Rheumatoid Arthritis Treatment and Mortality Quiz
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Questions and Answers

What is the most common extraarticular manifestation of RA?

  • Vasculitis
  • Scleritis
  • Episcleritis
  • Nodules (correct)

    • Which systemic manifestation of RA is associated with skin thinning due to steroid use?

  • Sjogren's
  • Vasculitis
  • Nodules (correct)
  • Raynaud's

    • Which organ system is affected by amyloidosis in RA?

  • Cardiovascular
  • Kidney and Gut (correct)
  • Nervous System
  • Lungs

    • Which systemic manifestation of RA is associated with peripheral neuropathy?

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

    What is a common cardiovascular manifestation of RA that contributes to increased mortality?

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

    What is the role of RANKL in the pathobiology of RA?

    <p>Stimulates the migration and activity of osteoclasts</p> Signup and view all the answers

    Which of the following cells play a key role in the formation of pannus in RA?

    <p>B cells</p> Signup and view all the answers

    What is the primary function of synoviocytes in the context of RA pathobiology?

    <p>Production of metalloproteinases and other effector molecules</p> Signup and view all the answers

    Which cytokine has a dual role in RA pathobiology by promoting both inflammation and bone erosion?

    <p>IL-6</p> Signup and view all the answers

    What is the main effect of TNF in the pathobiology of RA?

    <p>Promotion of osteoclast activity and bone erosion</p> Signup and view all the answers

    What is the recommended approach to treating rheumatoid arthritis (RA) according to the text?

    <p>Begin treatment with disease-modifying antirheumatic drugs (DMARDs) as early as possible</p> Signup and view all the answers

    What is a potential systemic manifestation of RA mentioned in the text?

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

    Which of the following is a guiding principle of RA treatment according to the text?

    <p>Treat early and with a targeted goal</p> Signup and view all the answers

    What is the significance of erosion and synovitis in relation to RA, as mentioned in the text?

    <p>Synovitis is more sensitive to ultrasound, and guided injections are more accurate for complex joints</p> Signup and view all the answers

    What is the role of TNF-a inhibitors in the treatment algorithm for RA?

    <p>They are added after escalation of methotrexate (MTX) dose and addition of traditional DMARDs</p> Signup and view all the answers

    What is the lifetime risk of interstitial lung disease (ILD) for Rheumatoid Arthritis (RA) patients compared to non-RA subjects?

    <p>7.7% for RA patients vs 0.9% for non-RA subjects</p> Signup and view all the answers

    What is the hazard ratio (HR) for risk of death in RA patients with ILD compared to RA patients without ILD?

    <p>2.86 [95% CI 1.98-4.12]</p> Signup and view all the answers

    What systemic manifestation contributes similarly to excess mortality in RA as cardiovascular disease (CVD)?

    <p>Interstitial lung disease (ILD)</p> Signup and view all the answers

    What do the graphs in the text depict about the duration of disease and severity of RA?

    <p>The severity of RA increases exponentially with longer duration of disease</p> Signup and view all the answers

    What is the impact of chronic obstructive pulmonary disease (COPD) on survival in patients with RA when adjusted for smoking?

    <p>Greater impact on survival</p> Signup and view all the answers

    What is the annual incidence of Rheumatoid Arthritis (RA)?

    <p>40/100,000</p> Signup and view all the answers

    Which gender has a higher prevalence of RA?

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

    What is the lifetime risk of RA for females over 60 years old?

    <p>5%</p> Signup and view all the answers

    Which factor contributes 53-65% of the risk for RA?

    <p>Genetic factors</p> Signup and view all the answers

    What percentage of the general population carries the minor allele of SNP in PTPN22, compared to the percentage in individuals with RA?

    <p>28% vs. 17%</p> Signup and view all the answers

    What is the hazard ratio for all-cause mortality associated with methotrexate use in patients with RA?

    <p>1.0</p> Signup and view all the answers

    Which factor was NOT included in the adjustments when comparing methotrexate to other treatments in patients with RA?

    <p>Body mass index (BMI)</p> Signup and view all the answers

    In the study, which patient group had inferior outcomes when compared to methotrexate use in patients with RA?

    <p>Patients with high disease activity</p> Signup and view all the answers

    What is the hazard ratio for mortality associated with TNF inhibitor use in patients with RA, adjusted for age and sex?

    <p>0.5</p> Signup and view all the answers

    Which measure was NOT included in the adjustments when assessing the effect of TNF inhibitor use on mortality in patients with RA?

    <p>Physical activity level</p> Signup and view all the answers

    What is the standardized mortality ratio for RA patients compared to the general population?

    <p>3.08</p> Signup and view all the answers

    Which event shows an increased rate in persons with Rheumatoid Arthritis (RA) when compared to the general population?

    <p>All of the above</p> Signup and view all the answers

    What is the relative risk (RR) for stroke in persons with RA when compared to the general population?

    <p>1.8 (1.7 - 2.0)</p> Signup and view all the answers

    Which gender has a Kaplan-Meier survival curve showing increased mortality in RA patients?

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

    What is the event rate per 1000 person-years for myocardial infarction (MI) in persons with RA?

    <p>1.6</p> Signup and view all the answers

    What is the significance of the Kaplan-Meier survival curve for U.S. males with RA?

    <p>It indicates similar mortality to the general population</p> Signup and view all the answers

    What does a relative risk (RR) of 1.9 (1.7 - 2.1) indicate in the context of cardiovascular (CV) death for persons with RA?

    <p>Significant increase in risk compared to the general population</p> Signup and view all the answers

    What can be inferred from the data regarding lung involvement in RA?

    <p>It confers significant morbidity and mortality</p> Signup and view all the answers

    How does the event rate for stroke compare in persons with RA to the general population?

    <p>It is higher in persons with RA</p> Signup and view all the answers

    What does a standardized mortality ratio of 2.08 indicate in relation to RA patients?

    <p>Slight increase in mortality rate compared to the general population</p> Signup and view all the answers

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