Rheumatoid arthritis Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 48-year-old woman presents to the office for evaluation of bilateral hand pain and morning stiffness for 6 months. The stiffness lasts for 60 minutes each morning, making it challenging for her to button her shirt and get ready. It gradually improves throughout the morning and is not as noticeable throughout the rest of the day. She also has fatigue which started 5 months ago, but she does not have fever, chills, weight loss, rashes, or hair loss. She has no significant past medical history. Temperature is 37.1°C (98.7°F), pulse is 82/minute, respiratory rate is 18/minute, and blood pressure is 126/74 mmHg. Physical examination of the hands shows tenderness and swelling with a “boggy” feel on palpation of the bilateral proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the hands. There is no warmth on palpation of the joints. Laboratory results are shown below.  Which of the following tests should be ordered next to help make the diagnosis?  

Laboratory value
Result
Reference range
Leukocyte count
9,000/mm3
4,500-11,000/mm3
Erythrocyte sedimentation rate
35 mm/hr
0-20 mm/hr
Rheumatoid factor
1:40  
<1:80

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