Question 1

Which of the following exercise recommendations would you give to a patient having an exacerbation of RA?&#10;A) Avoid vigorous activity&#10;B) Continue muscle conditioning and strength training through the episode&#10;C) Do not use isometric exercises during an exacerbation&#10;D) Dynamic exercises are fine but do not do them if they cause pain

Accepted Answer

During an exacerbation of RA, it is important to avoid vigorous activity that may further aggravate the joints and cause more pain. Instead, low-impact exercises and gentle stretching may be beneficial.

Question 2

Your patient with hypertension and psoriasis has a history of taking diuretics.Now he is showing evidence of an acute onset of inflammatory arthritis in the great toe and ankle of one foot.What do you suspect is occurring with this patient?

A) He is experiencing ankylosing spondylitis
B) He has gout
C) He has an acute form of JRA
D) He has RA

He has gout

Accepted Answer

The acute onset of inflammatory arthritis in the great toe and ankle is a classic presentation of gout, which is known to be associated with hypertension and use of diuretics. Ankylosing spondylitis would present with back pain and stiffness, while JRA and RA typically affect multiple joints and present with a more chronic course.

Question 3

Which of the following is the most common form of arthritis in adults and is generally the most painful and disabling joint disorder?&#10;A) Rheumatoid arthritis (RA)&#10;B) Osteoarthritis (OA)&#10;C) Psoriatic arthritis&#10;D) Septic arthritis

Accepted Answer

Osteoarthritis is the most common form of arthritis in adults and is generally the most painful and disabling joint disorder. Rheumatoid arthritis and psoriatic arthritis are autoimmune disorders, while septic arthritis is caused by bacterial infection in the joint.

Question 4

Which of the following is an example of an analgesic used in treating rheumatic disorders?&#10;A) Acetaminophen&#10;B) Ibuprofen&#10;C) Hydrocortisone&#10;D) Methotrexate

Accepted Answer

The answer of Which of the following is an example...

Question 5

Your patient has had noninflammatory joint pain for 1-4 days with skin lesions over the palms and soles of feet.Which type of arthritis does the patient likely have?&#10;A) Septic&#10;B) Gonococcal&#10;C) Nongonococcal&#10;D) JRA

Accepted Answer

The combination of noninflammatory joint pain with skin lesions over the palms and soles of the feet is highly suggestive of gonococcal arthritis, which is a type of septic arthritis caused by the bacteria Neisseria gonorrhea. Treatment with antibiotics is necessary to quickly address the joint infection and prevent complications.

Question 6

What does physical therapy focus on for a patient with ankylosing spondylitis?&#10;A) Strengthening postural muscles,back and neck extensors,shoulder retractors,and hip extensors and abductors&#10;B) Pain management and antiinflammatory drug treatments&#10;C) Aquatic therapy and heat treatments&#10;D) Preventing pain by monitoring the level and type of exercises done during occupational therapy

Accepted Answer

Physical therapy for a patient with ankylosing spondylitis focuses on strengthening postural muscles, back and neck extensors, shoulder retractors, and hip extensors and abductors in order to improve their posture, increase range of motion, and reduce pain.

Question 7

Which of the following would you suspect in a young man with conjunctivitis,urethritis,and oligoarticular arthritis?&#10;A) OA&#10;B) RA&#10;C) Psoriatic arthritis&#10;D) Reactive arthritis

Accepted Answer

The combination of conjunctivitis, urethritis, and oligoarticular arthritis is typical of reactive arthritis, formerly known as Reiter's syndrome. It is commonly associated with a previous genital or gastrointestinal infection. The other options, OA, RA, and psoriatic arthritis, do not typically present with these specific symptoms.

Question 8

Which of the following forms of arthritis would you suspect in a 50-year-old woman with painful knees and hips after activity that is relieved with rest?&#10;A) RA&#10;B) OA&#10;C) Psoriatic arthritis&#10;D) Septic arthritis

Accepted Answer

The symptoms described suggest osteoarthritis (OA), which commonly affects weight-bearing joints such as the knees and hips. OA pain is often described as stiffness after rest and aggravation with repeated use that is relieved by rest. The age and gender of the patient also fit with the typical profile of those affected by OA. Rheumatoid arthritis (RA) typically presents with more systemic symptoms and symmetrical joint involvement, while psoriatic arthritis and septic arthritis typically have additional symptoms such as skin lesions or fever, respectively.

Question 9

Which physical changes would you expect to see in the hands of a person with RA arthritis?&#10;A) Swelling of the joints&#10;B) Hyperflexion and extension of the joints&#10;C) Swan neck deformity&#10;D) Boutonniere deformity&#10;E) All of the above

Accepted Answer

All of the physical changes listed (swelling, hyperflexion and extension of joints, swan neck deformity, and boutonniere deformity) are commonly seen in individuals with RA arthritis.

Question 10

Which test is performed to diagnose osteoporosis?&#10;A) Vitamin D blood levels&#10;B) Calcium blood levels&#10;C) Dual energy x-ray absorptiometry&#10;D) Exercise stress test

Accepted Answer

Dual energy x-ray absorptiometry (DEXA or DXA) is the most commonly used test to diagnose osteoporosis. It is a low radiation x-ray that measures bone density in the hip and spine. It can detect even small changes in bone density, making it a useful tool for diagnosing osteoporosis before a fracture occurs. Vitamin D blood levels and calcium blood levels can provide information on bone health but are not typically used to diagnose osteoporosis. An exercise stress test is used to evaluate cardiovascular health, not bone health.

Question 11

Which of the following is an example of a DMARD?&#10;A) Acetaminophen&#10;B) Ibuprofen&#10;C) Hydrocortisone&#10;D) Methotrexate

Accepted Answer

The answer of Which of the following is an example...

Question 12

Which of the following is similar to RA but not so severe,seen in those aged 30-50,and usually affecting joints asymmetrically?&#10;A) OA&#10;B) RA&#10;C) Psoriatic arthritis&#10;D) Reactive arthritis

Accepted Answer

The answer of Which of the following is similar to...

Question 13

What description would your fibromyalgia patient use to describe his pain?&#10;A) Sharp,stabbing pain over one or more joints&#10;B) Burning or aching&#10;C) Tenderness,stiffness,or throbbing&#10;D) B and C

Accepted Answer

The answer of What description would your fibromyalgia patient use...

Question 14

Which disease is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to fragility and risk of fracture?&#10;A) RA&#10;B) Synovitis&#10;C) Systemic lupus erythematosus&#10;D) Osteoporosis

Accepted Answer

The answer of Which disease is characterized by low bone...

Question 15

Which arthritic condition affects the spine as well as all the joint ligaments of the spine,spreads superiorly up the spine,and has an onset usually in the late teens to early twenties?&#10;A) Gonococcal&#10;B) Ankylosing spondylitis&#10;C) Gout&#10;D) JRA

Accepted Answer

The answer of Which arthritic condition affects the spine as...

Question 16

Which of the following forms of arthritis would you suspect in a 30-year-old woman with complaints of fatigue,fever,pain in the knees and wrists,and morning stiffness?&#10;A) RA&#10;B) OA&#10;C) Psoriatic arthritis&#10;D) Septic arthritis

Accepted Answer

The answer of Which of the following forms of arthritis...

Question 17

What is the first line of drug therapy for pain,stiffness,and swelling for children with JRA?&#10;A) Corticosteroids&#10;B) Disease-modifying antirheumatic drugs (DMARDs)&#10;C) Nonsteroidal antiinflammatory drugs (NSAIDs)&#10;D) Immunosuppressive medications

Accepted Answer

The answer of What is the first line of drug...

Question 18

In providing patient education to your gout patient,which recommendations would be useful?&#10;A) Lose weight and lower intake of alcohol&#10;B) Take colchicine as prescribed by the doctor&#10;C) Avoid foods that are high in purine&#10;D) All of the above

Accepted Answer

The answer of In providing patient education to your gout...

Question 19

Which form of juvenile rheumatoid arthritis (JRA)presents with a high fever,rash,malaise,irritability,anemia,lymphadenopathy,and splenomegaly?&#10;A) Pauciarticular&#10;B) Polyarticular&#10;C) Systemic&#10;D) Septic

Accepted Answer

The answer of Which form of juvenile rheumatoid arthritis (JRA)presents...

Question 20

When beginning an exercise program with a newly diagnosed fibromyalgia patient,which of the following would you recommend?&#10;A) One 30-minute session daily that has some aerobic and some stretching exercises&#10;B) Daily stretches with 5 minutes of aerobic activity&#10;C) Dumbbell weights and a walking regimen for 30 minutes three times a week&#10;D) Water aerobics for 1 hour three times a week

Accepted Answer

The answer of When beginning an exercise program with a...

Deck 24: Orthopedic Management of Rheumatic Disorders