Choose the single best answer to the following questions.

1. The general estimate is that more than __ percent of children with JIA will continue to have active arthritis into adulthood.
a) 20
b) 40
c) 50
d) 35

2. In regard to the rheumatoid factor negative group with polyarticular JIA, the presentation is often …
a) asymmetrical and usually involves the knee and the ankle
b) symmetrical and usually involves the small joints of the feet
c) symmetrical and often involves both large joints (such as knees, elbows or wrists) as well as small joints in the hands and feet
d) None of the above

3. Which of the following are characteristic manifestations of systemic JIA?
a) Ulcerative vasculitic rash
b) intermittent, spiking fever in excess of 102^ºF
c) generalized lymphadenopathy and hepatosplenomegaly
d) chronic uveitis
e) b and c
f) a, b and c

4. Which of the following is a true state- ment in regard to JIA-associated uveitis?
a) It is asymptomatic in over 80 percent of cases.
b) It results in permanent eye damage in at least 15 percent of the involved eyes.
c) Eye involvement can develop years after the onset of arthritis or when arthritis is inactive
d) It often requires systemic treatment e) a and c
f) a,b,c and d

5. The ACR pediatric 50 (ACR Pedi 50) level of response requires …
a) 50 percent improvement in at least four of the six core set parameters and no more than one of the parameters can get worse by 50 percent
b) 50 percent improvement in at least two of the six core set parameters and no more than two of the parameters can get worse by 30 percent
c) 50 percent improvement in at least three of the six core set parameters and no more than one of the parameters can get worse by 30 percent
d) 50 percent improvement in at least three of the six core set parameters and no more than one of the parameters can get worse by 50 percent

6. When it comes to the use of naproxen in children with JIA, the side effect of pseudoporphyria is …
a) more common in children with fair skin and blond hair
b) more common in African-American children
c) often totally asymptomatic
d) a and c
e) b and c
f) None of the above

7. In regard to more extensive forms of JIA such as polyarticular JIA …
a) NSAID therapy, with or without intraarticular steroid injections, is the mainstay of therapy
b) the move to treatments in addition to NSAIDs can occur very early
c) one can often adequately treat this with NSAIDs alone
d) None of the above

8. In regard to JIA, which of the following NSAIDs have b.i.d. dosing?
a) celecoxib
b) meloxicam
c) naproxen
d) a and c
e) All of the above

9. Which of the following medications has been the subject of the most studies for JIA?
a) etanercept
b) celecoxib
c) methotrexate
d) abatacept

10. The pharmacokinetics and clearance of _____ in children is similar enough to adults to suggest that once-weekly dosing in children would also be effective.
a) celecoxib
b) etanercept
c) infliximab
d) naproxen

11. Which of the following is true about the mechanism and dosing of adalimumab for possible use in children with JIA?
a) It is a completely humanized, anti-TNF agent that is given subcutaneously every two weeks.
b) It is a chimeric monoclonal antibody that patients receive via infusion every month.
c) It is an agent with bid dosing that works through a complex, co-stimulatory process that selectively decreases T-cell activation.
d) None of the above

12. Pascual and others have demonstrated that systemic JIA, especially with systemic features, is predominantly driven by ______.
a) t-cells
b) b-cells
c) IL-1 and/or IL-6
d) None of the above