Rheumatoid Arthritis Flashcards Preview

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Flashcards in Rheumatoid Arthritis Deck (25):
1

What is Rheumatoid Arthritis?

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

2

Whats is the Female:Male ration of RA?

3:1

3

What genes are involved in RA?

HLA
DR4
DR1

4

What happens to the Synovium in RA?`

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

5

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

It expands, actively invading and erodes surrounding bone and cartilage

6

What are symptoms of RA?

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

7

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

Respiratory
Neurological
Dermatology
Ophthalmology
Hematological

8

What are signs of RA?

Swelling, tenderness, reduced range of movement, deformities

9

What eats at the cartilage?

Cytokines

10

What inflammatory markers should be checked with suspected RA?

PV
CRP

11

What else should be checked in suspected RA?

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

12

What are some possible late complications of RA?

Infection
Cervical myelopathy
Interstitial lung disease
Peripheral

13

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

3 months

14

What are DMARD's?

Disease Modifying Drugs

15

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

Steroids

16

What problems can occur in the eye with RA?

Dry eye due to fibrosis, same process causes dry mouth.
Epi something in the sclera

17

What problems can occur in the lungs with RA?

Pulmonary fibrosis

18

Are DMARD's fast or slow acting?

Slow

19

What do DMARD's do?

Reduce rate of joint damage

20

What other drugs can be given for RA?

Methotrexate
Sulfasalazine
Leftunamide
Hydroxychloroquine, pencillamine,
gold

21

What 5 biological approaches have helped in RA?

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

What drugs help inhibit TNF-alpha?

Inflximab
Adalmumab
Etanercept

23

What drugs help deplet B cells?

Rituximab

24

What drugs disrupt T cell costimulation?

Abatacept

25

What drugs inhibit IL-1 and IL-6?

Anankira for IL-1
Tocilizumab for IL-6