Deck 30: Rheumatoid Arthritis

Question 1

MATCHING
Match the form of juvenile rheumatoid arthritis (JRA)with the appropriate description.

Pauciarticular arthritis

A)Tends to be HLA-DR5-positive.Polyarthritis begins in five or more joints and occurs in about 40% of patients
B)Arthritis involving four or fewer joints occurs in 40% of patients.One subgroup is associated with HLA-Dw5 and HLA-DR5

Answer 1

Arthritis involving four or fewer joints occurs in 40% of patients.One subgroup is associated with HLA-Dw5 and HLA-DR5

Question 2

Prognostic markers that may help identify patients with more severe RA who are still in the early stages of the disease include persistently high numbers of swollen joints.

Answer 2

True

Question 3

Rheumatoid arthritis (RA)is characterized by:

A) joint pain and tenderness.
B) the presence of rheumatoid factor in the blood.
C) association with HLA-DR genes.
D) all of the above.

Answer 3

all of the above.

Question 4

Indicate whether the following laboratory assays are highly specific or nonspecific for RA:
1)Cyclic citrullinated peptide (CCP)antibodies
2)Antibodies to anti-perinuclear factor (APF)
3)Antibodies to keratin (AKA)
4)Antinuclear antibodies (ANAs)

A) Highly specific for RA
B) Nonspecific for RA

Question 5

Prognostic markers that may help identify patients with more severe RA who are still in the early stages of the disease include the presence of certain HLA class I alleles.

Question 6

Immunologic features of rheumatoid arthritis include anti-cyclic citrullinated peptide (anti-CCP).

Question 7

A biologic false-positive rheumatoid factor (RF)assay can be manifested by patients with:

A) systemic lupus erythematosus (SLE).
B) hepatitis.
C) syphilis.
D) all of the above.

Question 8

Immunologic features of rheumatoid arthritis include antinuclear antibodies (ANAs).

Question 9

Which of the following immunoglobulins or molecular components is used in rheumatoid factor (RF)rapid slide assays?

A) Fc portion of IgM
B) Fc portion of IgG
C) IgM
D) IgG

Question 10

Rheumatoid arthritis (RA)can be treated with the ______________ class of drugs.

A) nonsteroidal antiinflammatory
B) corticosteroid
C) disease-modifying antirheumatic
D) all of the above

Question 11

The female-to-male ratio in patients with rheumatoid arthritis (RA)is:

A) 0.5:1.
B) 1:1.
C) 2.5:1.
D) 2:3.

Question 12

Pathogenic mechanisms hypothesized for rheumatoid arthritis include:

A) an infective agent or other stimulus binds to receptors on dendritic cells (DCs).
B) activated T lymphocytes proliferate and migrate into the joint.
C) complement activation.
D) both a and b

Question 13

MATCHING
Match the form of juvenile rheumatoid arthritis (JRA)with the appropriate description.

Still's disease

A)Tends to be HLA-DR5-positive.Polyarthritis begins in five or more joints and occurs in about 40% of patients
B)Arthritis involving four or fewer joints occurs in 40% of patients.One subgroup is associated with HLA-Dw5 and HLA-DR5

Question 14

Immunologic features of rheumatoid arthritis include immune complexes.

Question 15

The laboratory serum agglutination assay for rheumatoid factor (RF):

A) detects IgG rheumatoid factors.
B) detects IgM rheumatoid factors.
C) does not generate many false-positive results.
D) is sensitive to changes in RF titer.

Question 16

Prognostic markers that may help identify patients with more severe RA who are still in the early stages of the disease include low serum levels of acute-phase reactants of immunoglobulin M (IgM)rheumatoid factor.

Question 17

In RA,stimulated macrophages and fibroblasts release cytokines.One that is particularly important is:

A) TNF-a.
B) complement.
C) IL-30.
D) IL-15.

Question 18

The immunoglobulin classes most often associated with rheumatoid factors (RFs)are:

A) IgM and IgG.
B) IgG and IgA.
C) IgM and IgA.
D) IgA and IgD.

Question 19

Being rheumatoid factor (RF)-positive correlates with the severity of the disease (in general).

Question 20

The RA agglutination test is based on the reaction between patient antibodies in the serum,known as the rheumatoid factor,and an antigen derived from:

A) human gamma globulin (IgM).
B) rabbit gamma globulin (IgM).
C) human gamma globulin (IgG).
D) rabbit gamma globulin (IgG).

Question 21

Being rheumatoid factor (RF)-positive correlates with the absence of nodules.

Question 22

Being rheumatoid factor (RF)-positive correlates with other organ system involvement (e.g. ,vasculitis,Felty's syndrome,Sjögren's syndrome).