CH 52

To avoid the progression of cutaneous lesions, a patient diagnosed with systemic lupus erythematosus should A. avoid sun exposure B. avoid excessive use of moisturizers C. refrain from washing the affected areas D. apply warm, wet compresses daily

A. avoid sun exposure

Characteristics of gout include (select all) A. disturbed uric acid metabolism B. crystalline deposits in bony connective tissue C. onset before menopause in women D. cardiac involvement E. renal involvement

A. disturbed uric acid metabolism B. crystalline deposits in bony connective tissue D. cardiac involvement E. renal involvement

ankylosing spondylitis is characterized by A. inflammation, stiffness, and fusion of spinal joints B. loss of articular cartilage in weight-bearing joints C. excessive bone remodeling leading to soft bone D. immune mechanisms leasing to widespread joint inflammation

A. inflammation, stiffness, and fusion of spinal joints

Si/Sx of lyme disease include (select all) A. fever and chills B. migratory rash C. arthritic pain D. headache E. myalgia

A. fever and chills C. arthritic pain D. headache E. myalgia

The pathophysiology of rheumatoid arthritis involves A. immune cells accumulating in pannus and destroying articular cartilage B. free radicals attaching to the synocial membrane and tunneling into articular cartilage C. excessive wear and tear and microtrauma that damage articular cartilage D. cysts developing in suchondral cone and creating fissures in articular cartilage

A. immune cells accumulating in pannus and destroying articular cartilage

Polymyositis involves inflammation and necrosis of _____ tissue. A. muscle B. epidermal C. nerve D. fat

A. muscle

polymyositis leads to (select all) A. muscle weakness and stiffness B. difficulty lifting head from a pillow C. severe muscle pain D. difficulty with overhead functional activity E. cardiac involvement

A. muscle weakness and stiffness B. difficulty lifting head from a pillow D. difficulty with overhead functional activity E. cardiac involvement

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue is called A. tophaceous gout B. gouty arthritis C. complicated gout D. asymptomatic hyperuricemia

A. tophaceous gout

The chief pathologic features of osteoarthritis are A. stress fractures of the epiphysis, inflammation of the diaphysis, and accumulation of excessive synovial fluid B. autoimmune damage to the synovium, destruction of cartilage by pannus, thickening of synovial fluid C. degeneration of articular cartilage, destruction of the bone under the cartilage, thickening of the synovium D. thinning of the joint capsule, reabsorption of bone, excessive formation of new bone, and formation of bone spurs

C. degeneration of articular cartilage, destruction of the bone under the cartilage, thickening of the synovium

Prosthetic joint infection is most often due to A. defective replacement material B. injury to joint C. hematogenous transfer D. arthritis

C. hematogenous transfer

Individuals diagnosed with systemic lupus erythmatosus (SLE) are at risk for developing numerous complications of various organs because of A. excessive production of connective tissue B. formation of osteophytes in tissues C. immune injury to basement membranes D. impaired tissue oxygen

C. immune injury to basement membranes

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is A. elevated serum calcium B. elevated monoclonal antibody titer C. positive antinuclear antibodies D. positive microsomal bodies

C. positive antinuclear antibodies

"Tell me again the name of that chemical that makes crystals when my gout flares up", asks a client. The nurse's best response is A. calcium phosphate B. urea C. uric acid D. beta-hydroxybutric acid

C. uric acid

Gouty arthritis is a complication of A. group A streptococcal infection B. autoimmune destruction of joint collagen C. excessive production of urea D. inadequate renal excreation of uric acid

D. inadequate renal excreation of uric acid

Enteropathic arthritis is associated with A. irritable bowel syndrome B. inflammatory bowel disease C. chronic constipation D. chronic diarrhea

B. inflammatory bowel disease

The most common presenting Si/Sx with rheumatic fever is A. cardiac murmur B. polyarthritis C. rash D. painless nodules

B. polyarthritis

"Please explain the pathophysiology of osteoarthritis to me, " says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best responses is A. "Yes; repeated use just wears out the cartilage until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation". B. "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears". C. No; cells in bone, cartilage, and synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone". D. "No; autoimmune cells infiltrated the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage".

C. No; cells in bone, cartilage, and synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone".

Rheumatoid arthritis involves joint inflammation caused by A. bacterial infection B. trauma C. autoimmune injury D. congenital hypermobility

C. autoimmune injury

Manifestations of osteoarthritis include (select all) A. nodules on joints of the hands B. crepitus with joint movement C. pain that is worse upon arising in the morning D. stiffness that worsens with joint use E. narrowing of joint spaces

A. nodules on joints of the hands B. crepitus with joint movement E. narrowing of joint spaces

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be A. systemic manifestations of inflammation B. localized pain in weight-bearing joints C. reduced excreation of uric acid by the kidney D. firm, crystallized nodules or tophi at the affected joints

A. systemic manifestations of inflammation

Tophi are A. renal calculi of uric acid B. deposits of urate crystals in tissues C. painful edematous joints D. spots that coalesce in a malar rash

B. deposits of urate crystals in tissues

In contrast to osteoarthritis, rheumatoid arthritis may be associated with A. debilitating joint pain and stiffness B. improvement in symptoms with asprin therapy C. changes in activities of daily living D. systemic aching in the musculoskeletal system

D. systemic aching in the musculoskeletal system

It is true that scleroderma involves A. inflammation and fibrosis of connective tissue B. autoantibodies against acetylcholine receptors C. infection by beta-hemolytic streptococcus D. inflammation due to antigenic fragments of dead organisms

A. inflammation and fibrosis of connective tissue

Ankylosing spondylitis causes A. intervetebral joint fusion B. instability of synovial joints C. costal cartilage degeneration D. temporomandibular joint degeneration

A. intervetebral joint fusion

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be A. due to bacterial infection B. an autoimmune process C. an infective process D. due to an enzymatic defect

B. an autoimmune process

A patient diagnosed with systemic lupus erythematosus (SLE) is treated with low-dose oral steroids to reduce joint imflammation during intermittent flare-ups. Steroids are used because they A. can be rapidly discontinued when no longer needeed B. specifically suppress autoantibody production C. have minimal side effects D. effectively suppress a variety of immune responses

D. effectively suppress a variety of immune responses

Systemic disorders include A. adhesive capsulitis B. verucae C. osteoarthritis D. rheumatoid arthritis

D. rheumatoid arthritis

The earliest manifestations of scleroderma is A. thick, tight, shiny skin B. skin C. hyper/hypopigmentation D. Raynaud phenomenon

D. Raynaud phenomenon

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus includes A. lesions affecting the palms of hands and soles of feet B. dry, scaly patches in the antecubital area behind the knees C. cracked, scaly areas in the webs of fingers D. a butterfly pattern rash on the face across the bridge of the nose

D. a butterfly pattern rash on the face across the bridge of the nose

systemic lupus erythematosus (SLE) is a rheumatic disease attributed to A. wear and tear on weight-bearing joints B. septic joint inflammation and necrosis C. unknown etiologic factors D. autoimmune mechanisms

D. autoimmune mechanisms

The pain of nonarticular rheumatism (growing pain) is worse A. during activity B. following strenuous exercise C. upon waking D. during the night

D. during the night