Flashcards in Clinical (Weeks 1+2) Deck (183)
What genes are associated with a susceptibility to RA?
What cells invade the synovium in RA?
Multinucleated giant cells
What is the basic process behind RA?
1. Synovial expansion
2. Invasion of bone
3. Erodes bone and cartilage
Articular symptoms of RA?
Extra-articular manifestations of RA
Rheumatoid nodules on extensor surfaces
- Nodular scleritis
Increased CVS morbidity and mortality
What hand joint is not affected by RA?
What pattern of joint involvement is seen in RA?
How is RA defined by the EULAR/ACR Classification?
Synovitis in >/=1 joint
Absence of better diagnosis
Achievement of >/=6/10 of:
- Number and site of affected joints (0-5)
- Serological abnormality (0-3)
- Increased CRP/ESR (0-1)
- Symptom duration (0-1)
What is the best autoantibody to test for to aid in the diagnosis of RA?
Anti-CCP (Cycli citrullinated peptide) Antibody
Does a patient need to be Rheumatoid Factor positive (RhF) to have RA?
What chronic haematological change may be seen in RA?
What x-ray changes are seen in RA?
- Loss of joint space
- Periarticular erosions
Soft tissue swelling
What late complications can be seen in RA?
Cervical myelopahy secondary to:
- Atlanto-axial/Subaxial subluxation
What comorbidities is RA associated with?
What genetic factor is a poor prognostic factor in RA?
HLA DR4 positive
How soon must treatment be begun in RA to prevent irreversible damage?
Within 3 months
What are the principles of RA treatment?
Steroids to cover lag phase
Give examples of DMARDs and when they might be used?
1st line - Methotrexate
2nd line and in pregnancy - Sulphasalazine
What four approaches to biologic therapy can be used in RA and give examples of drugs in each class?
B cell depletion:
Disruption of T cell co-stimulation:
- Anankira (IL-1)
- Tocilizumab (IL-6)
What is the pathogenesis of OA?
Loss of matrix (Collagen ii with chondrocytes embedded)
- Prostaglandins from chondrocytes
Surface fibrosis and attempted repair -> Oestophytes
How are localised and generalised idiopathic OA defined
Generalised is >/= 3 sites involved
What are some secondary causes of OA?
Risk factors of OA
When is pain typically present in OA?
How long does morning stiffness last in OA?
Less than 30 minutes
What might be found on examination of a patient with OA?
Joint tenderness and effusion
What can lumbar spine OA result in?
Where does hip OA pain radiate to?
OA at what site can result in genu valgum and a Baker's cyst?