QuestionSBA
QuestionChoice
TRAb is an autoantibody found in Graves' disease, which causes hyperthyroidism. Our patient is not having heat intolerance, weight loss or any other hyperthyroid symptoms. This test would be inappropriate for this patient.

ANA testing, although a positive marker can be indicative of RA, is mainly used in the diagnosis of Systemic Lupus Erythematosus (SLE).
10001803
b
TSH receptor antibody (TRAb), Antinuclear antibody test (ANA)
QuestionChoice
This patient is presenting with symptoms of Rheumatoid Arthritis (RA.

RA classically presents with bilateral joint pain (throbbing or aching), swelling and early morning stiffness.

In RA, the two main autoinflammatory markers that **can** be elevated are Rheumatoid Factor (Rf) and Anti-CCP (cyclic citrullinated peptide) - these are the blood markers you would test for.
10001802
a
Rheumatoid factor (Rf), Anti-cyclic citrullinated peptide
QuestionChoice
Anti-La and Anti-Ro are used to diagnose Sjögren's Syndrome, a disease where the body is unable to produce an adequate amount of bodily fluids.

The patient is presenting with classical symptoms of Rheumatoid Arthritis, for which you would test for Rheumatoid Factor (Rf) and Anti-CCP first line.
10001805
d
Anti-La, Anti-Ro
QuestionChoice
Rheumatoid factor (Rf) would indeed be tested for in a patient presenting with symptoms of Rheumatoid Arthritis. However, it would be most appropriate to start with measuring Anti-cyclic citrullinated peptide before antinuclear antibodies. The latter is more commonly used for the diagnosis of systemic lupus erythematosus (SLE).
10001804
c
Antinuclear antibody test (ANA), Rheumatoid factor (Rf)
QuestionChoice
You would measure Anti-CCP levels when investigating this patient as he is presenting with classical symptoms of Rheumatoid Arthritis.

However, measuring TRAb levels would be inappropriate, as this is raised in Graves' Disease. Only if the patient were presenting with hyperthyroid symptoms would this be measured.
10001806
e
Anti-cyclic citrullinated peptide (Anti-CCP), TSH Receptor Antibody (TRAb)
Concept
Chapter
2693
3975
Rheumatoid Arthritis
Topic
146
Rheumatology
12907
A 67-year-old man presents to General Practice with early morning stiffness and bilateral pain in his hands and wrists.

Which of the following blood markers would be the next best investigations to guide you towards the diagnosis?
a