Rheumatoid Arthritis Flashcards

1
Q

What is Rheumatoid Arthritis?

A

A chronic systemic inflammatory disease, characterised by potentially deforming symmetrical polyarthritis and extra-articular features

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2
Q

Whats is the Female:Male ration of RA?

A

3:1

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3
Q

What genes are involved in RA?

A

HLA
DR4
DR1

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4
Q

What happens to the Synovium in RA?`

A

It becomes laden with macrophages, fibroblasts and multi-nucleated giant cells (resemble osteoclasts)

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5
Q

What does the Synovium membrane (pannus) do in RA?

A

It expands, actively invading and erodes surrounding bone and cartilage

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6
Q

What are symptoms of RA?

A

Joint pain, stiffness (esp in morning) joint swelling, mailaise and fatigue etc.

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7
Q

What other systems of the body can be effected by RA?

A
Respiratory
Neurological
Dermatology
Ophthalmology
Hematological
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8
Q

What are signs of RA?

A

Swelling, tenderness, reduced range of movement, deformities

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9
Q

What eats at the cartilage?

A

Cytokines

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10
Q

What inflammatory markers should be checked with suspected RA?

A

PV

CRP

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11
Q

What else should be checked in suspected RA?

A

Anti CCP (Cyclic Citrullintaed Peptide)
RF (Rheumatoid Factor)
Anaemia

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12
Q

What are some possible late complications of RA?

A

Infection
Cervical myelopathy
Interstitial lung disease
Peripheral

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13
Q

How long is the “Window of Opportunity” where irreversible damage to the joints can be avoided?

A

3 months

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14
Q

What are DMARD’s?

A

Disease Modifying Drugs

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15
Q

What are DMARD’s given with (to cover lag phase)

A

Steroids

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16
Q

What problems can occur in the eye with RA?

A

Dry eye due to fibrosis, same process causes dry mouth.

Epi something in the sclera

17
Q

What problems can occur in the lungs with RA?

A

Pulmonary fibrosis

18
Q

Are DMARD’s fast or slow acting?

A

Slow

19
Q

What do DMARD’s do?

A

Reduce rate of joint damage

20
Q

What other drugs can be given for RA?

A
Methotrexate
Sulfasalazine
Leftunamide
Hydroxychloroquine, pencillamine, 
gold
21
Q

What 5 biological approaches have helped in RA?

A
  1. TNF-alpha inhibiton
  2. B cell depletion
  3. Disruption of T cell costimulation
  4. Interleukin-1 and IL-6 inhibition
  5. Jak2 inhibitors
22
Q

What drugs help inhibit TNF-alpha?

A

Inflximab
Adalmumab
Etanercept

23
Q

What drugs help deplet B cells?

A

Rituximab

24
Q

What drugs disrupt T cell costimulation?

A

Abatacept

25
Q

What drugs inhibit IL-1 and IL-6?

A

Anankira for IL-1

Tocilizumab for IL-6