Rheumatoid Arthritis Flashcards

1
Q

What type of condition is rheumatoid arthritis?

A

Chronic, autoimmune condition

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2
Q

What is characteristic of rheumatoid arthritis?

A

Symmetrical polyarthritis and systemic symptoms

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3
Q

What is meant by rheumatoid arthritis being polyarthritis?

A

At least four joints are involved

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4
Q

Which joints tend to be affected by rheumatoid arthritis?

A

Small joints, commonly MCJ, PIPJ

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5
Q

How long do symptoms need to be present for a diagnosis of rheumatoid arthritis to be made?

A

Six weeks

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6
Q

Who is more likely to get rheumatoid arthritis?

A

Females > males
Peak incidence is in 4th and 5th decade but can occur from age of 16

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7
Q

What are the causes of rheumatoid arthritis?

A

Genetic- 50%
Environmental
Hormonal

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8
Q

Which gene is associated with rheumatoid arthritis?

A

HLA-DRB1

B is beta idk how to get that sign…writing these on my tablet, you feel the pain

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9
Q

What are some of the environmental factors which can cause rheumatoid arthritis?

A

Smoking
Chronic infection e.g. EBV, periodontal disease

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10
Q

Which hormonal changes can cause rheumatoid arthritis?

A

Early menopause
Low testosterone levels in men

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11
Q

Symptoms of rheumatoid arthritis?

A

Pain
Morning stiffness >30mins
Immobility
Poor function
Systemic symptoms

->apparently some patients with rheumatoid arthritis have to get up several hours before work so the stiffness wears off so they can get ready

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12
Q

Signs of rheumatoid arthritis?

A

Tenderness
Redness
Warmth
Swelling
Limited movement

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13
Q

There are a few joints that rheumatoid arthritis cannot affect. If a patient presents with issues and pain with these joints, rheumatoid arthritis can be ruled out.
What are some of these joints?

A

Spinous joints e.g. lumbar joints- if affected by arthritis, it tends to be inflammatory rather than rheumatoid
Sacroiliac joints

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14
Q

Sometimes hand with established rheumatoid arthritis can develop ulnar deviation, what does this mean?

A

Fingers and joints start pointing medially, towards ulna

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15
Q

What are some of the non-specific systemic features of rheumatoid arthritis?

A

Fatigue
Weight loss
Anaemia

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16
Q

What are some of the specific organs affected systemically due to rheumatoid arthritis?

A

Eyes
Lungs
Nerves
Skin
Kidneys

17
Q

What are the baseline investigations used for diagnosis of rheumatoid arthritis?

A

Bloods
Immunology

17
Q

In the long term, what systemic issues can be as a result of rheumatoid arthritis?

A

CVS problems
Malignancy

18
Q

Which bloods are done in suspicion of rheumatoid artheritis?

A

FBC
LFTs
Kidney function tests
CRP
ESR

19
Q

What is looked at in immunology if rheumatoid arthritis is suspected?

A

Anti-Cyclic Citrullinated Antibodies (anti-CCP)
Rheumatoid factor but that is present in differing levels for other conditions so not specific

20
Q

Which score can be used in the assessment of rheumatoid artheritis?

A

Disease Activity Score (DAS)

21
Q

In rheumatoid arthritis, what does a DAS score of <2.6 mean?

A

Clinical remission

22
Q

In rheumatoid arthritis, what does a DAS score of >5.1 mean?

A

Patient eligible for biologic therapy

23
Q

What are some of the other investigations used in rheumatoid artheritis?

A

Xrays
Ultrasounds - show synovial hypertrophy

24
Q

Key part of treatment is early aggressive treatment to allow for optimal outcomes.
What are the different area of management for rheumatoid arthritis?

A

Pharmacological treatment
Multidisciplinary care
Management of flares
Surgery

25
Q

If a patient presents for the first time with rheumatoid arthritis or has a flare up, what can be given?

A

NSAIDs e.g. ibuprofen or naproxen
Glucocorticoids (steroids) e.h. prednisone

26
Q

What forms part of disease modifying management for rheumatoid arthritis?

A

Biologic DMARDs e.g. TNF-a
Conventional synthetic DMARDs e.g. methotrexate
Targeted synthetic DMARDs

27
Q

Who forms a part of the MDT for rheumatoid arthritis?

A

Rheumatologist
Specialist nurse
Physiotherapist
Occupational therapist
Podiatrist
Pharmacist
Psychologist

28
Q
A