FAMILY MEDICINE BOARD FINAL PAPER
REVIEW GUIDE WITH VERIFIED ITEMS AND
SOLUTION WALKTHROUGH
●● Rheumatoid Arthritis Areas in Criteria (4)
Answer: 1. Joint involvement
2. Serological parameters (lab)
3. Acute phase reactants (lab)
4. Duration of arthritis
●● Joint involvement in RA
Which area the large joints?
Point system:
0 points:
1 point:
2 points:
3 points:
5 points
Answer: Large Joints = Shoulders, elbows, hips, knees, and ankles
0 pt= 1 large joint
1 pt= 2-10 large joints
,2 pt= 1-3 small joints
3pt= 4-10 small joints
5p = >10 joints (with involvement of at least 1 small joint)
●● Serological parameters in RA
What is ACPA?
0 points:
2 points:
3 points:
Answer: ACPA = anti-citrullinated protein
0 = Neg RF and neg ACPA
2= Low positive RF OR low positive ACPA
3 = High positive RF or high positive ACPA
●● Acute phase reactant and Duration Criteria in RA
Which are the acute phase reactants?
What is the point system for these?
What is the point system for duration of arthritis
Answer: ESR or CRP
1 point for elevated ESR or CRP
1 point for arthritis lasting longer than 6 weeks
, ●● What radio graphic finding is most sensitive for RA?
What deformities occur in RA over time?
What group of patients had extra-articular manifestations and what is the
most common one?
Answer: Rheumatoid joint erosions
Ulnar deviation of fingers, swan neck deformity, boutonnière deformity,
Valgas deformity of knees.
Seropositive patients. Rheumatoid nodules (20%)
●● Rheumatoid Arthritis Lab testing
Which antibody is found in what % of RA patients?
What is the best test?
What are some false positives?
Answer: RF IgM in 75% of RA patients (but can be negative early on)
ACPA is + earlier; more sensitive and specific
Syphilis, sarcoidosis, infective endocarditis, TB, leprosy, parasitic
infections, advanced age, and asx kin of RA patients
●● RA Treatment (general)
Target goal:
When to start DMARDS?
Which DMARD works best?
REVIEW GUIDE WITH VERIFIED ITEMS AND
SOLUTION WALKTHROUGH
●● Rheumatoid Arthritis Areas in Criteria (4)
Answer: 1. Joint involvement
2. Serological parameters (lab)
3. Acute phase reactants (lab)
4. Duration of arthritis
●● Joint involvement in RA
Which area the large joints?
Point system:
0 points:
1 point:
2 points:
3 points:
5 points
Answer: Large Joints = Shoulders, elbows, hips, knees, and ankles
0 pt= 1 large joint
1 pt= 2-10 large joints
,2 pt= 1-3 small joints
3pt= 4-10 small joints
5p = >10 joints (with involvement of at least 1 small joint)
●● Serological parameters in RA
What is ACPA?
0 points:
2 points:
3 points:
Answer: ACPA = anti-citrullinated protein
0 = Neg RF and neg ACPA
2= Low positive RF OR low positive ACPA
3 = High positive RF or high positive ACPA
●● Acute phase reactant and Duration Criteria in RA
Which are the acute phase reactants?
What is the point system for these?
What is the point system for duration of arthritis
Answer: ESR or CRP
1 point for elevated ESR or CRP
1 point for arthritis lasting longer than 6 weeks
, ●● What radio graphic finding is most sensitive for RA?
What deformities occur in RA over time?
What group of patients had extra-articular manifestations and what is the
most common one?
Answer: Rheumatoid joint erosions
Ulnar deviation of fingers, swan neck deformity, boutonnière deformity,
Valgas deformity of knees.
Seropositive patients. Rheumatoid nodules (20%)
●● Rheumatoid Arthritis Lab testing
Which antibody is found in what % of RA patients?
What is the best test?
What are some false positives?
Answer: RF IgM in 75% of RA patients (but can be negative early on)
ACPA is + earlier; more sensitive and specific
Syphilis, sarcoidosis, infective endocarditis, TB, leprosy, parasitic
infections, advanced age, and asx kin of RA patients
●● RA Treatment (general)
Target goal:
When to start DMARDS?
Which DMARD works best?
