Rheumatoid Arthritis: The Daily PANCE Blueprint
Which of the following would you expect to be elevated in rheumatoid arthritis?
A. Anticentromere antibodies
B. Anti-neutrophil cytoplasmic antibodies
C. Antihistone antibodies
D. Anti-smith antibodies
E. Anti-citrullinated protein antibodies
Answer and topic summary
The answer is E. Anti-citrullinated protein antibodies
Rheumatoid arthritis is an autoimmune polyarthritis with no known cause. Onset is typically gradual. Symptoms include morning stiffness, swelling of joints, depression, and fatigue. The main signs of early RA include symmetric effusions and swelling around MCP and PIP joints. About 80% of patients with RA will test positive for rheumatoid factor, anti-citrullinated protein antibody, or both. Often patients will have elevations of ESR and CRP too (but this is nonspecific). Other laboratory findings you may see include leukocytosis, anemia of chronic disease, thrombocytosis, etc. Plain radiographs of joints may actually be NORMAL early in the disease. Treatment includes disease-modifying antirheumatic drug (DMARD) therapy (methotrexate) and use of anti-inflammatory therapies (NSAIDs, steroids) to help control symptoms.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
Also covered in the Internal Medicine and Family Medicine PAEA EOR topic lists
