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q8 - honey91
#1
A patient presents to her physician and mentions that after many years without teeth problems, she has recently developed 7 caries. She reveals that for many years she has had pain and swelling in her hands and knees. More specifically, she finds that her MCP joints and wrists are warm and tender, and are most painful in the morning. Which of the following would most likely reveal the definitive diagnosis for this patient?

A. Antithyroglobulin antibody assay

B. ds-DNA antibody assay

C. Extensive examination of oral cavity

D. p-ANCA assay

E. SS-A and SS-B antibody assay
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#2
EE.
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#3
E.
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#4
EE
Sjogren's resulting in dry mouth due to decreased salivation and hence multiple caries !
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#5
Answer: E

Rheumatoid arthritis can coexist with a variety of autoimmune diseases. It's most frequently associated with Sjogren syndrome. Sjogren syndrome, diagnosed with positive SS-A/B titer, is due to autoimmune involvement with subsequent scarring of salivary glands and lacrimal glands, leading to dry mouth and eyes.

The caries are due to the inability to produce saliva. dental caries, parotid gland enlargement, and recurrent tracheobronchitis are all secondary effects of sjogren syndrome.

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