Arthritis

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Which joints are affected by RA:

a) Rigid joints
b) Synovial joints
c) Fixed joints
d) Slightly moveable joints

2. The ___________ has no direct blood supply which may limit its ability to heal when injured.

a) Bone
b) Bursa
c) Ligament
d) Cartilage

3. The trigger that causes inflammation in RA could be:

a) A virus or foreign substance
b) Overactive T cells and B cells
c) A lowered immune system
d) Linked to heredity

4. At this stage of RA, an inflamed synovium can grow and spread over the top of joint cartilage and a pannus develops:

a) Stage l
b) Stage 2
c) Stage 3
d) Stage 4
e) Stage 5

5. This type of arthritis appears in matching joints, for instance left and right wrists or left and right knees:

a) Palindromic rheumatism
b) Osteoarthritis
c) Symmetrical arthritis
d) Gouty arthritis

6. In this course people with RA have a series of flare-ups of arthritis and return to normal health between attacks:

a) Spontaneous remission
b) Remitting
c) Remitting progressive
d) Progressive

7. RA is generally a(n) _________ condition in which 'True cures or permanent remissions are unusual with the medications presently available.

a) Chronic
b) Acute

8. One of the most helpful tests in rheumatology involves the evaluation of:

a) The sedimentation rate
b) A rheumatoid titer
c) The number of neutrophils in a blood sample
d) Synovial fluid

9. Anemia frequently accompanies RA, and it may contribute to the fatigue which many people with RA experience.

a) True
b) False

10. This anemia affects between one-half and two-thirds of individuals with RA with a significant decrease in red blood cells:

a) Felty's syndrome
b) Iron deficiency anemia
c) Anemia of chronic disease

11. Rheumatoid nodules:
  1. Are benign
  2. Develop in most people with advanced RA
  3. Result in numbness and burning sensations
  4. Occur in approximately one-quarter of people with established RA
  5. Do not merit special treatment unless there is pain or they become infected

a) 2 and 4
b) 1, 4, and 5
c) 1 and 3
d) 2 only

12. Which of the following is 'True about osteoporosis:
  1. Women are at a higher risk
  2. Corticosteroids are the most common cause of drug induced bone loss
  3. A diet low in calcium and vitamin D contributes to osteoporosis
  4. 15 percent of the people with RA will sustain a fracture
  5. Osteoblasts break down bone

a) 1, 3, and 5
b) 2 and 4
c) 4 and 5
d) 1, 2, and 3

13. This is the first step when coping with RA. Many fail to take it and it often proves difficult.

a) Searching for available resources
b) Asking for a second opinion
c) Setting short term goals
d) Identifying the problem

14. Pain receptors are activated by:

a) Injury only
b) Irritation and inflammation
c) Injury, irritation, and inflammation
d) Endorphins and enkephalins

15. Gelling is pain:

a) After exercising
b) Aņer sitting
c) With specific exercises
d) In the morning

16. The most incapacitating feature of RA is:

a) Fatigue
b) Pain
c) Lack of sleep

17. An example of local rest is to wear splints, especially on the wrists and hands.

a) True
b) False

18. Frequently depression is caused by:

a) Inability to maintain a positive attitude
b) Heredity
c) A chemical imbalance
d) Chronic pain, fatigue and anger

19. Dr. Edmund Jacobson described this technique in 1929:

a) Biofeedback
b) Meditation
c) Imagery
d) Progressive relaxation
e) Expanded spirituality

20. When joints change their alignment it is called _________ .

a) Bridging
b) Drift
c) Accommodation
d) Fusion

21. This exercise simply involves tightening or contracting muscles to maintain muscle strength. Exercise bands can be used.

a) Isometric exercises
b) Range of motion
c) Strengthening exercises
d) Endurance exercises

22. Target heart rate is based on:

a) Level of pain
b) Health condition
c) Pulse rate
d) Age

23. The pulse is taken in the __________ for 15 seconds and multiplied by __________ .

a) Neck, two
b) Wrist, four
c) Arm, three
d) Foot, two

24. This drug is the first biogenetically engineered drug in a new class of drugs called biologic response modifiers:

a) Aspirin
b) Prednisone
c) Enbril
d) Aleve

25. Nonsteroidal anti-inflammatory drugs often induce a remission of RA.

a) True
b) False

26. The most common side effect of high-dose aspirin therapy is:

a) Stomach distress
b) Ringing in the ears
c) Abnormal liver test
d) Passing blood in the stool

27. Cyclo-oxygenase-2 or COX-2 is an enzyme in the body known to stimulate inflammation by producing __________ .

a) Erythrocytes
b) Cystokines
c) Antibodies
d) Prostaglandins

28. The purpose of DMADS is to:.

a) Control pain and reduce symptoms
b) Alter body chemistry to reduce inflammation
c) Control the arthritis process and prevent damage
d) Extend the time and frequency of remissions

29. Methotrexate has become very popular for RA treatment because it:
  1. Is inexpensive
  2. Has fewer side effects
  3. Has a rapid improvement rate
  4. Is very effective
  5. Can be taken 1 time a week

a) 2, 3 and 4
b) 1 and 4
c) 2 and 5
d) 1, 2 and 3
e) 3, 4 and 5

30. One biologic treatment option is to copy naturally occurring anti-inflammatory proteins, increasing their presence in the body in an effort to control inflammation, mimicking the body's natural response to balance inflammation.

a) True
b) False

31. Enbrel:
  1. Is a protein and must be injected
  2. Has to be refrigerated
  3. Can cause severe nausea
  4. Is an anti-tumor necrosis factor drug
  5. Does not require precertification

a) 2 and 3
b) 1, 2 and 4
c) 4 and 5
d) 1, 3 and 5

32. Corticosteroids can be substituted temporarily to control inflammation rapidly while awaiting effects of the slower-acting disease-modifying antirheumatic drugs. This is called:

a) Titrating
b) A disease-modifying technique
c) Apheresis
d) Bridge therapy

33. One long-term side effect of oral corticosteroids is a decreased blood supply to bones called:

a) Osteoporosis
b) Osteomyelitis
c) Osteonecrosis

34. Treatment after a corticosteroid injection is:
  1. Apply a heating pad to reduce stiffness
  2. Keep the site covered with a sterile dressing for two days
  4. Elevate the joint to decrease swelling
  5. Apply ice packs for 20 minutes as soon as after the injection

a) 1, 2 and 3
b) 4 and 5
c) 1, 3 and 5
d) 2 and 5

35. Osteoporosis is diagnosed by:

a) A blood test
b) Symptoms described by the patient
c) Bone density testing
d) A urine sample

36. Vitamin ______ helps your body absorb calcium and comes from sunlight and fortified dairy products.

a) A
b) B
c) C
d) D

37. Individuals who want to thoughtfully combine mainstream medication with complementary therapies can focus on program called:

a) Integrative medicine
b) Alternative therapies
c) Self-healing

38. This practice stems from ancient Ayurvedic healing and brings "union" to body, mind and spirit:

a) Hydrotherapy
b) Music therapy
c) Yoga
d) Breathing techniques
e) Meditation

39. Unsaturated fats do not raise cholesterol.

a) True
b) False

40. The two principles for special diets in RA is to avoid offending food and:

a) Monthly fasting
b) Removing dairy products and taking supplements
c) Following the "living food diet"
d) Adding healthy food

41. Vitamin Bl2 is important for:

a) Normal immune system function
b) Development of new red blood cells
c) Preventing bone loss
d) Effective absorption of copper

42. This supplement has been widely studied and can reduce the pain and swelling of RA. The most influential studies are led by Joel Kremer at Albany Medical Center:

a) Glucosamine
b) Essential fatty acids
c) Fish oil

43. When a severely damaged joint is reconstructed it is called a(n):

a) Arthroscopic surgery
b) Synovectomy
c) Tendon reconstruction
d) Osteotomy
e) Arthroplasty

44. Scrupulous dental hygiene is essential after a joint replacement to avoid spreading bacteria into the new joint.

a) True
b) False

45. The safest kind of blood tranfusion is:

a) From a family member or friend
b) An autologous transfusion
c) From a blood warmer when a cold agglutinin is present
d) One that has been typed and crossmatched by two laboratories

46. The Americans with Disabilities Act states:

a) Employers must pay FICA taxes
b) You may be eligible for vocational rehabilitation
c) How disability is defmed
d) Employers are required by law to make reasonable accommodations to help employees keep working

47. The Social Security Administration offers disability programs which are:
  1. Government Health Insurance
  2. The " Ticket to Work and Work Incentives Act"
  3. Disability Insurance
  4. Supplemental Security Income

a) 1 and 2
b) 2 and 4
c) 1 and 3
d) 3 and 4

48. Medicare has two parts. Part ______ covers inpatient hospital care and is finaced through FICA taxes. Part _________ covers a percentage of doctors' fees, x-rays, and diagnostic tests.

a) A, B
b) B, A

49. In this phase of clinical research, studies are undertaken to establish dosage and duration of treatment:

a) Phase I
b) Phase II
c) Phase III
d) Phase IV

50. There are three types of juvenile rheumatoid arthritis. This type affects a few joints:

a) Polyarticular onset JRA
b) Pauciarticular JRA
c) Systemic onset JRA