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Chapter 57. Rheumatoid Arthritis

Student Questions

Which of the following treatment goals should be considered in a patient newly diagnosed with systemic juvenile idiopathic arthritis (JIA)?

A. Maintain normal growth

B. Evaluate for osteoporosis risk

C. Protect joint function by limiting activity

D. Initiate treatment for uveitis

Answer: A

Option A: Correct. In addition to controlling disease activity to minimize joint damage, it is important to ensure that a child with JIA continues to maintain normal growth.

Option B: Incorrect. Osteoporosis risk would be a concern in an adult instead of a child.

Option C: Incorrect. Patients should not be encouraged to limit joint movement. Instead, they should be referred to occupational or physical therapy to improve joint function.

Option D: Incorrect. Uveitis is more common in oligoarticular JIA.

Janus kinases may influence the pathogenesis of RA by:

A. Releasing cytokines

B. Stimulating release of macrophages

C. Enhancing cell signaling

D. Binding CD28 receptors to antigen-presenting cells

Answer: C

Option A: Incorrect. B lymphocytes may produce cytokines.

Option B: Incorrect. T lymphocytes stimulate the release of macrophages.

Option C: Correct. Kinases enhance communication or signaling between and within cells.

Option D: Incorrect. A ligand-receptor complex on antigen-presenting cells binds CD28 receptors on T lymphocytes.

Which one of the following potential adverse effects should be discussed with a patient who presents with a new prescription for methotrexate for RA?

A. Hair loss

B. Changes in peripheral vision

C. Yellow-orange skin discoloration

D. Patchy skin pigmentation

Answer: A

Option A: Correct. A side effect of methotrexate may be alopecia or hair loss.

Option B: Incorrect. Changes in peripheral vision may be a side effect of hydroxychloroquine.

Option C: Incorrect. Yellow-orange skin discoloration may be a side effect of sulfasalazine.

Option D: Incorrect. Patchy skin pigmentation may be a side effect of hydroxychloroquine.

A 5-year-old boy and his mother present to the pediatrician. The child has a 2-month history of intermittent fevers, joint pain, and tenderness in ...

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