40 Questions
What should be assessed for a patient with latent TB who has never been treated?
Hepatitis B and hepatitis C
What should be done if a client tests positive for hepatitis?
The infection should be treated prior to starting medication
Why is liver and kidney monitoring recommended for most DMARD therapy?
It can cause elevation of the liver enzymes and affect kidney function
Which radiographic study is the most common for tracking disease progression?
Plain x-ray
What is the purpose of assessing the joints for erosions and synovitis?
To establish a baseline for joint evaluation
Why is MRI useful in addition to plain x-ray or ultrasound?
To detect small erosions that may not be visible on x-ray or ultrasound
When may joint damage occur after diagnosis?
Within the first 6 to 12 months
Why are X-ray, ultrasound, or both of the hands, wrists, and feet useful?
To establish a baseline for joint evaluation
What impact can hepatitis B and hepatitis C have on treatment strategies?
They could impact treatment strategies if positive
Why is it important to treat the infection if a client tests positive for hepatitis?
To prevent complications before starting medication
What is a key initial clinical manifestation of rheumatoid arthritis?
Symmetric joint pain
What is a potential effect of RA inflammation on the nervous system?
Numbness and tingling
What is used to evaluate RA activity and monitor treatment efficacy?
ESR and CRP levels
Which extra-articular feature is associated with rheumatoid arthritis?
Fatigue
What is used for RA diagnosis?
Rheumatoid factor and antiCCP antibodies
What should be assessed in the CBC due to the inflammatory process in RA?
Platelet count
What is a characteristic of joint involvement for classifying RA?
Symmetric joint involvement
What is a potential manifestation of RA in the cervical spine?
Axial skeletal fusion
What is a potential finding associated with RA assessment?
Rheumatoid nodules
What should be done before starting certain medications for RA?
Tuberculin skin test
What is the approximate percentage of the population worldwide affected by rheumatoid arthritis?
1% to 2%
In rheumatoid arthritis, at what age does the onset commonly occur?
Third and sixth decade of life
What is the term used for rheumatoid arthritis that occurs after the age of 65?
Elderly onset RA
Which of the following is identified as a modifiable risk factor for rheumatoid arthritis?
Smoking and obesity
What is the consequence of pannus formation in rheumatoid arthritis?
Loss of articular surfaces and joint motion
What does the RA inflammatory process potentially affect, in addition to the joints?
Nervous system
What is the main consequence of the breakdown of collagen in the synovium in RA?
Edema
What is the main consequence of pannus formation in RA?
Joint fusion
What is the term used for RA synovium breaking down collagen, causing edema, and ultimately pannus formation?
Autoimmune reaction
What is the term for the loss of articular surfaces and joint motion in RA?
Ankylosis
What is the incidence of rheumatoid arthritis in the population worldwide?
1% to 2%
At what age does the onset of rheumatoid arthritis commonly occur?
Between the third and sixth decade of life
What is the term for rheumatoid arthritis that occurs after the age of 65?
Elderly onset RA
What are the additional risks identified for rheumatoid arthritis?
Family history, environmental influences, nulliparity, smoking, and obesity
What is the mechanism of action for the etiology of rheumatoid arthritis?
Genetic predisposition and the development of immunologically mediated joint inflammation
What occurs in the synovial tissue in rheumatoid arthritis?
Autoimmune reaction causing breakdown of collagen, edema, and pannus formation
What does pannus formation do in rheumatoid arthritis?
Destroys cartilage and erodes the bone
What happens to muscle fibers in rheumatoid arthritis?
Undergo degenerative changes
What are the modifiable factors associated with rheumatoid arthritis?
Smoking and obesity
What has the RA inflammatory process been implicated in, besides joint inflammation?
Other disease processes such as arteriosclerosis
Study Notes
Rheumatoid Arthritis: Clinical Manifestations, Assessment, and Diagnostic Findings
- Rheumatoid arthritis (RA) may interfere with the production of high-density lipoprotein cholesterol, which is antiatherosclerotic.
- RA inflammation can affect the nervous system, causing neuropathies, paresthesias, and potential axonal degeneration.
- Criteria for classifying RA require a total score of 6 or greater based on joint involvement, serology, acute phase reactants, and symptom duration.
- Initial clinical manifestations of RA include symmetric joint pain and morning joint stiffness lasting longer than 1 hour.
- RA symptoms vary and may include joint pain, swelling, warmth, erythema, and lack of function, especially in small joints.
- Disease progression can affect knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints.
- RA is a systemic disease with extra-articular features such as fever, weight loss, fatigue, anemia, and rheumatoid nodules.
- Assessment findings associated with RA include rheumatoid nodules, joint inflammation, and certain laboratory findings.
- Disease activity scores are used to evaluate RA activity and monitor treatment efficacy.
- Rheumatoid factor and antiCCP antibodies are used for RA diagnosis, and ESR and CRP levels are monitored for disease progression.
- CBC should be assessed for anemia and elevated platelets due to the inflammatory process.
- A tuberculin (TB) skin test should be done before starting certain medications to rule out tuberculosis.
Test your knowledge of Rheumatoid Arthritis (RA) clinical manifestations, assessment, and diagnostic findings with this informative quiz. Explore the systemic impact of RA, assessment criteria, and key laboratory findings essential for diagnosis and monitoring disease progression.
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