b. Pulmonary - interstitial fibrosis
c. Neurological - carpal tunnel syndrome
d. Haematological - polycythaemia
Answer: d
Patients with RA frequently develop anaemia.
(Polycythaemia = an abnormally high concentration of red blood cells)
Which of the following would NOT be appropriate in the non-pharmacological management of RA?
a. Mediterranean diet high in omega-3 fatty acids.
b. Smoking cessation.
c. Restricted mobility to preserve joint function.
d. Referral to a podiatrist.
Answer: c
Restricted mobility in the long term is detrimental to joint function in RA.
- Regular, appropriate exercise, ROM activities, and PT are essential to maintain joint flexibility, strength, and overall function, prevent stiffness, and reduce pain.
- (a) Omega-3 fatty acids = anti-inflammatory
Which one of the following statements regarding pharmacological treatments is NOT correct?
a. Pain may be managed by means of a tricyclic antidepressant agent.
b. Non-steroidal anti-inflammatory drugs (NSAIDS) are important in altering the course of the disease.
c. NSAIDS have a high complication rate.
d. Corticosteroids are useful for management of extra-articular disease.
Answer: b
NSAIDS are effective in symptomatic relief of pain and inflammation in RA.
NSAIDS do NOT alter the underlying disease process or prevent joint damage.
Which one of the following statements regarding the modern treatment of RA is NOT correct?
a. Patient education, physiotherapy and occupational therapy should be initiated early and continued.
b. NSAIDS should be withdrawn once disease modifying agents (DMARDS) are achieving desired results.
c. Gold is a recognised DMARD and may be administered parenterally.
d. Biological agents such as Etanercept should be introduced as early as possible to minimise damage.
Answer: d
Conventional synthetic DMARDS (csDMARDS) are introduced first.
- Biological agents are only introduced if the pt. has an inadequate response to an initial trial of csDMARDS.
In this case the patient asks whether her diagnosis (RA) is certain or whether systemic lupus erythematous (SLE) could be an alternative diagnosis. Which one of the following is NOT a feature of SLE?
a. Arthritis
b. Myopathy
c. Low erythrocyte sedimentation rate
d. Low red and/or white blood cell count
Answer: c
SLE causes high (elevated) erythrocyte sedimentation rate (ESR).
Still looking for an alternative diagnosis the patient asks about ankylosing spondylitis which is one of the spondylo-arthropathies. Which one of the following statements regarding this group of conditions is NOT correct?
a. There is axial involvement.
b. Peripheral arthritis is common.
c. Enthesitis may be a feature.
d. Extra-articular disease is uncommon.
Answer: d
Spondylo-arthropathies have significant and diverse extra-articular manifestations.
