[MCQ] Rheumatoid Arthritis- Part 2

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Rheumatoid Arthritis- Part 2

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Question 1

Interleukin-4 inhibits the production of ?

A	Interleukin-1
B	Interleukin-6
C	Interleukin-8
D	All of the above

Question 1 Explanation:

Interleukin-4 inhibits activation of type 1 helper T cells leading to decreased production of interleukin- 1 & TNF-. Interleukin-4 inhibits production of interleukin-6 & interleukin-8.

Question 2

Which of the following is a chemokine ?

A	Interleukin-1
B	Interleukin-6
C	Interleukin-8
D	Interleukin-10

Question 2 Explanation:

Some cytokines, called chemokines, attract inflammatory cells to travel to the synovial joint. These include interleukin 8 (IL-8) and RANTES.

Question 3

CTLA-4 stands for ?

A	Cytotoxic T-lymphocyte-associated antigen-4
B	Cytotoxic T-lymphocyte-associated antibody-4
C	Cytopathic T-lymphocyte-associated antigen-4
D	Cytopathic T-lymphocyte-associated antibody-4

Question 3 Explanation:

CTLA-4 stands for Cytotoxic T-lymphocyte-associated antigen-4. It is a co-stimulatory molecule involved in the interaction between T lymphocyte and antigen-presenting cell.

Question 4

TNF blockade causes deterioration of which of the following inflammatory disease ?

A	Rheumatoid arthritis
B	Multiple sclerosis
C	Ankylosing spondylitis
D	Psoriasis

Question 4 Explanation:

TNF blockade causes deterioration of Multiple sclerosis. It is helpful in rheumatoid arthritis, ankylosing spondylitis, psoriasis, Psoriatic arthritis, and Crohn’s disease.

Question 5

Which of the following about RA is false ?

A	Morning stiffness of >1 hour is an invariable feature
B	Symmetric joint involvement is more typical
C	Pain originates predominantly from joint capsule
D	None of the above

Question 6

In RA, joint swelling results from ?

A	Accumulation of synovial fluid
B	Hypertrophy of synovium
C	Thickening of the joint capsule
D	None of the above

Question 7

In RA, which of the following joints is rarely involved ?

A	Proximal interphalangeal joints
B	Distal interphalangeal joints
C	Metacarpophalangeal joints
D	Wrist joints

Question 7 Explanation:

In RA, distal interphalangeal joints are rarely involved

Question 8

Baker’s cyst is related to which of the following joint ?

A	Elbow joint
B	Knee joint
C	Ankle joint
D	Wrist joint

Question 8 Explanation:

Baker’s cyst is extension of inflamed synovium into popliteal space causing pain & swelling behind knee

Question 9

Part of the axial skeleton that is not spared in RA is ?

A	Cervical spine
B	Thoracic spine
C	Lumbar spine
D	Sacral spine

Question 9 Explanation:

Axial involvement is usually limited to the upper cervical spine.

Question 10

In RA, which of the following is the characteristic deformity of hand ?

A	“Z” deformity
B	Swan-neck deformity
C	Boutonnière deformity
D	All of the above

Question 10 Explanation:

Characteristic changes of hand in RA include radial deviation at wrist with ulnar deviation of digits with palmar subluxation of proximal phalanges (“Z” deformity), hyperextension of proximal interphalangeal joints with compensatory flexion of distal interphalangeal joints (swan-neck deformity), flexion contracture of proximal interphalangeal joints & extension of distal interphalangeal joints (Boutonnière deformity), and hyperextension of first interphalangeal joint & flexion of first metacarpophalangeal joint.

Question 11

Which of the following about extra-articular manifestations of RA is false ?

A	High titers of rheumatoid factor
B	High titers of antibodies to CCP
C	Increased mortality
D	None of the above

Question 11 Explanation:

Patients of RA with extra-articular manifestations have high titers of autoantibodies to Fc component of IgG (rheumatoid factor) or with antibodies to CCP. RA patients with severe extraarticular manifestations have an increased mortality.

Question 12

Common location of rheumatoid nodule is ?

A	Olecranon bursa
B	Achilles tendon
C	Occiput
D	All of the above

Question 12 Explanation:

Common locations of rheumatoid nodule include olecranon bursa, proximal ulna, Achilles tendon, & occiput.

Question 13

Histologically, central zone of rheumatoid nodules consists of ?

A	Palisading macrophages
B	Necrotic material
C	Granulation tissue
D	Calcified tissue

Question 13 Explanation:

Histologically, rheumatoid nodules (focal vasculitis) consist of a central zone of necrotic material, a midzone of palisading macrophages and an outer zone of granulation tissue.

Question 14

Treatment with which of the following can increase the number of rheumatoid nodules dramatically ?

A	Aspirin
B	Chloroquine
C	Methotrexate
D	Penicillamine

Question 14 Explanation:

In some patients, treatment with methotrexate can increase the number of nodules dramatically.

Question 15

RA tends to spare which of the following systems ?

A	Central nervous system
B	Peripheral nervous system
C	Cardiovascular system
D	Renal

Question 15 Explanation:

RA tends to spare central nervous system directly. Renal vasculitis is rare.

Question 16

Scleromalacia perforans is related to involvement of which of the following organ in RA ?

A	Bone
B	Cartilage
C	Tendon
D	Eye

Question 16 Explanation:

Thinning & perforation of globe due to scleritis which involves deeper layers of eye is termed as scleromalacia perforans

Question 17

Felty’s syndrome consists of all except ?

A	Chronic rheumatoid arthritis
B	Splenomegaly
C	Neutropenia
D	Lymphadenopathy

Question 17 Explanation:

Felty’s syndrome consists of chronic RA, splenomegaly, neutropenia, anemia & thrombocytopenia

Question 18

RA is associated with an increased incidence of ?

A	Cataract
B	Lymphoma
C	Mesothelioma
D	All of the above

Question 18 Explanation:

RA is associated with an increased incidence of lymphoma, especially large B cell lymphoma.

Question 19

Rheumatoid factor may be present in all except ?

A	Systemic lupus erythematosus
B	Sjogren’s syndrome
C	Wegeners granulomatosis
D	Sarcoidosis

Question 20

Rheumatoid factor may be present in all except ?

A	Interstitial pulmonary fibrosis
B	Infectious mononucleosis
C	Hepatitis C
D	Hepatitis B

Question 21

Rheumatoid factor may be present in all except ?

A	Tuberculosis
B	Leprosy
C	Syphilis
D	HIV/AIDS

Question 22

Rheumatoid factor may be present in all except ?

A	Subacute bacterial endocarditis
B	Visceral leishmaniasis
C	Trypnosomiasis
D	Malaria

Question 22 Explanation:

Besides RA rheumatoid factor may be found in SLE, Sjögren’s syndrome, chronic liver disease, sarcoidosis, interstitial pulmonary fibrosis, infectious mononucleosis, hepatitis B, tuberculosis, leprosy, syphilis, SABE, visceral leishmaniasis, schistosomiasis and malaria

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See all quizzes of Rheumatoid Arthritis- Part 2 here:

1 Interleukin-4 inhibits the production of ?
A. Interleukin-1
B. Interleukin-6
C. Interleukin-8
D. All of the above

2 Which of the following is a chemokine ?
A. Interleukin-1
B. Interleukin-6
C. Interleukin-8
D. Interleukin-10

3 CTLA-4 stands for ?
A. Cytotoxic T-lymphocyte-associated antigen-4
B. Cytotoxic T-lymphocyte-associated antibody-4
C. Cytopathic T-lymphocyte-associated antigen-4
D. Cytopathic T-lymphocyte-associated antibody-4

4 TNF blockade causes deterioration of which of the following
inflammatory disease ?
British Medical Bulletin 2005;73 & 74:71-82
A. Rheumatoid arthritis
B. Multiple sclerosis
C. Ankylosing spondylitis
D. Psoriasis

5 Which of the following about RA is false ?
A. Morning stiffness of >1 hour is an invariable feature
B. Symmetric joint involvement is more typical
C. Pain originates predominantly from joint capsule
D. None of the above
6 In RA, joint swelling results from ?
A. Accumulation of synovial fluid
B. Hypertrophy of synovium
C. Thickening of the joint capsule
D. None of the above
7 In RA, which of the following joints is rarely involved ?
A. Proximal interphalangeal joints
B. Distal interphalangeal joints
C. Metacarpophalangeal joints
D. Wrist joints

8 Baker’s cyst is related to which of the following joint ?
A. Elbow joint
B. Knee joint
C. Ankle joint
D. Wrist joint

9 Part of the axial skeleton that is not spared in RA is ?
A. Cervical spine
B. Thoracic spine
C. Lumbar spine
D. Sacral spine

10 In RA, which of the following is the characteristic deformity of
hand ?
A. “Z” deformity
B. Swan-neck deformity
C. Boutonnière deformity
D. All of the above

11 Which of the following about extra-articular manifestations of RA
is false ?
A. High titers of rheumatoid factor
B. High titers of antibodies to CCP
C. Increased mortality
D. None of the above

12 Common location of rheumatoid nodule is ?
A. Olecranon bursa
B. Achilles tendon
C. Occiput
D. All of the above

13 Histologically, central zone of rheumatoid nodules consists of ?
A. Palisading macrophages
B. Necrotic material
C. Granulation tissue
D. Calcified tissue
.
14 Treatment with which of the following can increase the number of
rheumatoid nodules dramatically ?
A. Aspirin
B. Chloroquine
C. Methotrexate
D. Penicillamine

15RA tends to spare which of the following systems ?
A. Central nervous system
B. Peripheral nervous system
C. Cardiovascular system
D. Renal

16Scleromalacia perforans is related to involvement of which of the
following organ in RA ?
A. Bone
B. Cartilage
C. Tendon
D. Eye

17 Felty’s syndrome consists of all except ?
A. Chronic rheumatoid arthritis
B. Splenomegaly
C. Neutropenia
D. Lymphadenopathy

18 RA is associated with an increased incidence of ?
A. Cataract
B. Lymphoma
C. Mesothelioma
D. All of the above

19 Rheumatoid factor may be present in all except ?
A. Systemic lupus erythematosus
B. Sjogren’s syndrome
C. Wegeners granulomatosis
D. Sarcoidosis
20 Rheumatoid factor may be present in all except ?
Harrison’s 17th Ed. 208A. Interstitial pulmonary fibrosis
B. Infectious mononucleosis
C. Hepatitis C
D. Hepatitis B
21 Rheumatoid factor may be present in all except ?
A. Tuberculosis
B. Leprosy
C. Syphilis
D. HIV/AIDS
22 Rheumatoid factor may be present in all except ?
A. Subacute bacterial endocarditis
B. Visceral leishmaniasis
C. Trypnosomiasis
D. Malaria

Rheumatoid Arthritis

[MCQ] Rheumatoid Arthritis- Part 2

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Rheumatoid Arthritis- Part 2

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