Rheumatoid Arthritis Flashcards Preview

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Flashcards in Rheumatoid Arthritis Deck (45)
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1

Female to male ratio for rheumatoid arthritis

3:1

2

Dose of sulfasalazine

40mg/kg/day

3

Presentation of rheumatoid arthritis?

symmetrical distribution, positive compression test of the MCP and MTP joints, involvement of the small joints of the hands and feet, tenosynovitis, carpal tunnel syndrome

4

A DAS-28 score of <2.6 indicates?

disease remission

5

What must patients be screened for before commencing biologic therapy? (5)

TB, Hep B/C, HIV, varicella zoster

6

A DAS-28 score of 2.6-3.2 indicates?

low disease activity

7

Which vertebrae may be affected by rheumatoid arthritis?

C1/2

8

1st line treatment for rheumatoid arthritis

DMARDS

9

Rheumatoid Arthritis

symmetrical inflammatory arthritis mainly affecting the peripheral joints

10

When should steroids be used in rheumatoid arthritis?

To start treatment until DMARDs kick in and to control flare ups

11

X-ray findings in more advanced rheumatoid arthritis?

erosions, soft tissue swelling, periarticular osteopaenia

12

Use of USS in rheumatoid arthritis?

good for detecting synovitis and 7x more MCP erosions than an x-ray

13

Side effect of methotrexate

may cause bone marrow suppression

14

Describe a swan neck deformity 

15

Key clinical features pointing to an inflammatory rheumatoid disease

prolonged morning stiffness, fatigue, weight loss, fever

16

Describe a boutonniere deformity 

17

A DAS-28 score of >5.1 indicates?

severe, active disease

18

A DAS-28 score of 3.2-5.1 indicates?

moderate disease activity

19

Complications of unresolved rheumatoid arthritis

Swan-neck deformities and boutonnieres, atlanto-axial subluxation

20

Example B cell depletor

rituximab

21

Dose of methotrexate used initially in Rheumatoid arthritis?

15mg/week

22

What must be prescribed with methotrexate and why?

folic acid - MTX prevents the incorporation of folic acid into the joint

23

How are DMARDs typically prescribed?

as a combination therapy i.e. MTX, Sulfasalazien and hydroxychloroquine

24

Which auto-antibody test is more specific to rheumatoid arthritis?

Anti-CCP

25

X-rays in early rheumatoid arthritis may show?

nothing or some soft tissue swelling

26

why is hydroxychloroquine prescribed alongside methotrexate?

it does not prevent erosions

27

Ideal timescale for starting rheumatoid arthritis treatment?

3 months from symptom onset

28

How is methotrexate best taken?

parenterally to provide best bioavailability i.e. IM, IV

29

3rd line DMARD

hydroxychloroquine

30

Example anti-TNF agent

infliximab, etanercept