623 Adult - Rheumatoid Arthritis 2023 with verified questions and answers

c. peak age for disease onset in individuals is age 50 to 70 yrs (peak age is 20-40 yrs) which of the following is not characteristic of rheumatoid arthritis? a. it is more common in women at a 3:1 ratio b. family hx of autoimmune conditions often is reported c. peak age for disease onset in individuals is age 50 to 70 yrs d. wrists, ankles, and toes often are involved b. symmetrical early morning stiffness which of the following best describes the presentation of a person with rheumatoid arthritis? a. worst sxs in weighty-bearing joints later in the day b. symmetrical early morning stiffness c. sausage-shaped digits with characteristic skin lesions d. back pain with rest and anterior uveitis c. thinning of the protective GI mucosa NSAIDs cause gastric injury primarily by: a. direct irritative effect b. slowing GI motility c. thinning of the protective GI mucosa d. enhancing prostaglandin synthesis d. 72 y/o man who takes aspirin 4times a day for pain control of osteoarthritis of the following individuals, who is at highest risk for NSAID induced gastropathy? a. 28 y/o man with an ankle sprain who has taken ibuprofen for the past week and who drinks four to six beers every weekend b. 40 y/o woman who smokes and takes about six doses of naproxen sodium per month to control dysmenorrhea c. 43 y/o man with dilated cardiomyopathy who uses ketoprofen one to two times per week for low back pain d. 72 y/o man who takes aspirin 4times a day for pain control of osteoarthritis d. misoprostol (cytotec) which of the following is the preferred method of preventing NSAID induced gastric ulcer? a. high dose histamine 2 receptor antagonist b. timed antacid c. sucralfate (carafate) d. misoprostol (cytotec) a. an increase in the drug's half-life taking a high dose of aspirin or ibuprofen causes: a. an increase in the drug's half-life b. enhanced renal excretion of the drug c. a change in the drug's mechanism of action d. a reduction of antiprostaglandin effect a. joint erosions are often evident on radiographs or MRI which of the following statements is most accurate concerning rheumatoid arthritis? a. joint erosions are often evident on radiographs or MRI b. rheumatoid arthritis is seldom associated with other autoimmune diseases c. a butterfly-shaped facial rash is common d. parvovirus B19 infection can contribute to its development c. Hg = 9.7 g/dL (12-14 g/dL); MCV = 87 fL (90=96 fL); reticulocytes = 0.8% (1%-2%) hemograms usually reveal normocytic, normochromic, hypoprolifertive anemia associated with chronic disease which of the following hemograms would be expected for a 46 y/o woman with poorly controlled rheumatoid arthritis? a. Hg = 11.1 g/dL (12-14 g/dL); MCV = 66 fL (90=96 fL); reticulocytes = 0.8% (1%-2%) b. Hg = 10.1 g/dL (12-14 g/dL); MCV = 103 fL (90=96 fL); reticulocytes = 1.2% (1%-2%) c. Hg = 9.7 g/dL (12-14 g/dL); MCV = 87 fL (90=96 fL); reticulocytes = 0.8% (1%-2%) a. Hg = 11.4 g/dL (12-14 g/dL); MCV = 84 fL (90=96 fL); reticulocytes = 2.3% (1%-2%) a. 30% x-rays will fail to show changes in affected joint in approximately what percent of pts with RA at disease onset? a. 30% b. 50% c. 75% d. 95% c. echosonography RA disease progression is typically evaluated using all of the following approaches except: a. x-ray b. MRI c. echosonography d. ultrasound b. methotrexate plus oral NSAIDs Mrs. S. is a 42 y/o mother of 3, who reports pain and stiffness in multiple joints that have lasted for more than 6 months. she is dx with rheumatoid arthritis. she has no other clinical conditions of significance. you recommend which of the following txments for first-line tx? a. topical analgesics and oral NSAIDs b. methotrexate plus oral NSAIDs c. acetaminophen plus leflunomide d. anakinra and systemic corticosteroids c. adding methotrexate to his regimen you see a 37 y/o man with RA who has been tx with hydroxychloroquine and oral NSAIDs for the past 3 months with little improvement in sxs. radiography indicates slight progression of RA in several major joints. you recommend: a. maintaining the current regimen b. increasing the dose of NSAIDs c. adding methotrexate to his regimen d. switching from hydroxychloroquine to a biologic agent b. infections a significant adverse effect of biologic txment for treating RA is: a. myopathy b. infections c. renal impairment d. elevated liver enzymes a. elevated levels of rheumatoid factor which of the following tests is most specific to the dx of RA? a. elevated levels of rheumatoid factor b. abnormally high ESR c. leukopenia d. positive ANA titer b. systemic lupus erythematosus a positive ANA test is a sensitive marker for the presence of: a. hyperparathyroidism b. systemic lupus erythematosus c. Kawasaki disease d. leukocytosis c. Sjogren syndrome a 52 y/o woman has RA. she now presents with decreased tearing "gritty" feeling eyes and a dry mouth. you consider: a. systemic lupus erythematosus b. vasculitis c. Sjogren syndrome d. scleroderma c. maintenance of gastric protective mucosal layer cyclooxygenase-1 (COX-1) contributes to: a. inflammatory response b. pain transmission c. maintenance of gastric protective mucosal layer d. renal arteriole function c. maintenance of gastric protective mucosal layer cyclooxygenase-2 (COX-2) contributes to: a. inflammatory response b. pain transmission c. maintenance of gastric protective mucosal layer d. renal arteriole constriction a. dilated eye retinal exam which of the following special exam should be periodically obtained during hydroxychloroquine sulfate use? a. dilated eye retinal exam b. bone marrow biopsy c. pulmonary function tests d. exercise tolerance test a. weight gain common physical findings of SLE include all of the following except: a. weight gain b. joint pain and swelling c. fatigue d. facial rash c. negative ANA test all of the following dx findings are expected in a pt with SLE except: a. elevated ESR b. anemia c. negative ANA test d. proteinuria b. hydroxychloroquine (antimalarial drug) plus NSAIDs first line txment of SLE in a pt with mild sxs is: a. systemic corticosteroids b. hydroxychloroquine plus NSAIDs c. anakinra d. methotrexate c. rituximab all of the following agents can be considered for the txment of severe cases of SLE except: a. leflunomide b. azathioprine c. rituximab d. belimumab . SLE is associated with a high risk of pregnancy loss you see a 26 y/o woman who has been recently dx with SLE and has initiated txment to control moderate sxs of the disease. including fatigue and joint pain. she mentions that she and her husband are hoping to start a family soon. in counseling her about pregnancy, you consider that: a. there is a low probablity of conception during symtomatic flares of SLE b. most rxments for SLE must be dc once a woman becomes pregnant c. SLE is associated with a high risk of pregnancy loss d. there is a higher risk of gestational diabetes in women with SLE