Rheumatoid artheritis

Question 1

What antibodies are markers of severe diseae? What are they at risk of?

Answer 1

Anti-CCP (cyclic citrullinated peptide)

Question 2

What can methatrexate cause in the lungs and what do we need to do before we start this?

Answer 2

Pneumonitis, so need to do a CXR

Question 3

What do we give instead of mehtatexate in pregnant women?

Answer 3

Sulfasalazine

altetrnatively hydroxychloroquine

Question 4

What do we give along with stsrting DMARD and why?

Answer 4

Corticosteroids

Takes 2-3 months for the DMARDS to start working, so just given in the inbetween time

Question 5

Rheumatology follow ups: 4/5 weeks -> reassesment. 2 months -> MDT: nurse, pharmacy, OT, psychologist, podiatrist, orthotics

Question 6

What are the complications of RA?

Answer 6

Rheumatoid nodules, vasculitis, interstitial lung disease

chronic synovitis
deformatives and secondary osteoartheritis
pain and poor function

Question 7

Monst common biologic used and how

Answer 7

Adalimumab and etanercept -> s/c pen fortnighly or weekly

Question 8

Which upper limb joints aren’t included on a DAS-28 score?

Answer 8

Distal interpharyngeal joints