algorithms and biomarkers Flashcards
(32 cards)
what to do with an abnormal LFT/ ALT of >100 on a DMARD
stop therapy for 2 weeks and re-check
what if the ALT is still over 100 after 2 weeks
contact rheumatology service
what if the ALT is less than 100 after 2 weeks
recommence DMARD at lower dose
what to do with an abnormal LFT ALT of 50-100
continue treatment and recheck to see if ALT is stable- then call rheum service if not
what are abnormal FBC on a dmard requiring stop for 2 weeks
platelets <150
WCC <4
neutrophils<2
what values on an FBC means DMARDS should be stopped completely and rheum contacted
platelets <100
wcc: <2
neutrophils <1
how much should methotrexate be reduced
5mg week
sulfasalzine reduced
500mg/day
azathioprine reduced
50mg/day
leflunomide reduced
10mg/day
mycophenylate reduce
500mg/day
rheumatoid arthritis typical biomarkers
rheumatoid factor + ESR ^ CRP^ ANA + ACPA+
most specific biomarker for rheumatoid
ACPA
typical biomarkers for sjorgren
RF + ESR^ ANA+ anti ENA: - ANTI RO/LA +
typical biomarkers for SLE
ESR^ normal CRP \+ANA ANAEMIA Ds-DNA + low c3/c4 neutopaenia lymphopaenia anti-ENA -anti-sm
systemic sclerosis typical biomarkers
ESR ^
ANA +
IgG
antibody to topisomerase
typical biomarkers for gout
esr^
crp^
neutrophilia
urate crystals
typical biomarkers for pseudo-gout
esr^
crp^
CPPD crystals
neutrophilia
typical biomarkers for septic arthritis
esr^
crp^
leucocytes
neutrophilia
typical biomarkers for ank spondylitis
RF, ANA,ACPA -
esr^
crp^
HLA-B27 +
reactive arthritis typical biomarkers
rf, ana, acpa -
esr^
crp^
leucocytes
psoriatic arthritis biomarkers
rf, ana, acpa -
esr ^
crp^
giant cell arteritis biomarkers
esr or crp^
anaemia
what does anti-ccp stand for or acpa
anti cyclic citrullinated pepetide
