Question 1

Which of following structures is typically involved in initiation of the rheumatoid arthritis process at the joint level?&#10;A)Articular cartilage&#10;B)Synovium&#10;C)Local vascular system&#10;D)Ligaments and tendon sheaths

Accepted Answer

The synovium is the inner lining of the joint capsule and is believed to play a crucial role in the initiation of rheumatoid arthritis. Inflammation of the synovium leads to immune cell infiltration, secretion of inflammatory cytokines, and erosion of the cartilage and bone of the joint. Articular cartilage, ligaments and tendon sheaths may also be affected in the later stages of the disease, but they are not typically involved in the initial stages of the disease process. The local vascular system may play a role in delivering immune cells and cytokines to the joint, but it is not the primary structure involved in the initiation of the disease process.

Question 2

Which set of diagnostic test results is MORE likely to indicate a diagnosis of rheumatoid arthritis?&#10;A)Increased erythrocyte sedimentation rate,normal C-reactive protein,positive rhesus factor,and increased white blood cells in the synovial fluid&#10;B)Normal erythrocyte sedimentation rate,normal C-reactive protein,positive rhesus factor,and normal white blood cells in the synovial fluid&#10;C)Increased erythrocyte sedimentation rate,normal C-reactive protein,negative rhesus factor,and increased white blood cells in the synovial fluid&#10;D)Normal erythrocyte sedimentation rate,elevated C-reactive protein,negative rhesus factor,and normal white blood cells in the synovial fluid

Accepted Answer

An increased erythrocyte sedimentation rate and positive rhesus factor are common findings in rheumatoid arthritis. Increased white blood cells in the synovial fluid can also indicate inflammation, which is characteristic of rheumatoid arthritis. A normal C-reactive protein level does not necessarily rule out rheumatoid arthritis, as it can be normal in some cases.

Question 3

Which of the following statements BEST explains why improving strength is an important component of physical therapy management in patients with osteoarthritis?&#10;A)Improving strength is associated with reduction in pain levels.&#10;B)Strength is the most important predictor of functional capabilities.&#10;C)People with stronger muscles do not require surgical intervention.&#10;D)Improvement in strength leads to reversal of cartilage damage.Chapter 23: Arthritis

Accepted Answer

Improving strength is an important component of physical therapy management in patients with osteoarthritis because strength is the most important predictor of functional capabilities. Stronger muscles can help patients perform daily activities with less difficulty and pain.

Question 4

A patient presents with rheumatoid arthritis affecting the right knee.In addition to the right knee,what other joints and systems should be included in the assessment?&#10;A)Left knee,both hips,thoracic and lumbar spine&#10;B)Right hip,cervical spine,both hands&#10;C)Cardiovascular endurance,cervical spine&#10;D)Left knee,both hips,feet,hands,cardiovascular endurance

Accepted Answer

Rheumatoid arthritis (RA) is a systemic autoimmune disease that primarily affects joints but can also have systemic manifestations, including cardiovascular involvement. It typically presents with a symmetrical pattern of joint involvement. Therefore, if the right knee is affected, the left knee is likely to be involved as well. RA commonly affects small joints such as those in the hands and feet, and can also impact larger joints like the hips. Additionally, cardiovascular endurance should be assessed due to the increased risk of cardiovascular disease in patients with RA.

Question 5

Which of the following BEST describes the role of radiography in diagnosing knee osteoarthritis?&#10;A)Radiography of the entire limb is necessary for an accurate diagnosis.&#10;B)Either bony malalignment or reduced cartilaginous space must be present.&#10;C)Bony malalignment and reduced cartilaginous space must both be present.&#10;D)Radiography is not needed for diagnosis of osteoarthritis.

Accepted Answer

The answer of Which of the following BEST describes the...

Question 6

Which of the following statements BEST describes the relationship between age and the development of osteoarthritis?&#10;A)Osteoarthritis is considered an inevitable part of the normal aging process.&#10;B)Osteoarthritis is not part of the normal aging process,but is more common in older adults.&#10;C)Osteoarthritis is not associated with aging and is only associated with previous joint injury.&#10;D)Osteoarthritis is more closely related to hereditary factors rather than age.

Accepted Answer

Although osteoarthritis is not considered an inevitable part of normal aging, it is more common in older adults. Other risk factors for osteoarthritis include previous joint injury, obesity, and hereditary factors.

Question 7

In a patient with advanced rheumatoid arthritis of the wrist,what are the MOST likely radiographic changes?&#10;A)Swelling of the tissues surrounding the wrist&#10;B)Osteophyte formation&#10;C)Subluxation of the carpal bones,reduced joint space&#10;D)Microfracture of the articulating bones

Accepted Answer

In advanced rheumatoid arthritis of the wrist, subluxation of the carpal bones and reduced joint space are the most likely radiographic changes. This is due to joint destruction and erosion that occurs with the disease, leading to instability and misalignment of the bones. Swelling of the tissues and osteophyte formation may also occur, but are not as specific to rheumatoid arthritis and can be seen in other joint conditions. Microfracture of the articulating bones is not a typical finding in rheumatoid arthritis.

Question 8

A patient presents to physical therapy with a diagnosis of right knee osteoarthritis.In planning the physical therapy assessment,what functional activities are MOST important to include?&#10;A)Walking,balance,stair ascent,moving from sitting to standing&#10;B)Determining the activities that the patient reports are most painful for the right knee&#10;C)Determining the activities that the patient reports are least painful for the right knee&#10;D)Administering standardized questionnaires of function,including the Health Assessment Questionnaire

Accepted Answer

Walking, balance, stair ascent, and moving from sitting to standing are important functional activities to assess in a patient with knee osteoarthritis as they are often affected by the condition and impact the patient's ability to perform daily activities. Additionally, these activities can serve as baseline measures for tracking progress during physical therapy treatment. While determining the patient's most and least painful activities may provide valuable information, it is not as crucial to assess as the activities listed in option A. Administering standardized questionnaires may also be useful, but again, assessing functional activities should take priority.

Deck 23: Arthritis