Rheumatoid Arthritis
Also written as RA.
Caplan syndrome is rheumatoid arthritis with pulmonary nodules in coal (or silica or asbestos) workers.
Treatment at a glance
- Methotrexate once weekly with folic acid
- Short-term steroids to bridge
What our notes say
- Caplan syndrome is rheumatoid arthritis with pulmonary nodules in coal (or silica or asbestos) workers. (Internal Medicine Respiratory CAT 1: 30 MCQs and 5 short answer questions)
- | Inflammatory and autoimmune | Rheumatoid arthritis, inflammatory bowel disease, Sjögren's | (Bronchiectasis)
- | Connective tissue disease–related | Rheumatoid arthritis, systemic sclerosis, SLE, myositis, Sjögren's | (Interstitial Lung Diseases)
- CTD-ILD: commonly systemic sclerosis (NSIP), rheumatoid arthritis (UIP); treat with immunosuppression. (Interstitial Lung Diseases)
- | Coal worker's pneumoconiosis | Coal dust | Coal miners | Small upper-zone nodules, progressive massive fibrosis, Caplan syndrome (rheumatoid arthritis + nodules) | (Occupational Lung Disease)
- Topics tested: rheumatoid arthritis, systemic lupus erythematosus, CREST and systemic sclerosis, myositis, vasculitis, gout and pseudogout, osteoporosis and fibromyalgia. (Internal Medicine Rheumatology CAT: 30 MCQs and 5 short answer questions)
Study material on Rheumatoid Arthritis
- Internal Medicine Rheumatology CAT: 30 MCQs and 5 short answer questions
- Immunopathology complete mcqs
- Paediatrics Senior Clerkship end of 2nd semester exam: 4 October 2021, 50 MCQs
- Immunopathology
- Master Bone & Soft Tissue Pathology: CAT 2 MCQs & Answers
- Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 January 2024
- Internal Medicine Respiratory CAT 1: 30 MCQs and 5 short answer questions
- Examination of Respiratory system
- pathology essays
- systemic pathology essays
Practice questions on Rheumatoid Arthritis
A 60-year-old with rheumatoid arthritis shows synovial biopsy with organized lymphoid follicles containing germinal centers. What does this finding suggest?
- Acute bacterial infection requiring antibiotics
- Persistent immune activation with local lymphocyte proliferation
- Transition from acute to chronic inflammation
- Imminent malignant transformation to lymphoma
- Resolution phase with tissue remodeling
Answer: B. Tertiary lymphoid organs (organized lymphoid follicles resembling lymph nodes) form in chronically inflamed tissues when there's persistent immune activation against self-antigens (autoimmunity) or environmental antigens. They're seen in RA synovium, Hashimoto thyroiditis, and other chronic immune-mediated diseases. These structures contain B cells, T cells, follicular dendritic cells, and show ongoing immune respons
Rheumatoid arthritis (RA)
- Is a disease of the elderly
- Mainly affects males
- Is autoimmune in origin
- Suppurative inflammation is a key feature
- Susceptibility genes have no role in development of RA ✅ Answer: C
Answer: A. Rheumatoid arthritis is a chronic autoimmune disease characterized by systemic inflammation.
A patient with rheumatoid arthritis develops progressive bilateral interstitial lung disease. Biopsy shows diffuse uniform interstitial fibrosis without temporal heterogeneity and no honeycombing. The pattern is
- UIP pattern identical to IPF
- NSIP (nonspecific interstitial pneumonia) pattern
- Cryptogenic organizing pneumonia pattern
- Desquamative interstitial pneumonia pattern
Answer: B. NSIP is the most common pattern in collagen vascular disease lung involvement. It lacks the temporal heterogeneity of UIP and typically has no honeycombing or fibroblastic foci. Prognosis is better than IPF. ---