9 board-style questions on rheumatoid arthritis in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 56-year-old woman with a 20-year history of rheumatoid arthritis on methotrexate presents with 6 months of progressive dyspnea on exertion and a dry, nonproductive cough. Physical examination reveals bilateral fine inspiratory crackles at the lung bases and digital clubbing. Chest CT shows bilateral peripheral reticular opacities with honeycombing and traction bronchiectasis predominantly in the lower lobes. Pulmonary function tests show FVC 62% predicted, FEV1 70% predicted, FEV1/FVC ratio 0.82, and DLCO 48% predicted. What is the most likely diagnosis?
A 38-year-old woman presents with 3 months of bilateral hand pain and swelling. She reports morning stiffness lasting approximately 90 minutes each day that improves with activity. Physical examination reveals symmetric swelling and tenderness of the metacarpophalangeal and proximal interphalangeal joints bilaterally. The distal interphalangeal joints are spared. Laboratory studies show an ESR of 48 mm/hr, positive rheumatoid factor, and positive anti-cyclic citrullinated peptide (anti-CCP) antibodies. What is the most likely diagnosis?
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