RA Flashcards
(26 cards)
Systemic chronic inflammatory autoimmune disease
Rheumatoid Arthritis
Hallmark feature of RA
Persistent destructive symmetric poly arthritis
RA predominantly affects
Small joints of hands
Etiology of RA
Genetic
Environmental
Hormonal
Immunologic
Infectious
Genetic etiology of RA
HLA DR4 40-60% poor prognosis
HLA DRB1 (resistant)
Contraceptive pills ______ RA
Improve and delay onset
Rheumatoid hands
Radial deviation of hand
MCP subluxation
Ulnar deviation of fingers
Z shape deformity
Swan neck deformity
Boutonnière deformity
Rheumatoid foot
Halluxvalgus
MTPJ sub luxation
Hammer toe
Investigations for RA
CBC
CRP
ESR
RF
ACCP
General sx of RA
Myalgia
Fatigue
Low grade fever
Weight loss
Depression
Neuro complications of RA
C1-C2 sub luxation
And spinal compression
CTS
Mononeuritis Multiplex
Scleritis or episcleritis
Cardiac complications
Pericardial effusion
Myocarditis
Pericarditis
Endocarditis
Heart block
Respiratory complications
Interstitial lung fibrosis
Rheumatoid nodules
Vasculitus
DDX of RA
Fibromyalgia
OA
Relapsing Polyconditis
Poly myalgia Rheumatica
Psoriatic Arthritis
Sarcoidosis
SLE
Polyarticular gout
Goal in tx
Prevent or control joint damage
Decrease pain
Prevent loss of function
Minimize adverse effects of tx
Preserve muscle and joint function
1st line of tx of RA
Methotrexate
Non pharmacological tx
Diet
Exercise
Meditations
Folic acid
Vitamin C
Vitamin D
Vitamin B6, B12
Vitamin E
Calcium
Magnesium
Zinc
Pharma tx
NSAIDS
Glucocorticoids
Conventional synthetic DMARDS
Biologics
If contraindication to methotrexate
Leflunomide or sulfasalazine
DMARDS
Methotrexate
Sulfasalazine
Hydroxychloroquine
Leflunomide
Gold
Azathioprine
Sulfasalazine use you need to check
CBC, LFTS
Hydroxychloroquine SE
Ocular toxicity and cataract
Biological DMARDS
Etanercept once a week SC
Adalimumab SC every 2 wk
Infliximab
Screen for what when using Biologics
TB and hepatitis
