Rheumatoid arthtritis Flashcards
(27 cards)
What is Rheumatoid Arthritis?
Rheumatoid Arthritis is an autoimmune, inflammatory, symmetrical, distal polyarthropathy
It primarily affects the joints, leading to pain and swelling.
What genes are associated with Rheumatoid Arthritis?
HLA-DR1 and HLA-DR4
These genes are linked to the susceptibility of developing the disease.
What antibodies are associated with Rheumatoid Arthritis?
Rheumatoid Factor, Anti-CCP
These antibodies are often present in patients with the condition.
Which joints are affected by Rheumatoid Arthritis?
MTP, PIP joints. Ankle, wrist, cervical spine. DIP is rarely affected
The disease typically spares the distal interphalangeal joints.
What are the symptoms of Rheumatoid Arthritis?
Pain, stiffness, swelling, muscle aches, fatigue, weakness, weight loss
These symptoms can vary in intensity and duration.
What is Palindromic Rheumatism?
Symptoms which only last for 1-2 days
This condition may present with recurrent episodes of arthritis.
What is Atlantoaxial Subluxation?
A feature in some patients with Rheumatoid Arthritis, affecting the cervical spine
It involves the shift of the C2 vertebra and can cause spinal cord compression.
What tests must be ordered for patients with Atlantoaxial Subluxation?
AP and lateral radiographs
These imaging tests help assess the cervical spine alignment.
What signs may be visible in the hands of patients with Rheumatoid Arthritis?
MCP/PIP joints affected. May have Swan Neck or Boutonniere deformity. Z-shaped deformity and Ulnar deviation
These deformities are characteristic of chronic joint damage.
What are some extra-articular manifestations of Rheumatoid Arthritis?
Pulmonary fibrosis, Felty’s syndrome, Bronchiolitis Obliterans, Secondary Sjorgen’s syndrome
These conditions can occur outside of joint involvement.
What may be seen on XR in patients with Rheumatoid Arthritis?
Joint destruction, soft tissue swelling, bony erosions, periarticular osteopenia
These findings indicate the severity of the disease.
How can Rheumatoid Arthritis be monitored?
CRP and DAS28
These tests help assess disease activity and treatment response.
What is 1st line management for Rheumatoid Arthritis?
Any DMARD i.e. MTX, SSZ, Levoflunamide, Hydroxychloroquine
DMARDs are essential for disease control.
What is 2nd line management for Rheumatoid Arthritis?
Any two of these in combination
This approach is used if 1st line treatment is insufficient.
What is 3rd line management for Rheumatoid Arthritis?
MTX plus a Biologic
Biologics can enhance treatment effectiveness.
What is 4th line management for Rheumatoid Arthritis?
MTX plus Rituximab
This is considered for patients who do not respond to other therapies.
What is used to induce remission of a flare in Rheumatoid Arthritis?
Oral / IM Prednisolone
Corticosteroids are effective for managing acute exacerbations.
What are the side effects of Methotrexate (MTX)?
Pneumonitis, Pulmonary fibrosis, Hepatotoxicity
Monitoring for respiratory symptoms is important.
What are the side effects of Sulfasalazine (SSZ)?
Reversible reduced Sperm count, orange urine
These side effects may impact patient compliance.
What are the side effects of Levoflunamide?
HTN, Peripheral neuropathy
Patients should be monitored for these potential complications.
What are the side effects of Hydroxychloroquine?
Blue grey skin, retinopathy, hair lightening
Regular eye examinations are necessary during treatment.
What are the side effects of Biologics?
Reactivation of TB, hence must request CXR
Screening for TB is crucial before starting Biologics.
What is Felty’s Syndrome?
RA + splenomegaly + neutropenia
This syndrome is a rare complication of Rheumatoid Arthritis.
What are some complications of Rheumatoid Arthritis?
Respiratory (Pulmonary fibrosis, bronchiolitis obliterans, MTX pneumonitis), Ocular (Episcleritis, scleritis), Osteoporosis, IHD, Felty’s
These complications can significantly affect patient quality of life.
