Question 1

What is a pannus?&#10;A) It is excessive proliferative and invasive granulation tissue.&#10;B) It is a drug interaction that interferes with platelet function and causes excessive bleeding.&#10;C) It is a sudden retrognathia and anterior open bite caused by destruction of the condylar heads and loss of condylar height.&#10;D) It is worn subchondral bone that becomes polished and sclerotic.

Accepted Answer

A pannus is excessive proliferative and invasive granulation tissue.With rheumatoid arthritis,primary changes occur within the synovium causing edema,followed by thickening and folding of tissue,a pannus.In addition,marked infiltration of lymphocytes and plasma cells into the capsule occurs.Eventually,granulation tissue covers the articular surfaces and destroys the cartilage and subchondral bone through enzymatic activity.

Question 2

Which of the following characteristics is used to distinguish fibromyalgia (FM)from myofascial pain syndrome (MFP)?&#10;A) Regional rather than widespread muscular pain is associated with FM.&#10;B) The pain in FM is relatively stable and consistent in contrast to MFP.&#10;C) When the muscle pain is primarily due to the FM, it may not respond as well as the jaw pain from MFP because FM is a systemic and not a local condition.&#10;D) a and b&#10;E) b and c

Accepted Answer

The pain in FM is relatively stable and consistent in contrast to MFP,which can vary in intensity and location depending on which muscles are involved.When the muscle pain is primarily due to the FM,it may not respond as well as the jaw pain from MFP because FM is a systemic and not a local condition,and muscle pain is a typical presentation in FM.Regional pain is found with MFP and needs to be distinguished from the widespread muscular pain associated with FM.

Question 3

What is the primary difference between aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)in regard to platelets?&#10;A) Aspirin has no effect on platelets, in contrast to the other NSAIDs, which have a marked effect on platelets.&#10;B) The effects of aspirin are irreversible for the life of the platelet, whereas the effect of the other NSAIDs on platelets is reversible.&#10;C) Aspirin will cause prolonged bleeding, while the other NSAIDs will shorten bleeding time.&#10;D) There are no differences between aspirin and other NSAIDs in regard to bleeding time.

Accepted Answer

The effects of aspirin are irreversible for the life of the platelet (10 to 12 days),and this effect continues until new platelets have replaced the old.The effect of the other NSAIDs on platelets is reversible and lasts only as long as the drug is present in the plasma.All NSAIDs can cause a qualitative platelet defect that may result in prolonged bleeding,especially when given in high doses.

Question 4

Which of the following is the most common manifestation of systemic lupus erythematosus (SLE)?&#10;A) psychosis&#10;B) renal abnormalities&#10;C) heart murmur&#10;D) arthritis

Accepted Answer

The most common manifestation of SLE is arthritis,which is seen in 76% of patients.Neuropsychiatric symptoms are common and include organic brain syndrome,psychosis,seizures,stroke,movement disorders,and peripheral neuropathy.Serious renal abnormalities occur in less than one third of patients with SLE,although most show some abnormality on renal biopsy.A clinically detectable heart murmur is found in 18.5% of SLE patients.Approximately 4% of patients had cardiac valve abnormalities that placed them in the moderate risk group for endocarditis.

Question 5

Which of the following medications is the usual initial therapy for giant cell arteritis?&#10;A) glucocorticoids&#10;B) narcotic analgesics&#10;C) antidepressants&#10;D) methotrexate

Accepted Answer

The universal treatment for GCA is glucocorticoid therapy.Prednisone (60 mg per day)is the usual initial therapy.Once the immune response has subsided and symptoms diminish,the prednisone may be reduced by 10% per week.Adjunctive therapy with aspirin also is quite helpful.

Question 6

Giant cell arteritis (GCA)most commonly affects branches of the ___________ artery.&#10;A) maxillary&#10;B) carotid&#10;C) superior thyroid&#10;D) inferior thyroid

Accepted Answer

GCA is a systemic vasculitis involving medium-sized and large arteries,most commonly the extracranial branches of the carotid artery.GCA is the most common form of vasculitis.This inflammatory disorder affects women more often than men,almost exclusively after 50 years of age,and the average age is 72 years.Because of the occlusive nature of the narrowing of the vascular lumen,cranial pain,blindness,trAnswerient ischemic attacks (TIAs),and other strokes are common complications in patients with GCA.

Question 7

Which of the following is/are true of systemic lupus erythematosus (SLE)?&#10;A) SLE is due to wheat gluten allergy.&#10;B) SLE is more common in women than in men.&#10;C) These patients should be premedicated with antibiotics prior to invasive dental treatment.&#10;D) a and b&#10;E) b and c

Accepted Answer

The etiology of SLE is unknown,although it is clearly an autoimmune disease.It predominantly affects women of childbearing age,with a female-to-male ratio of 5:1; it is more common and more severe among African AmericAnswer and Hispanics than among whites.On the basis of 2007 American Heart Association guidelines,none of these patients are recommended for antibiotic prophylaxis for invasive dental procedures.

Question 8

What is synovial fluid derived from?&#10;A) osteoblasts&#10;B) plasma&#10;C) lysosome&#10;D) fibroblasts

Accepted Answer

Synovial fluid is derived from the synovium primarily as an ultrafiltrate of plasma.The synovium also secretes specialized molecules into the synovial fluid,such as hyaluronic acid.The cartilage has a high water content and obtains its nutrition solely from the synovial fluid.Cartilage loss may occur secondarily to synovial inflammation or trauma.

Question 9

The 2003 joint advisory statement by the American Dental Association (ADA)and the American Academy of Orthopedic Surgeons (AAOS)indicated that antibiotic prophylaxis prior to dental treatment can be considered for ________.

A) all prosthetic joint patients to prevent prosthetic joint infection (PJI)
B) patients with pins, plates, and screws in joints
C) most patients with total joint replacement
D) patients whose joint replacement has been in place for less than 2 years

Accepted Answer

The statement indicated that antibiotic prophylaxis can be considered for patients whose joint replacement has been in place for less than 2 years and for patients at increased risk to infection who are undergoing invasive dental procedures.No evidence suggests that even these patients are at increased risk for infection from dentally induced bacteremia and,in fact,the microbiology of late prosthetic joint infection (LPJI)in these patients is the same in other patients with LPJI.

Question 10

The tongue is commonly infected (in as many as 83%)with _________ in patients with Sicca syndrome (SS).&#10;A) Borrelia burgdorferi&#10;B) Candida albicans&#10;C) Streptococcus mutans&#10;D) Helicobacter pylori

Accepted Answer

The tongue is commonly infected with Candida albicAnswer in patients with Sicca syndrome.Not only must the acute candidal infection be treated,but some type of maintenance therapy must be provided to prevent recurrence of the fungal infection.As long as the oral environment is adversely affected by hyposalivation,susceptibility to recurrence of the oral infection and continued deterioration occur.

Question 11

Which of the following is the most significant oral complication of rheumatoid arthritis?&#10;A) salivary gland dysfunction (xerostomia)&#10;B) burning tongue syndrome (glossodynia)&#10;C) TMJ involvement&#10;D) vesiculobullous lesions

Accepted Answer

The answer of Which of the following is the most...

Question 12

Which of the following is true regarding antibiotic prophylaxis for dental treatment of a patient with osteoarthritis (OA)?&#10;A) Patients with OA will require antibiotic prophylaxis for the rest of their lives.&#10;B) Patients with OA usually do not require antibiotic prophylaxis for dental treatment except for the first 2 years.&#10;C) Patients with OA will require antibiotic prophylaxis if a concomitant condition exists or if the patient is immune suppressed.&#10;D) Patients with osteoarthritis do not require antibiotic prophylaxis at all.&#10;E) Both b and c

Accepted Answer

The answer of Which of the following is true regarding...

Question 13

The &#34;gold standard&#34; agent for treatment of patients with early rheumatoid arthritis is ________.&#10;A) penicillamine&#10;B) methotrexate&#10;C) infliximab&#10;D) sulfasalazine

Accepted Answer

The answer of The &#34;gold standard&#34; agent for treatment of...

Question 14

Which of the following is the causative agent of Lyme disease?&#10;A) Hodgkin disease&#10;B) dust mites&#10;C) Borrelia burgdorferi&#10;D) Helicobacter pylori

Accepted Answer

The answer of Which of the following is the causative...

Question 15

Which of the following is recommended as a first-line drug for the treatment of osteoarthritis (OA)?&#10;A) methotrexate&#10;B) acetaminophen&#10;C) celecoxib (Celebrex)&#10;D) cyclosporine

Accepted Answer

The answer of Which of the following is recommended as...

Question 16

For patients with osteoarthritis (OA)with a temporomandibular joint reducing anterior disk displacement,about a __% chance exists that no progression of the disorder will occur.&#10;A) 10&#10;B) 25&#10;C) 50&#10;D) 75

Accepted Answer

The answer of For patients with osteoarthritis (OA)with a temporomandibular...

Question 17

Which of the following is the most common form of arthritis?&#10;A) rheumatoid arthritis (RA)&#10;B) osteoarthritis (OA)&#10;C) juvenile rheumatoid arthritis (jRA)&#10;D) psoriatic rheumatoid arthritis (pRA)

Accepted Answer

The answer of Which of the following is the most...

Question 18

Sicca syndrome (SS)is characterized by enlargement of which of the following salivary glands?&#10;A) sublingual&#10;B) submandibular&#10;C) parotid&#10;D) minor accessory

Accepted Answer

The answer of Sicca syndrome (SS)is characterized by enlargement of...

Question 19

Secondary Sj&#246;gren syndrome (SS-2)is characterized by a triad of clinical conditions that consist of keratoconjunctivitis sicca,a connective tissue disease (usually rheumatoid arthritis),and ________.&#10;A) xerostomia&#10;B) facial palsy&#10;C) a &#34;pencil-in-cup&#34; deformity in patients with interphalangeal joint disease&#10;D) transient ischemic attacks (TIAs)

Accepted Answer

The answer of Secondary Sj&#246;gren syndrome (SS-2)is characterized by a...

Question 20

Which of the following is the most common form of psoriatic arthritis?&#10;A) selective targeting of the distal interphalangeal joints&#10;B) psoriatic spondylitis&#10;C) an asymmetric oligoarthritis that may involve both large and small joints&#10;D) a symmetric polyarthritis that mimics rheumatoid arthritis except for the absence of rheumatoid nodules and rheumatoid factor

Accepted Answer

The answer of Which of the following is the most...

Deck 20: Rheumatologic and Connective Tissue Disorders