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MARYVILLE NURS 623 EXAM 1
STUDYGUIDE BRAND NEW OFFICIAL
QUESTIONS WITH ANSWERS.
R.A : Signs & Symptoms - correct answer -Peripheral symmetric
polyarthritis and morning stiffness that improves throughout the
day
Joints affected: knees, proximal interphalangeal (PIP) and
metacarpophalangeal (MCP) joints in the hands and feet
Affected joints are painful to pressure (tender), swollen, and
partially immobile
Eventually, joints appear increasingly deformed and rigid
RA diagnosis - correct answer -Rheumatoid factor (RF): IgM that
reacts in an autoimmune fashion against IgG
Anti-cyclic citrulinated peptide (CCP) antibodies
Erythrocyte sedimentation rate (ESR) and/or C-reactive protein
ANA (differentiate RA from SLE)
CBC to rule out anemia
Platelet count
Joint-fluid analysis - if diagnosis uncertain
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Management of R.A - correct answer -Progresses from
conservative interventions to aggressive symptom management
Goals of management: to reduce pain and inflammation and to
preserve joint function
Early management: physical and occupational therapies, heat and
cold applications, exercise, rest, assistive devices, splints,
meditation, chiropractic adjustments, and weight loss
Analgesics
NSAIDs
Steroids
DMARDs
Older therapies (e.g., methotrexate)
Co manage with Rheumatologist after failure with NSAIDS
Chronic Fatigue Syndrome and Fibromyalgia Syndrome - correct
answer -Difficult to diagnose due to similar criteria
Patients often with co-morbid psych problems
FMS-most common generalized musculoskeletal pain (Females
20-55 yrs)
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NSAIDs and steroids often do not alleviate symptoms
Presentation of Chronic Fatigue Syndrome and Fibromyalgia
Syndrome - correct answer -Often vague symptoms
Malaise
Fatigue
Multiple joint pain
Difficulty concentrating
Difficulty sleeping
Pale skin
Diagnosis FMS & CFS - correct answer -FMS:
Widespread muscular pain
History and pain criteria
+ 11/18 trigger points
Symptoms >3months
CFS
Severity of fatigue and 4 or more:
Impaired memory
New headaches
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Sore throat
Tender cervical or axillary lymph nodes
Muscle pain
Restless sleep
Post exertion malaise
> 6months
CFS & FMS Management - correct answer -Cognitive behavioral
therapy
Exercise
Low dose tricyclic anti depressant (TCAs)? 3months?
SSRI's ?
Patient education
Polymyalgia Rheumatica - correct answer -Middle age and older
adults
Women > Men
Bilateral shoulder pain (can include proximal arms, hips and
thighs)
Worse in AM (duration up to 1 hour)
ESR >40mm/h, elevated CRP, normocytic anemia
MARYVILLE NURS 623 EXAM 1
STUDYGUIDE BRAND NEW OFFICIAL
QUESTIONS WITH ANSWERS.
R.A : Signs & Symptoms - correct answer -Peripheral symmetric
polyarthritis and morning stiffness that improves throughout the
day
Joints affected: knees, proximal interphalangeal (PIP) and
metacarpophalangeal (MCP) joints in the hands and feet
Affected joints are painful to pressure (tender), swollen, and
partially immobile
Eventually, joints appear increasingly deformed and rigid
RA diagnosis - correct answer -Rheumatoid factor (RF): IgM that
reacts in an autoimmune fashion against IgG
Anti-cyclic citrulinated peptide (CCP) antibodies
Erythrocyte sedimentation rate (ESR) and/or C-reactive protein
ANA (differentiate RA from SLE)
CBC to rule out anemia
Platelet count
Joint-fluid analysis - if diagnosis uncertain
, Page | 2
Management of R.A - correct answer -Progresses from
conservative interventions to aggressive symptom management
Goals of management: to reduce pain and inflammation and to
preserve joint function
Early management: physical and occupational therapies, heat and
cold applications, exercise, rest, assistive devices, splints,
meditation, chiropractic adjustments, and weight loss
Analgesics
NSAIDs
Steroids
DMARDs
Older therapies (e.g., methotrexate)
Co manage with Rheumatologist after failure with NSAIDS
Chronic Fatigue Syndrome and Fibromyalgia Syndrome - correct
answer -Difficult to diagnose due to similar criteria
Patients often with co-morbid psych problems
FMS-most common generalized musculoskeletal pain (Females
20-55 yrs)
, Page | 3
NSAIDs and steroids often do not alleviate symptoms
Presentation of Chronic Fatigue Syndrome and Fibromyalgia
Syndrome - correct answer -Often vague symptoms
Malaise
Fatigue
Multiple joint pain
Difficulty concentrating
Difficulty sleeping
Pale skin
Diagnosis FMS & CFS - correct answer -FMS:
Widespread muscular pain
History and pain criteria
+ 11/18 trigger points
Symptoms >3months
CFS
Severity of fatigue and 4 or more:
Impaired memory
New headaches
, Page | 4
Sore throat
Tender cervical or axillary lymph nodes
Muscle pain
Restless sleep
Post exertion malaise
> 6months
CFS & FMS Management - correct answer -Cognitive behavioral
therapy
Exercise
Low dose tricyclic anti depressant (TCAs)? 3months?
SSRI's ?
Patient education
Polymyalgia Rheumatica - correct answer -Middle age and older
adults
Women > Men
Bilateral shoulder pain (can include proximal arms, hips and
thighs)
Worse in AM (duration up to 1 hour)
ESR >40mm/h, elevated CRP, normocytic anemia
