Rheumatoid Arthritis Quiz
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Questions and Answers

Which of the following are considered increased risk factors for rheumatoid arthritis?

  • Sedentary lifestyle
  • Female sex (correct)
  • Exposure to tobacco smoke (correct)
  • High fiber intake

    • What is a common clinical manifestation of rheumatoid arthritis?

  • Chronic headache
  • Joint deformities (correct)
  • Nausea and vomiting
  • Persistent high fever

    • Which of the following statements about the symptoms of rheumatoid arthritis is accurate?

  • Rheumatoid arthritis only affects women.
  • Joint pain only occurs in the lower extremities.
  • Symptoms are always constant and do not vary.
  • Symptoms can appear and disappear, with periods of flares and remission. (correct)

    • Which symptom is indicative of rheumatoid arthritis involvement in multiple joints?

    <p>Morning stiffness lasting for at least one hour</p> Signup and view all the answers

    What type of arthritis is characterized by symmetrical involvement of joints?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    In which percentage of patients with rheumatoid arthritis is the cervical spine likely to be involved?

    <p>80-90%</p> Signup and view all the answers

    What does the presence of rheumatoid factor in the blood indicate?

    <p>Potentially established disease but not specific to rheumatoid arthritis</p> Signup and view all the answers

    What modality is recommended during acute inflammation stages?

    <p>Ice therapy</p> Signup and view all the answers

    Which condition is typically observed in X-ray findings of rheumatoid arthritis?

    <p>Destruction of bone around involved joints</p> Signup and view all the answers

    Which temperatures significantly affect the activity of cartilage-destroying enzymes?

    <p>Below 30° Celsius</p> Signup and view all the answers

    What is the ideal resting position for the shoulder joint in rheumatoid arthritis?

    <p>45° abduction</p> Signup and view all the answers

    How much can loading over the hip joint be reduced by using a cane?

    <p>50%</p> Signup and view all the answers

    What is the typical radiological finding in the early stages of rheumatoid arthritis?

    <p>Juxta-articular osteopenia</p> Signup and view all the answers

    What is the purpose of orthosis and splinting in managing joint health?

    <p>To prevent deformities and support joints</p> Signup and view all the answers

    Which modality is NOT used in physiotherapy for pain reduction and joint movement improvement?

    <p>Deep tissue massage</p> Signup and view all the answers

    Which deformity is most commonly associated with rheumatoid arthritis affecting the hands?

    <p>Ulnar deviation</p> Signup and view all the answers

    What is a common complication of tenosynovitis in rheumatoid arthritis?

    <p>Trigger finger</p> Signup and view all the answers

    What is the effect of hydrotherapy-balneotherapy on patients beyond physical benefits?

    <p>It has a positive effect on mental well-being</p> Signup and view all the answers

    Which of the following is NOT a typical knee deformity associated with rheumatoid arthritis?

    <p>Hyperextension</p> Signup and view all the answers

    In the management of rheumatoid arthritis, which type of therapy specifically helps with energy conservation?

    <p>Assistive devices</p> Signup and view all the answers

    What percentage of rheumatoid arthritis patients shows initial joint involvement in the foot?

    <p>20%</p> Signup and view all the answers

    Which blood test is commonly performed for diagnosing rheumatoid arthritis?

    <p>Rheumatoid factor</p> Signup and view all the answers

    Which of the following may indicate inflammation in the body for a person with rheumatoid arthritis?

    <p>Elevated ESR</p> Signup and view all the answers

    Which of these deformities significantly affect a patient's grip strength late in rheumatoid arthritis?

    <p>Boutonnière deformity</p> Signup and view all the answers

    What is the role of anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis?

    <p>They can be found in about 50% of patients with early arthritis.</p> Signup and view all the answers

    Which imaging modality is most sensitive for detecting early changes in rheumatoid arthritis?

    <p>MRI scan</p> Signup and view all the answers

    Which of the following treatment categories primarily focuses on altering the disease course in rheumatoid arthritis?

    <p>Disease-modifying anti-rheumatic drugs (DMARDS)</p> Signup and view all the answers

    Which dietary practices are recommended for managing symptoms of rheumatoid arthritis?

    <p>Incorporating vitamin D and cod liver oil supplements</p> Signup and view all the answers

    What is one of the primary goals of physical therapy management for rheumatoid arthritis?

    <p>Preventing deformity or controlling joint damage</p> Signup and view all the answers

    How should patient education be approached prior to starting an exercise program for rheumatoid arthritis?

    <p>Patients must understand both their condition and available therapies.</p> Signup and view all the answers

    What characterizes the type of changes that may appear on an X-ray in the early stages of rheumatoid arthritis?

    <p>Juxta-articular osteopenia may be present</p> Signup and view all the answers

    Among the four types of medications used to treat rheumatoid arthritis, which one is categorized as a Biologic Response Modifier?

    <p>Adalimumab</p> Signup and view all the answers

    What is the minimum intensity for initiating moderate-intensive exercise therapy as a percentage of 1 repetition maximum?

    <p>30-50 percent</p> Signup and view all the answers

    Which of the following exercises aims to improve coordination and stabilization by stimulating the sensorimotor system?

    <p>Balance board exercises</p> Signup and view all the answers

    How many exercises are included in the SARAH exercise program for the hand?

    <p>Seven mobility and four strength exercises</p> Signup and view all the answers

    What should be done if pain persists two hours after exercise therapy?

    <p>Revise the exercise program</p> Signup and view all the answers

    Which of the following is NOT mentioned as part of alternative therapies for improving exercise therapy outcomes?

    <p>Meditation</p> Signup and view all the answers

    What is the primary benefit of wearing therapy gloves?

    <p>To improve hand grip strength and manage pain</p> Signup and view all the answers

    Which type of joint exercise is recommended during the acute phase?

    <p>Isometric/static exercises</p> Signup and view all the answers

    What defines moderate-intensive exercise therapy?

    <p>30 minutes of exercise performed 5 times a week at 55-64% of maximal heart rate</p> Signup and view all the answers

    What is the purpose of compression gloves?

    <p>To give moderate joint compression to reduce swelling and pain</p> Signup and view all the answers

    Which of the following is NOT a recommendation for improving joint flexibility?

    <p>Performing ballistic movements</p> Signup and view all the answers

    How often should intensive exercise therapy sessions be conducted?

    <p>Three times a week for at least 20 minutes each</p> Signup and view all the answers

    What kind of materials are therapy gloves typically made from?

    <p>Nylon, wool, and elastane fibers</p> Signup and view all the answers

    What is the recommended duration for isometric exercises in the acute phase?

    <p>Held for 6 seconds, repeated 5-10 times each day</p> Signup and view all the answers

    Study Notes

    Rheumatoid Arthritis (RA)

    • RA is a chronic, systemic, autoimmune inflammatory disease
    • Inflammation affects synovial tissue, primarily in wrists, hands, and feet
    • Can affect other body systems (skin, eyes, lungs, heart, blood vessels)
    • HLA DR4 and "Shared" epitope on HLA DRB1 are associated with genetic predisposition, and account for ~30% of heritable risk.
    • RA affects roughly 0.5 to 1% of the global population
    • Women are affected 2-3 times more often than men
    • Peak prevalence is between 30 and 50 years of age
    • Disease can begin at any age

    Pathogenesis

    • Immune system attacks synovium
    • Unknown trigger, though genetic predisposition and environmental factors (infections) are implicated
    • Synovium thickens, forming a pannus
    • Damage to articular cartilage and subchondral bone
    • Erosion of bone and juxta-articular osteopenia (localized bone loss).
    • Tendons and ligaments weaken, and joints deform or shift
    • Inflammation often flares and remits

    Clinical Manifestations

    • Joint pain (feet, hands, knees), swelling, fatigue, fever, limping
    • Polyarthritis (multiple joints affected)
    • Loss of range of motion, tender joints
    • Anemia, joint warmth, and joint deformities (later stages)
    • Impacts daily activities (grooming, eating, dressing)
    • Disease severity varies and symptom duration varies

    Diagnostic Criteria

    • No single test confirms diagnosis
    • Elevated erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) indicate inflammation
    • High rheumatoid factor (RF) in blood is common but not specific.
    • 45% positive in first 6 months; 85% positive with established disease
    • Anti-cyclic citrullinated peptide (anti-CCP) antibodies found in about 50% of patients with early arthritis. High titer early is a bad sign
    • Imaging tests (X-rays, MRI, and ultrasound) are important to monitor progression
    • X-rays may show no change early in disease or juxta-articular osteopenia.
    • MRI can show changes earlier than X-rays.

    Deformities in RA

    • Ulnar drift in hands (deviation toward the little finger side)
    • Boutonniere and swan-neck deformities
    • Hallux valgus, dropped metatarsal heads
    • Hammer and claw toes

    Treatment

    • Pharmacological:
      • NSAIDs (nonsteroidal anti-inflammatory drugs)
      • Disease-modifying antirheumatic drugs (DMARDs)
      • Corticosteroids
      • Biologic response modifiers ("biologics")
    • Nutritional Guidelines:
      • Diet can manage symptoms
      • Supplements (vitamin D, cod liver oil, multivitamins)
      • Avoid foods that cause inflammation (processed foods, high salt, oils, butter, sugar, animal products)
    • Physical Therapy:
      • Knowledge and patient education
      • Pain control, daily living activities, joint stiffness, preventing deformity
      • Improve strength, fatigue, quality of life, Aerobic capacity (swimming, walking etc.)

    Physical Therapy Modalities

    • Heat (subacute/chronic stages)
    • Ice (acute inflammation)
    • Ultrasound
    • Electrical stimulation (TENS, Iontophoresis, Interferential current)

    Joint Protection Strategies

    • Rest and positioning (shoulder 45° abduction, wrist 20°-30° extension, etc.)
    • Splinting

    Orthotic Devices

    • Ankle foot orthoses to lessen joint contractures
    • Viscoelastic soles to decrease shock loading

    Assistive Devices

    • Assistive devices and adaptive equipment are used to protect joints, conserve energy, reduce functional deficits, diminish pain, and maintain independence.
    • Examples include elevated toilet seats, widened gripping handles, and canes.

    Alternative Therapies

    • Includes practices such as tai chi, muscular therapy, yoga therapy, relaxation techniques, and Pilates.

    • Intra-articular temperature rise (up to 36° C) is associated with increased collagenase activity and cartilage damage

    Important Note

    • Disease progression varies greatly among patients.
    • Early diagnosis and treatment are crucial to reduce joint damage and disability.

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    Rheumatoid Arthritis PDF

    Description

    Test your knowledge on rheumatoid arthritis, including its risk factors, clinical manifestations, symptoms, and treatment recommendations. This quiz will help solidify your understanding of this common autoimmune disorder and its impact on patients.

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