4. Rheumatoid arthritis Flashcards Preview

LCRS Y2: Musculoskeletal > 4. Rheumatoid arthritis > Flashcards

Flashcards in 4. Rheumatoid arthritis Deck (14)
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1

Define rheumatoid arthritis

Chronic
Autoimmune
Symmetrical
Synovitis

2

Why does back pain not present in rheumatoid arthritis?

It is a SYNOVIAL joint problem

3

Which joints are most commonly affected in rheumatoid arthritis?

MCP
PIP
MTP

4

Give 2 examples of joint deformity caused by rheumatoid arthritis

Swan-neck (hyperextension at PIP)
Boutonniere (hyperflexion at PIP)

5

What is rheumatoid factor?

MAY be present in blood with RA
= IgM auto-Ab against IgG

6

Recall 3 clinical features of RA

1. Early-morning stiffness
2. Swelling
3. Extra-articular disease

7

Recall the key radiological finding in extensive rheumatoid arthritis

Joint space narrows due to loss of cartilage

8

What does Anti-CCP stand for?

Anti-cyclic citrullinated peptide

9

What is citrullination?

Post-translational modification of arginine to citrulline associated with inflammation

10

What is the most common extra-articular manifestation of rheumatoid arthritis and what causes it?

Subcut nodes
= Necrotic area surrounded by macrophages
Caused by RF complexes

11

What causes malaise in rheumatoid arthritis?

Abnormal clutches of cytokines (particularly TNF)

12

What is a novel effective treatment for the systemic features of rheumatoid arthritis?

Anti-TNF

13

What are the 3 main approaches to rheumatoid arthritis management?

1. Stop smoking
2. DMARD - methotrexate to reduce inflammation
3. Biologics like anti-TNF

14

Recall 2 groups of people for whom anti-TNF is contra-indicated

1. Hep B - could re-activate latent virus
2. TB patients- as TNF key to fighting TB by granuloma formation