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A 52-Year-Old Woman with Known Rheumatoid Factor-Positive Rheumatoid Arthritis Comes

question 174

Multiple Choice

A 52-year-old woman with known rheumatoid factor-positive rheumatoid arthritis comes to the physician for routine follow-up. She currently takes 7.5 mg methotrexate weekly with good response. She has minimal morning stiffness and good exercise tolerance. The patient's last flare 2 years ago was treated with a short course of prednisone. Her other medications include folic acid daily and naproxen occasionally for joint pain. She has a 30-pack-year smoking history. There is no family history of cancer or heart disease.
Her blood pressure is 133/82 mm Hg and pulse is 75/min. Her BMI is 18 kg/m². There are mild deformities affecting small joints of both hands with no active synovitis. Lungs are clear to auscultation. Abdominal examination shows no organomegaly. There are no skin rashes.
Laboratory results are as follows:
$A 52-year-old woman with known rheumatoid factor-positive rheumatoid arthritis comes to the physician for routine follow-up. She currently takes 7.5 mg methotrexate weekly with good response. She has minimal morning stiffness and good exercise tolerance. The patient's last flare 2 years ago was treated with a short course of prednisone. Her other medications include folic acid daily and naproxen occasionally for joint pain. She has a 30-pack-year smoking history. There is no family history of cancer or heart disease. Her blood pressure is 133/82 mm Hg and pulse is 75/min. Her BMI is 18 kg/m<sup>2</sup>. There are mild deformities affecting small joints of both hands with no active synovitis. Lungs are clear to auscultation. Abdominal examination shows no organomegaly. There are no skin rashes. Laboratory results are as follows: Liver function tests are within normal limits. Which of the following is the best next step in management of this patient? A) Bone mineral density testing B) Left ventricular ejection fraction C) N-telopeptide D) Tuberculin skin testing E) Urine microalbumin excretion$
Liver function tests are within normal limits.
Which of the following is the best next step in management of this patient?

Examine the role of cultural differences in attributions, attitudes, and biases.

Differentiate between internal (personal) and external (situational) attributions and their application to self and others.

Understand the concepts of blaming the victim and diffusion of responsibility.

Recognize the impact of reporting styles across cultures on the perception of events.

Definitions:

Staffing Agency

A company that matches employers with employees to fill job positions, often on a temporary or contract basis.

Financialization

The increasing dominance of financial markets, financial motives, financial institutions, and financial elites in the economy, affecting decision-making and resource allocation.

Financial Transactions

Deals or exchanges of monetary value between parties, including buying, selling, and trading goods, services, or financial instruments.

Union Suppression

Efforts by employers or governments to hinder or prevent the formation and activities of labor unions.