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Rheumatoid arthritis — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Rheumatoid arthritisUSMLE Step 3

A 43-year-old woman has 3 months of symmetric pain and swelling in the MCP and PIP joints with morning stiffness lasting 2 hours. Anti-CCP is positive and x-rays show no erosions. Which of the following is the most appropriate next step in management?

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Correct answer: C — Start disease-modifying antirheumatic therapy

Early rheumatoid arthritis should be treated with DMARD therapy to prevent irreversible joint damage.

Reference: American College of Rheumatology rheumatoid arthritis guideline