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 44-year-old woman presents for evaluation of a 1-year history of bilateral hand and wrist joint pain, swelling, and stiffness. The morning stiffness lasts for 60-90 minutes before gradually improving. She also has fatigue that started shortly after the onset of her joint pain but denies fevers, unintentional weight loss, rashes, alopecia, and night sweats. She has been taking ibuprofen 600 mg intermittently to alleviate her pain. Medical history is significant for hypertension, and diabetes mellitus, type 2. Temperature is 37°C (98.5°F), pulse is 88/minute, respiratory rate is 14/minute, and blood pressure is 124/70 mmHg. Physical examination is significant for tenderness to palpation with swelling of bilateral proximal interphalangeal (PIP), and metacarpophalangeal (MCP). There is no overlying erythema or warmth on palpation of the joints. Laboratory results are shown below. Which of the following is the most appropriate treatment for this patient?
 
Laboratory value   
Result
Leukocyte count  
8,000/mm3   
Creatinine  
0.90 mg/dL  
Erythrocyte sedimentation rate  
50 mm/hr  
C-reactive protein  
8.0 mg/L  
Rheumatoid factor  
1:100  

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