Rheumatoid arthritis

Question 1

What 2 categories can rheumatic diseases be divided into?

Answer 1

Degenerative
Inflammatory

Question 2

Osteoarthritis is an example of which category of rheumatic disease?

Answer 2

Degenerative

Question 3

Rheumatoid arthritis is an example of which category of rheumatic disease?

Answer 3

Systemic autoimmune disease

Question 4

Ankylosing spondylitis is an example of which category of rheumatic disease?

Answer 4

Seronegative rheumatic disease

Question 5

Behcets disease is an example of which category of rheumatic disease?

Answer 5

Vascular rheumatic disease

Question 6

Gout is an example of which category of rheumatic disease?

Answer 6

Autoinflammatory disease

Question 7

Fibromyalgia is an example of which category of rheumatic disease?

Answer 7

Pain syndromes

Question 8

Which 2 parts of a joint does RA particularly affect?

Answer 8

Synovial membrane
Articular cartilage

Question 9

What is the function of Type A synoviocytes?

Answer 9

Mediate immune response

Question 10

What is the function of Type B synoviocytes?

Answer 10

Secrete synovial fluid

Question 11

In early stage RA, what 3 changes occur to the synovium?

Answer 11

Oedematous
Hyperplastic
Thickened

Question 12

In early stage RA, which 3 types of cells infiltrate?

Answer 12

T lymphocytes
B cells and plasma cells
Macrophages

Question 13

What is the term for the abnormal fibrovascular tissue that forms in later stage RA?

Answer 13

Pannus

Question 14

Later stage RA can result in which 2 deformities which would restrict movement?

Answer 14

Fibrous ankylosis
Bony ankylosis

Question 15

Which gene is the strongest genetic risk factor for RA?

Answer 15

HLA-DR4

Question 16

Which specific T helper cells are triggered by self-antigens in RA?

Answer 16

Th1
Th17

Question 17

How are lymphocytes and macrophages recruited in RA?

Answer 17

Th17 produce IL-17

Question 18

In RA, which specific 4 cytokines do macrophages release?

Answer 18

IL-1
IL-6
IL-8
TNF-a

Question 19

In RA, which cytokine is thought to be responsible for the sustained inflammatory response?

Answer 19

TNF-a

Question 20

Which 2 antibodies are found in RA?

Answer 20

Anti-citrullinated peptide

Rheumatoid factor

Question 21

What is rheumatoid factor?

Answer 21

IgM autoantibody binding to Fc portion of IgG

Question 22

What percentage of RA patients have a positive test for rheumatoid factor?

Answer 22

75%

Question 23

What are the 3 most commonly affected joints in RA?

Answer 23

Metacarpophalangeal

Proximal interphalangeal

Metatarsophalangeal

Question 24

Describe how the fingers deviate in RA.

Answer 24

Ulnar deviation

Question 25

Describe the joint deformities found in swan-neck sign.

Answer 25

Hyperextension of PIP joint Flexion of DIP joint

Question 26

Describe the joint deformity found in Boutonniere's sign.

Answer 26

Hyperflexion of PIP joint

Question 27

RA can cause synovitis in which vertebrae?

Answer 27

C1-C2

Question 28

RA can cause subluxation of which joint in the neck?

Answer 28

Atlantoaxial joint

Question 29

What percentage of RA patients get nodules?

Answer 29

20 - 25%

Question 30

What is found in the centre of rheumatoid nodules?

Answer 30

Fibrous necrosis

Question 31

What 2 cells are found in the surrounding ring of rheumatoid nodules?

Answer 31

Lymphocytes Plasma cells

Question 32

RA increases the risk of which heart pathology?

Answer 32

Ischaemic heart disease

Question 33

What percentage of RA patients have raised ANA?

Answer 33

30%

Question 34

What percentage of RA patients have anti-CCP?

Answer 34

60 - 70%