MSRA: Rheumatoid Arthritis Flashcards
What are the eye manifestations of rheumatoid arthritis?
Keratoconjuctivitis sicca (most common)
Episcleritis
Scleritis
What are the baseline tests for biologics?
TB risk assessment as per BTS guidelines
This may involve Mantoux or CXR
What are the early X-ray changes in rheumatoid arthritis?
Loss of joint space
Soft tissue swelling
Periarticular osteopenia
What is the appropriate contraception advice regarding the use of methotrexate?
Women should avoid pregnancy for at least 6 months after treatment has stopped
The BNF also advises that men need to use effective contraception for at least six months after treatment
Which antibodies are associated with Rheumatoid Arthritis?
RhF
Anti-CCP
What are the primary care investigations for suspected RA?
FBC, CRP ESR
anti-CCP and RhF
Xray of the hands and feet
What are the respiratory complications of RA?
Pulmonary fibrosis
Pleural effusion
What monitoring is required for Methotrexate?
FBC, U+Es, LFTs every 1-2 weeks until stable
Then every 2-3 months
What are the side effects of methotrexate?
Myelosuppression
Liver cirrhosis
Pulmonary fibrosis/pneumonitis
What are the side effects of sulfasalazine?
Rashes
Oligospermia
Heinz body anaemia
Interstitial lung disease
(Don’t give to patients with Aspirin allergy)
What are the side effects of Leflunomide?
Liver impairment
Interstitial lung disease
Hypertension
What are the side effects of Hydroxychloroquine?
Retinopathy
Corneal deposits
What are the side effects of Penicilliamine?
Proteinuria
Exacerbation of myasthenia gravis
What are the side effects of Etanercept?
Reactivation of TB
Demyelination
What is the management of RA flare?
Oral or intramuscular steroids
