Questions for CME: rheumatoid arthritis and statins.1. The immunologic derangement de·range·ment n. 1. Disturbance of the regular order or arrangement of parts in a system. 2. Mental disorder; insanity. de·range characteristic of rheumatoid arthritis is: a. Increase in Th2 cytokines, with IL-4, IL-5, and IL-10 driving inflammation b. Increase in Th1 cytokines, with IL-1, IL-6 and TNF TNF abbr. tumor necrosis factor TNF, n an abbreviation for tumor necrosis f [alpha] driving inflammation c. Increase in CD8+ cell-mediated immunity 2. C-reactive protein a. Is an acute phase reactant Acute phase reactant A substance in the blood that increases as a response to an acute conditions such as infection, injury, tissue destruction, some cancers, burns, surgery, or trauma. Mentioned in: Erythrocyte Sedimentation Rate, Haptoglobin Test and measure of systemic inflammation in RA b. Is associated with cardiovascular risk in the general population c. Decreases after treatment of active RA with TNF inhibitors d. Decreases after treatment with statin e. All of the above 3. Treatment with methotrexate has been found to raise cardiovascular mortality in RA. a. True b. False 4. Statins have been proven effective in the a. Prevention of non-hemorrhagic stroke b. Prevention of cardiovascular events in patients with known cardiovascular disease c. Reduction of serum total cholesterol and LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. levels d. Prevention of cardiovascular events in patients with known cardiovascular disease e. All of the above 5. The reduction in cardiovascular morbidity and mortality Morbidity and Mortality can refer to:
a. True b. False 6. Statins' beneficial effects on endothelial function include: a. Inhibition of endothelial nitric oxide (NO) synthase b. Stimulation of endothelin-1 expression c. Upregulation of decay-accelerating factor, protecting against complement-mediated endothelial injury 7. Factors associated with endothelial dysfunction include all of the following except: a. Hypertension b. Cigarette smoking c. Rheumatoid arthritis d. Aspirin use e. Diabetes mellitus 8. Statins may act to decrease inflammation within atherosclerotic plaques. a. True b. False 9. Small trials have shown that statins may offer which of the following benefits to patients with RA a. Decreased systemic inflammation b. Improved disease activity score c. Decreased swollen joint counts d. Decreased cardiovascular risk e. Improved endothelial function f. All of the above 10. Potential side effects of statin use in patients with rheumatoid arthritis include all of the following except a. Hepatotoxicity hepatotoxicity (hepˑ·  ·tō·t
b. Osteoporosis c. Myalgias d. Rhabdomyolysis rhabdomyolysis /rhab·do·my·ol·y·sis/ (-mi-ol´i-sis) disintegration of striated muscle fibers with excretion of myoglobin in the urine. rhab·do·my·ol·y·sis n. Answers to CME CME See: Chicago Mercantile Exchange CME See Chicago Mercantile Exchange (CME). Questions 1. B, 2. E, 3. B, 4. E, 5. B, 6. C, 7. D, 8. A, 9. F, 10. B |
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