Rheumatoid Arthritis

Question 1

What is rheumatoid arthritis?

Answer 1

Chronic inflammation of joints that can potentially cause deformity + systemic symptoms

Question 2

What sex and age range does rheumatoid arthritis tend to affect?

Answer 2

Females 3:1 males

30-50 yrs old

Question 3

What is the basic pathology behind rheumatoid arthritis?

Answer 3

Synovium becomes inflamed and invasive; inflammatory mediators eats away into articular cartilage and bone

Question 4

List classic symptoms and signs of rheumatoid arthritis

Answer 4

Joint pain/swelling
Stiffness in the morning
Systemic features
Tenderness
Reduced movement
Deformities

Question 5

Rheumatoid arthritis usually affects less joints than osteoarthritis. True/False?

Answer 5

False

Usually affects more joints

Question 6

List investigations for rheumatoid arthritis

Answer 6

Anti-CCP, rheumatoid factor
Inflammatory markers
USS

Question 7

List some poor prognostic indicators for rheumatoid arthritis

Answer 7

Young age
Male
Many active joints
High CRP
Early erosions
Extraarticular features

Question 8

What is the “window of opportunity” of treating rheumatoid arthritis, where treating in this period can prevent irreversible damage to joints?

Answer 8

3 months

Question 9

What is the main treatment of rheumatoid arthritis?

Answer 9

DMARDS (methotrexate)

Question 10

What 4 other groups of biological agents have been effective for rheumatoid arthritis?

Answer 10

Anti-TNF (infliximab)
B cell depletors (ritixumab)
IL-6 inhibitor (tocilizumab)
T cell distruptors (abatacept)