PATHO CH 52

Ankylosing spondylitis causes a. intervertebral joint fusion. b. instability of synovial joints. c. costal cartilage degeneration. d. temporomandibular joint degeneration.

A

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. caused by bacterial infection. b. an autoimmune process. c. an infective process. d. because of an enzymatic defect.

B

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 caused by antigenic fragments of dead organisms.

A

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

. The most common presenting sign/symptom with rheumatic fever is a. cardiac murmur. b. polyarthritis. c. rash. d. painless nodules.

B

"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 response 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 the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone." d. "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."

C

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is a. calcium phosphate. b. urea. c. uric acid. d. beta-hydroxybutyric acid.

C

Prosthetic joint infection is most often because of a. defective replacement material. b. injury to the joint. c. hematogenous transfer. d. arthritis.

C

Rheumatoid arthritis involves joint inflammation caused by a. bacterial infection. b. trauma. c. autoimmune injury. d. congenital hypermobility.

C

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 articular cartilage by pannus, and thickening of synovial fluid. c. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium. d. thinning of the joint capsule, resorption of bone, excessive formation of new bone, and formation of bone spurs.

C

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 excretion of uric acid.

D

In contrast to osteoarthritis, rheumatoid arthritis may be associated with a. debilitating joint pain and stiffness. b. improvement in symptoms with aspirin therapy. c. changes in activities of daily living. d. systemic aching in the musculoskeletal system.

D

Systemic disorders include a. adhesive capsulitis. b. verrucae. c. osteoarthritis. d. rheumatoid arthritis.

D

Enteropathic arthritis is associated with a. irritable bowel syndrome. b. inflammatory bowel disease. c. chronic constipation. d. chronic diarrhea.

B

. The pathophysiology of rheumatoid arthritis involves a. immune cells accumulating in pannus and destroying articular cartilage. b. free radicals attaching to the synovial membrane and tunneling into articular cartilage. c. excessive wear and tear and microtrauma that damage articular cartilage. d. cysts developing in subchondral bone and creating fissures in articular cartilage.

A

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 excretion of uric acid by the kidney. d. firm, crystallized nodules or "tophi" at the affected joints

A

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 leading to widespread joint inflammation.

A

Characteristics of gout include (Select all that apply.) a. disturbed uric acid metabolism. b. crystalline deposits in bony and connective tissue. c. onset before menopause in women. d. cardiac involvement. e. renal involvement.

A, B, D, E

Manifestations of osteoarthritis include (Select all that apply.) 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, B, E

Tophi are a. renal calculi composed of uric acid. b. deposits of urate crystals in tissues. c. painful edematous joints. d. spots that coalesce in a malar rash

B

The earliest manifestation of scleroderma is a. thick, tight, shiny skin. b. skin hyper/hypopigmentation. c. renal impairment. d. Raynaud phenomenon.

D

The pain of nonarticular rheumatism ("growing pain") is worse a. during activity. b. following strenuous exercise. c. upon awakening. d. during the night.

D