Deck 40: Medical and Nutrition Therapy for Rheumatic Disease

Question 1

What drugs are the first line of therapy for controlling the inflammatory process seen in arthritis?

A)Corticosteroids
B)Salicylates
C)Gold salts
D)Methotrexate

Answer 1

B
For the control of pain and inflammation in rheumatoid arthritis, salicylates and nonsteroidal anti-inflammatory drugs are first used.Methotrexate is a secondary medication used, but it is a folate antagonist and could contribute to neutropenia with long-term use.Corticosteroids have other metabolic derangement effects when used continuously.Use of gold salts can promote proteinuria.

Question 2

A group of self-reacting antibodies found in the sera of rheumatic patients

A)include CRP.
B)are known to suppress the immune system.
C)are known as rheumatoid factor.
D)are known as eicosanoids.

Answer 2

C
The term rheumatic factor is used to refer to a group of self-reacting antibodies found in the sera of rheumatic patients.It is used to screen for and monitor rheumatic disease along with CRP.Eicosanoids are modulators of the inflammation process that include prostaglandins.

Question 3

Which feature associated with the joint of a person affected with gout is different from the joint of a person affected with rheumatoid arthritis?

A)Bone erosion
B)Inflamed synovium
C)Bone spurs
D)Presence of tophi

Answer 3

D
Tophi are deposits of uric acid that crystallize on the bone and cartilage, leading to damage of the joint.In rheumatoid arthritis, inflammation of the synovial fluid damages the cartilage and bone, leading to bone erosion and loss.Osteoarthritis is characterized by the presence of bone spurs in the joint.

Question 4

Which of the following CAM therapies has been demonstrated as effective in the treatment of rheumatoid arthritis?

A)Copper bracelets
B)Echinacea
C)Borage and evening primrose oil
D)Thunder god vine

Question 5

What is the role of prostacyclin or PGI₂?

A)Converts arachidonic acid into PGE1
B)Converts arachidonic acid into PGE2
C)Promotes platelet aggregation
D)Inhibits platelet aggregation

Question 6

How are thromboxanes involved in the inflammation process?

A)Activation of platelet aggregation
B)Activation of cytokines
C)Attraction of neutrophils and macrophages
D)Production of arachidonic acid

Question 7

Which of the following conditions is characterized by a hardening of the skin and visceral organs?

A)Gout
B)Scleroderma
C)Fibromyalgia
D)Sjögren's syndrome

Question 8

Which of the following is an important component in the nutritional assessment of patients with rheumatoid arthritis?

A)ADLs
B)Degree of malabsorption
C)Blood glucose control
D)Nitrogen balance

Question 9

Which spices are included in the "anti-inflammatory diet??

A)Thyme, cayenne, and cloves
B)Oregano, lemon peel, and thyme
C)Ginger, curry, tumeric, and rosemary
D)Cayenne, cumin, and parsley

Question 10

Which of the following dietary recommendations assists in the management of patients with gout?

A)Fluid restriction and avoidance of coffee and chocolate
B)Limit intake of animal foods, seafood, and alcohol
C)High-fat, low-carbohydrate diet
D)Low-pyrimidine diet with decreased carbohydrates

Question 11

Which of the following food lists has a high-purine content?

A)Enriched white bread, rice, and tomatoes
B)Cheese, chocolate, butter, and coffee
C)Fruit, ice cream, pasta, and nuts
D)Herring, kidney, sardines, and consommé

Question 12

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A)include the drug Tylenol.
B)work by inhibiting the COX-1 enzyme.
C)work by blocking interleukin.
D)have significant catabolic effects.

Question 13

Which of the following is an autoimmune disorder that presents with severe fatigue, painful or swollen joints, and skin rashes?

A)Chronic fatigue syndrome
B)Systemic lupus erythematosus
C)Raynaud's syndrome
D)Scleroderma

Question 14

Which of the following dietary manipulations may have a beneficial effect in the treatment of patients with fibromyalgia?

A)Increase fiber.
B)Increase fruits and vegetables.
C)Limit fiber.
D)Limit dairy.

Question 15

Which of the following provides abundant omega-3 fatty acids such as DHA and EPA?

A)Flaxseed and walnuts
B)Soy and canola oils
C)Salmon and tuna
D)Lard

Question 16

With what do the plasma copper levels seen in patients with rheumatoid arthritis correlate?

A)Dietary intake of copper
B)Type of medication
C)Degree of joint inflammation
D)Degree of malabsorption and diarrhea

Question 17

Current research suggests that which of the following play a role in the inflammatory process?

A)Polyunsaturated fatty acids
B)Monounsaturated fatty acids
C)Omega-3 and omega-6 fatty acids
D)Medium-chain triglycerides

Question 18

Which of the following conditions is NOT a disease of autoimmune origin?

A)OA
B)RA
C)SLE
D)Scleroderma

Question 19

Which of the following is characteristic of Sjögren's syndrome?

A)Excessive sweating and salivation
B)Temporomandibular joint symptoms
C)Diminished production of tears and saliva
D)Diminished production of hydrochloric acid

Question 20

What should be the primary nutritional goal for patients with osteoarthritis?

A)Achieve and maintain a desirable body weight.
B)Increase fiber intake to prevent constipation.
C)Increase omega-3 oils in the diet.
D)Decrease sodium intake to reduce edema.