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 (C)</p> Signup and view all the answers

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

<p>Atherosclerosis (D)</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 (B)</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 (D)</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 (C)</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 (A)</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 (B)</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 (D)</p> Signup and view all the answers

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

<p>Osteoporosis (D)</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 (D)</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 (D)</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 (C)</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 (B)</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] (A)</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) (A)</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 (B)</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 (B)</p> Signup and view all the answers

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

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

Which gender has a higher prevalence of RA?

<p>Female (B)</p> Signup and view all the answers

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

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

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

<p>Genetic factors (D)</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% (D)</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 (A)</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) (C)</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 (D)</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 (A)</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 (C)</p> Signup and view all the answers

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

<p>3.08 (A)</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 (D)</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) (D)</p> Signup and view all the answers

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

<p>Females (C)</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 (B)</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 (B)</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 (C)</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 (C)</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 (B)</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 (B)</p> Signup and view all the answers

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