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5_Rheum and Musc > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

(18 cards)

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1
Q

What is the definition of RhA?

A

Chronic inflammatory systemic disease characterised by symmetrical deforming polyarthritis and extra-articular manifestations

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2
Q

Associations

A 
Female
Family history
Smoking
Obesity
HLA DR-1 and DR-4
Autoimmune diseases (Sjögren's, Raynaud's)
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3
Q

Overall features

A 
Gradual onset
Peripheral joints
Symmetrical
Painful, swelling, stiffness
Warm and tender joints
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4
Q

Classic hand signs

A

Swan neck deformity
Boutonniere deformity
Z deformity of thumbs
Trigger finger

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5
Q

What is swan neck deformity?

A

MCP + DIP fixed flexion, PIP extension

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6
Q

What is boutonniere deformity?

A

MCP + DIP extension, PIP fixed flexion

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7
Q

What is trigger finger?

A

Unable to straighten finger

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8
Q

Extra-articular manifestations

A 
Fatigue, fever, weight loss
Elbow and lung nodules
Aveolitis and bronchiolitis
Pleural and pericardial effusions
Carpal tunnel syndrome
Peripheral neuropathy
Scleritis, episcleritis
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9
Q

Bloods

A

FBC - -Hb, +platelets, +CRP, +ESR
Rheumatoid factor
Anti-cyclic citrullinated peptide antibodies

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10
Q

What is rheumatoid factor?

A

Monoclonal IgM against Fc portion of IgG

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11
Q

In how many people with RhA are RhF positive?

A

70%

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12
Q

Joint X-ray

A 
"LESS"
Loss of joint space
Erosions
Subchondral Cysts
Soft bone swelling and osteoporosis
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13
Q

What are the 3 categories of pharmacological treatment?

A

DMARDs
Biological agents
Symptomatic

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14
Q

What are the 3 gold-standard DMARDs and what they do?

A

Methotrexate - antifolate
Sulfasalazine - immunosuppressant
Hydroxychloroquine - TLR blocker

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15
Q

Other possible DMARDs?

A

Azathioprine - inhibits purine synthesis
Penicillamine - T-cell inhibitor
Cyclophosphamide - alkylating agent

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16
Q

Biological agents

Study These Flashcards
A

Anti-TNFa - etanercept, infliximab

Anti-CD20 - rituximab

17
Q

Drugs for symptoms

Study These Flashcards
A

NSAIDs

Steroids

18
Q

Indication for steroids

Study These Flashcards
A

Severe extra-articular disease

5_Rheum and Musc (4 decks)

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