Rheumatoid Arthritis Flashcards Preview

The Musculoskeletal System > Rheumatoid Arthritis > Flashcards

Flashcards in Rheumatoid Arthritis Deck (37):
1

What percentage of the general UK population suffer from rheumatoid arthritis?

1%

2

How can rheumatoid arthritis be defined?

A symmetrical inflammatory arthritis

3

Which joints (axial/peripheral) does rheumatoid arthritis affect?

Peripheral joints

4

Rheumatoid arthritis affects only articular joints.

True or false?

False

It affected extra-articular structures e.g. lungs, heart (endocarditis), GI system

5

Which sex is more likely to suffer from rheumatoid arthritis?

Females (3x more likely)

6

Rhematoid arthritis is an ___________ condition and is __________ mediated

Autoimmune

HLA-DR4

7

Give 3 examples of triggers which can bring on rheumatoid arthritis

  1. Stress
  2. Infection
  3. Cigarette smoking

8

What is the most common form of arthritis in children?

Juvenile idiopathic arthritis

This is essentially rhematoid arthrtis, yet can resolve spontaneously and is not necessarily chronic

9

The presence of what in rheumatoid arthritis worsens the prognosis?

Auto-antibodies

10

Which stucture is the main structure involved in rheumatoid arthritis?

Synovium of a synovial joint

(capsules and tendon sheaths may also be affected)

11

Why can the C1/C2 vertebrae be affected by rheumatoid arthritis when other vertebrae cannot?

They are lined with synovium

12

Two of the main hallmarks for rheumatoid arthritis are?

  1. Synovitis
  2. Tenosynovitis

Tenosynovitis - inflammation of synovium that surrounds a tendon

13

Regarding rheumatoid arthritis, what does the term "pannus" describe?

The inflamed, spongy synovium as a result of inflammation and hypertrophy

14

Why does rheumatoid arthritis cause bony erosions?

As part of the inflammatory process, osteoclasts are activated and these break down bone

15

What are the most frequent joints associated with rheumatoid arthritis?

  • Proximal interphalangeal (PIP)
  • Metacarpophalangeal (MCP)

16

How is early rheumatoid arthritis defined?

Rheumatoid arthritis diagnosed less than two years after symptom onset

(the first 3 months offer the best therapeutic window)

17

Which inflammatory markers can be tested for in rheumatoid arthritis?

  • CRP
  • ESR
  • Plasma viscosity

18

What is palindromic rhematism?

Rheumatoid arthritis that is episodic

It comes on, completely reverses and comes on again

19

Which is more specific for rheumatoid arthritis?

  1. Rheumatoid factor
  2. Anti-CCP antibodies

Anti-CCP antibodies

(Antibodies to cyclic citrullinated peptide)

These are virtually 100% specific

(but more like 60-70% sensitive)

20

With treatment, anti-CCP antibodies will reduce as the condition dampens down.

True or false?

False

Anti-CCP antibodies will always be present

21

What is the gold standard for imaging joints?

MRI

22

Which scoring system is used for rheumatoid arthritis?

DAS 28

(Disease activity score 28)

(28 joints are tested during the screening test)

23

Which score on the DAS 28 scoring system indicates severe active disease?

>5.1

24

Which score on the DAS 28 scoring system indicates remission?

<2.6

25

Which specific drugs are always given for rheumatoid arthritis?

  • Aspirin
  • NSAIDS
  • DMARDs

26

What is the first line disease modifying drug for rheumatoid arthritis?

Methotrexate

27

What is the second line disease modifying drug?

Sulfasalazine

28

Disease modifying drugs will be given and reassessed ever 6 weeks until what?

Until DAS28 is <2.6

29

How are steroids used during rheumatoid arthritis?

As a bridge therapy

Then gradually withdrawn

This is due to bad side effects

30

How often is methotrexate given for patients with rheumatoid arthritis?

Weekly

31

24 hours after methotrexate administration, what is given?

Folic acid

32

Which rheumatoid arthritis patients are given disease modifying drugs?

All of them

33

Which pulmonary condition is associated with the use of methotrexate?

Pneumonitis

(SOB and dry cough too)

34

The use of biological agents for rheumatoid arthritis may risk reactivation of what condition?

Tb

(the granuloma breaks down as it is partially composed of immune cells)

35

When are biological agents administered for rheumatoid arthritis?

  1. There is failure to respond to two DMARDS including methotrexate
  2. DAS28 >5.1 on two occasions 4 weeks apart

36

Which drug will be co-prescribed with biological agents for rheumatoid arthritis?

Methotrexate

37

Rheumatoid arthritis gets worse in pregnancy.

True or false?

False

Rheumatoid arthritis often gets better in pregnancy

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