rheumatoid arthritis Flashcards
(24 cards)
what is inflammatory arthritis
group of conditions where there is joint pr tendon inflammation
is rheumatoid arthritis symmetrical or asymmetrical
symmetrical
how many joints for rheumatoid arthritis
5 or more
rheumatoid arthritis presentation
- pain and stiffness in small joints, usually hands and feet
- morning stiffness
- long lasting stiffness
- rapid onset
- swelling of affected joints
what structure is mainly involved in RA
the synovium
risk factors for RA
smoking
viral infection
genetics
what is the criteria for symptom duration
must be 6 or more weeks
how long does the morning stiffness need to last
more than 30 mins
anti-CCP
- can be present several years prior to symptoms
- correlates with disease activity
- associated with erosive damage and smoking history
which auto-antibody is most specific for RA
anti-CCP antibody
complications of RA
- increased cardiovascular risk
- osteopenia/osteoporosis
examples of disease modifying anti-rheumatic drugs
- methotrexate
- sulfasalazine
- leflunomide
- hydroxychloroquine
- combination therapy
- steroids
side effects of DMARDS
- bone marrow suppression
- infection
- liver function derangement
- pneumonitis
- nausea
does rheumatoid arthritis cause pulmonary fibrosis
yes
what is the first choice DMARD in most patients
methotrexate
methotrexate and contraception
methotrexate must be stopped 3 months before contraception
what drug blocks T cell receptor
abatacept
what drug is a B cell depletor
rituximab
which drugs are anti TNF agents
infliximab, etanercept, adalimumab, certolizumab, golimumab
which drug is an IL-6 blocker
tocilizumab
which drugs are JAK inhibitors
tofacitinib
baricitinib
who gets biologics in the UK
tried 2 DMARDS
DAS 28 score > 5.1
adverse effects of biologics
risk of infection
risk of malignancy?
examples of when biologics are contraindicated
pulmonary fibrosis
heart failure
