Rheumatology

Question 1

What is a chronic inflammatory disease of unknown etiology marked by symmetric polyarthritis

Answer 1

Rheumatoid Arthritis

Question 2

What is the most common form of chronic inflammatory arthritis

Answer 2

Rheumatoid Arthritis

Question 3

What are the 2 laboratory test used for diagnostic and prognostic Biomarkers of Rheumatoid Arthritis

Answer 3

ACPA and RF

Question 4

Incidence of RA increases between ages of_____________plateaus until the age of ___________ and decreases after __________ of age

Answer 4

25-55 years
75 years
After 75 years

Question 5

How many Joints:
1. Oligoarticular
2. Polyarticular

Answer 5

1. <=4
2. > =5

Question 6

Too few affected joints to be classified as RA is known as?

Answer 6

Undiffirentiated Inflammatory Arthritis

Question 7

Most frequently involved joint in RA

Answer 7

Wrist, MCP, PIP

Question 8

Involvement of this joint may indicate coexisting osteoarthritis in RA

Answer 8

DIP (Distal Interphalengeal Joints)

Question 9

What is the frequent hallmark of RA

Answer 9

Flexor Tensynovitis

Question 10

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

Answer 10

Ulnar Deviation

Question 11

Hyperextension of tge PIP joint with flexion of the DIP joint

Answer 11

Swan Neck deformity

Question 12

Flexion of PIP joint with hyperextension of DIP joint

Answer 12

Boutonniere deformity

Question 13

Subluxation of First MCP joint + hyperextension of the first IP joint

Answer 13

Z-line deformity

Question 14

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

Answer 14

“Piano-key Movement” of Ulnar Styloid

Question 15

In RA, Antlantoaxial involvement of cervical spine increases the risk of?

Answer 15

Compressive Myelopathy and Neurologic Dysfunction

Question 16

RA rarely affects the?

Answer 16

Thoracic and Lumbar Spine

Question 17

In RA, Affectation of this Joint is mostly seen as radiographic abnormality but rarely with significant symptoms or functional impairment

Answer 17

TMJ

Question 18

Risk factors that will most likely manifest with extraarticular manifestations in RA

Answer 18

1. Cigarette smoking
2. Early onset of significant physical disability
3. Positive RA or ACPA

Question 19

In RA, if patient has fever of more than 38.3 c (101F) you will suspect?

Answer 19

1. Systemic Vasculitis
2. Infection

Question 20

10% of patients with RA have?

Answer 20

Sjögren’s Syndrome

Question 21

Keratoconjunctivitis Sicca and Xerostomia is present in?

Answer 21

Sjögren’s Syndrome

Question 22

Most common pulmonary manifestation in RA

Answer 22

Pleuritis

Question 23

Presents with dry cough and progressive SOB, confers poor prognosis in RA

Answer 23

Interstitial Lung Disease

Question 24

This shows a progressive scarring of the lungs seen on chest CT scan as honeycomb changes in the periphery and lower portion of the lungs?

Answer 24

Usual Interstitial Pneumonia

Question 25

Relatively symmetric and bilateral ground glass opacities with associated fine reticulations, with volume loss and traction bronchiectasis?

Answer 25

Non Specific Interstitial Pneumonia

Question 26

Pulmonary Function Test result of Interstitial Lung Disease?

Answer 26

Restrictive Pattern: - Reduced TLC - Reduced DLCO

Question 27

Pulmonary Nodules + pneumoconiosis following Silica exposure?

Answer 27

Caplan's Syndrome

Question 28

Most frequent site of cardiac involvement in RA

Answer 28

Pericardium

Question 29

Most common Valvular abnormality in RA

Answer 29

Mitral Regurgitation

Question 30

Most common hematologic abnormality in RA

Answer 30

Normochromic, Normocytic Anemia

Question 31

Triad of Felty's Syndrome

Answer 31

1. Neutropenia 2. Spleenomegaly 3. Nodular RA

Question 32

Due to aggressive treatment for RA there is noted decreased incidence of?

Answer 32

Felty's Syndrome

Question 33

Differential diagnosis for Felty's Syndrome due to similar presentation and may develop early in RA as opposed with Felty's syndrome which usually occur during the late course of RA?

Answer 33

T Cell large granular lymphocyte Leukemia (T-LGL)

Question 34

Most common histopathologic type of lymphoma in RA

Answer 34

Diffuse Large B cell lymphoma (DLBCL)

Question 35

Most common cause of death in RA?

Answer 35

Cardiovascular Disease

Question 36

This Fracture is more likely to occur in RA due to chronic glucocorticoid use and/or disability -related immobility

Answer 36

Hip Fracture

Question 37

This is most common in RA than in age and sex matched population?

Answer 37

Osteoporosis

Question 38

Likelyhood of RA if with first degree relative with RA

Answer 38

2-10x

Question 39

Heretibility of RA is?

Answer 39

40-50%

Question 40

MHC Alleles known to confer the greatest risk of RA

Answer 40

Located within MHC class II

Question 41

Epigenetic mechanisms that are theoretically involved in three important aspects of RA

Answer 41

1. Disease etiology 2. Perpetuation of chronic inflammatory responses 3. Disease severity

Question 42

Best studied epigenetic mechanism in RA?

Answer 42

Post translational histone modifications and DNA methylation

Question 43

Most reproducible of the environmental links implicated in the pathogenesis of RA

Answer 43

Cigarette Smoking

Question 44

Risk of RA persist even after ______years of smoking cessation

Answer 44

15

Question 45

The bacteria in periodontis can trigger RA development, what bacteria is it?

Answer 45

Porphyromonas Gingivalis (P. Gingivalis)

Question 46

Type A Synoviocytes

Answer 46

Macrophage-derived

Question 47

Type B synoviocytes

Answer 47

Fibroblast derived

Question 48

Pathologic Hallmark of RA

Answer 48

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

Question 49

What is Pannus?

Answer 49

Thickened cellular membrane containing fibroblast-like synoviocytes and granulation reactive fibrovascular tissue that invades the underlying cartillage and bone

Question 50

What are the 3 bone loss types in RA

Answer 50

1. Osteoclast-mediated bone erosions 2. Periarticular osteopenia 3. Generalized osteoporosis

Question 51

Induced structural damage to the mineralized cartilage and subchondral bone

Answer 51

Osteoclast

Question 52

Bone erosion in joints with active inflammation, characterized by thinning of the bony trabeculae