Gout And Rheumatoid Arthritis

Question 1

What is rheumatoid arthritis

Answer 1

Autoimmune and an inflammatory disease that attacks healthy joint cells (synovial) usually many at once

Question 2

Cytokines responsible for joint destruction?

Answer 2

TNF-a
IL-1
IL-6
IL-17

Question 3

Pathogenesis of RA?

Answer 3

Synovial membrane swollen > dec fluid > dec lubrication of ligaments and joints

Question 4

Drugs for acute gout?

Answer 4

NSAIDs
Glucocorticoids
Colchicine

Question 5

Drugs for chronic gout? (Preventive)

Answer 5

Allopurinol
Pegloticase
Febuxostat
Probenecid

Question 6

Which drugs inhibit xanthine oxidase?

Answer 6

Allopurinol
febuxostat

Question 7

Allopurinol also used in?

Answer 7

Lymphoma and leukemia to prevent tumor lysis associated urate nephropathy

Question 8

Allopurinol ADR

Answer 8

Steven johnson syndrome in ppl with G6DP def

Question 9

Pegloticase MOA?

Answer 9

Recombinant uricase catalyzing uric acid to allantoin (water sol)

Question 10

Probenecid MOA

Answer 10

Inhibits uric acid reabsorption in PCT

Question 11

Probenecid Interactions

Answer 11

Inhibits pencillin secretion

Question 12

Probenecid ADR

Answer 12

uric acid calculi
Sulfa allergy

Question 13

Salicylates (diuretics) in low doses may inhibits tubular secretion or reabsorption of uric acid

Answer 13

Secretion

Question 14

Colchicine MOA

Answer 14

Inhibit microtubule polymerisation imparing chemotaxis and degranulation

Question 15

Colchicine ADR

Answer 15

GI
Neuromyopathic
Myelo suppression
Nephrotoxicity

Question 16

Glucocorticoids route

Answer 16

Oral
Intra articular
Parenteral

Question 17

Glucocorticoids ADR

Answer 17

Enhances osteoporosis
Stimulate diabetic tendencies

Question 18

________ contraindicated in gout?

Answer 18

Aspirin

Question 19

Therapy for RA

Answer 19

NSAIDs -for acute pain
Glucocorticoids -bridge to DMARDs
DMARDs -for late stage

Question 20

Drug that is gold standard for RA treatment

Answer 20

DMARDs

Question 21

Combination therapy for RA

Answer 21

2 or 3 DMARDs

Question 22

Double therapy for RA

Answer 22

MTX + any other

Question 23

Triple therapy for RA

Answer 23

MTX + sulphasalazine + hydroxycholorquine

Question 24

Types of DMARDs?

Answer 24

Biologic
Synthetic

Question 25

Biological DMARDs?

Answer 25

TNF-a inhibitors Co-stimulant inhibitor IL-6 inhibitors B-cell depletors

Question 26

Synthetic DMARDs

Answer 26

Methotrexate Sulphasalazine Chloroquine, hydroxychloroquine Leflunomide

Question 27

Chloroquine/hydroxychlroquine ADR

Answer 27

Ca deposition on retina

Question 28

Methotrexate (MTX) is an anti-_________ as well but taken in __________ doses

Answer 28

Anti neoplastic but taken in lower doses

Question 29

MTX ADRs?

Answer 29

Gastric irritation Stomatitis Pancytopenia

Question 30

Theres an increased risk of developing ________ due to MTX use

Answer 30

B-cell lymphoma/ secondary cancer

Question 31

Which DMARD is teratogenic

Answer 31

METHOTREXATE

Question 32

Course of MTX?

Answer 32

Once / week

Question 33

TNF-a inhibitors

Answer 33

Infliximab Adalimumab Golimumab

Question 34

Infliximab MOA

Answer 34

anti-TNF-a monoclonal antibody

Question 35

TNF-a ADRs

Answer 35

Predisposition to infections Reactivation of latent TB Drug induced Lupus

Question 36

Leflunomide MOA

Answer 36

Prevent pyrimidine synthesis Suppression of T cell proliferation

Question 37

Leflunomide ADRs

Answer 37

Diarrhea Hypertension Hepatotoxic Teratogenic

Question 38

Glucocorticoids inhibits which enz

Answer 38

Phospholipase A2