A 43-year-old woman has symmetric swelling and morning stiffness of MCP and PIP joints for 4 months. Anti-CCP antibodies are positive and x-rays show

Question

A 43-year-old woman has symmetric swelling and morning stiffness of MCP and PIP joints for 4 months. Anti-CCP antibodies are positive and x-rays show early erosions. She has no pregnancy, liver disease, or renal impairment. Which of the following is the most appropriate next step in management?

Accepted Answer

Start methotrexate with folic acid

Answer

Delay DMARD therapy until deformity

Answer

Use chronic high-dose prednisone as sole therapy

Answer

Begin antibiotics for septic arthritis

Answer

Treat with acetaminophen alone

Rheumatoid arthritis — USMLE Step 3 MCQ

A 43-year-old woman has symmetric swelling and morning stiffness of MCP and PIP joints for 4 months. Anti-CCP antibodies are positive and x-rays show early erosions. She has no pregnancy, liver disease, or renal impairment. Which of the following is the most appropriate next step in management?