Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reumatologia > T2 - Artrite Reumatoide > Flashcards

T2 - Artrite Reumatoide Flashcards

1
Q

Frequência de Artrite Reumatóide?

A

0,7%

3:1 (mulheres:homem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Heridabilidade da Artrite Reumatóide?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fatores Ambientais na Artrite Reumatóide?

A 
Virus (EBV, parvovirus B19)
Tabaco
Stress/Comida
Álcool
Fatores Hormonais (prolactina como imunomodulador)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gene que aumenta risco de Artrite Reumatóide?

A

PTPN22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Manifestações articulares da Artrite Reumatóide?

A 
Monoartrite (punho e joelho)
Tenosinovite isolada
Oligoartrite
Poliartrite Simétrica (IFPs, MCFs, punho e MTFs) - Típico
Idosos - Poliartrite Rizomélica
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Detection of synovitis?

A
  • Soft tissue swelling
  • Tenderness
  • Limited motion (frequently)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Extra-articular manifestations of Rheumatoid Arthritis?

A
  • Fever
  • Pericarditis
  • Pleuritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Laboratory investigations in Rheumatoid Arthritis?

A
  • Elevated erythrocyte sedimentation rate and C-reactive protein
  • Thrombocytosis; sometimes leucocytosis
  • Rheumatoid factor in high titles
  • Anti-cyclic citrullinated peptides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Conventional radiographic examinations in Rheumatoid Arthritis?

A
  • Hands
  • Wrists
  • Feet
  • Baseline assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gold Standard?

A

Conventional radiography

Presence of erosions: key feature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Early conventional radiographic signs of Rheumatoid Arthritis?

A
  • Soft tissue hipertrophy, mainly in MCPs and PIPs
  • Periarticular osteoporosis in MCPs and PIPs
  • Marginal erosions (1st. Carpus; second MCP; ulnar styloid; lateral fifth metatarsal head)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Advantage of High-resolution ultrasonography with power Doppler?

A

Higher sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Magnetic resonance imaging (MRI) in Rheumatoid Arthritis?

A

Higher sensitivity.

Bone marrow edema is also typical, which is a predictor of subsequent erosions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Rheumatoid Arthritis classification criteria?

A

Joint involvement
Serology
Acute-phase reactants
Duration of symptons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diagnóstico diferencial na Artrite Reumatóide?

A

Distinguir de Osteoartrite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Prediction of outcome in Rheumatoid Arthritis?

A

Prediciton of future physical disability
Prediciton of future structural damage
Prediciont of increased mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hands involvement in Established rheumatoid arthritis?

A 
Boutonnière deformity
Z or 90-90 thumb
Swan-neck deformity
MCP deformities
Volar subluxation of the wrist
18
Q

Elbow and shoulder involvement in Established Rheumatoid Arthritis?

A 
Elbow
• Frequently involved
• Early sign: loss of extension
• After: loss of supination 
Shoulder
• Not very frequently;
• Synovitis leads to erosion and damage of both the humeral head and glenoid fossa.
19
Q

Mais comum Subluxação da atlanto-axial?

A

Anterior (space between the odontoid process of C2 and the arch of the atlas
≥ 3 mm in cervical x-ray with the head in the flexed position)

20
Q

Lower limbs involvement in Established rheumatoid arthritis?

A

Knee
• Frequently involved (80%)
• Early sign: reduction of knee extension
• After: Baker`s cyst in the popliteal region and Valgus knee.
Hip
• Infrequently involved

21
Q

Feet involvement in Established Rheumatoid Arthritis?

A 
• Triangle forefoot deformity
– Hálux valgus + quintus varus
• MTP joints subluxation
– Clawing of the toes
• Evolution: valgus flat foot
• Calcaneal valgus
22
Q

Other joints involvement in Established rheumatoid arthritis?

A 
Temporal-mandibular joint
• Painful limitation of mouth opening
Cricoarytenoid joint
• Hoarseness
Ear ossicles
• Hearing loss independent of medication-induced effects
23
Q

Tenossinovites mais comuns?

A
  • Flexor tenosynovitis
  • Ulnar extensor carpi tenosynovitis
  • Common fingers extensor tenosynovitis
24
Q

Typical Bursitis in Established rheumatoid arthritis?

A

Olecranon bursitis

Sub-Achilles bursitis

25
Q

Subcutaneous nodules in Established rheumatoid arthritis?

A

Extensor aspects of the proximal ulna
Other pressure locations
Not exclusive of rheumatoid arthritis

26
Q

Extra-articular manifestations in Established rheumatoid arthritis?

A 
Secondary osteoporosis
Secondary Sjögren`s syndrome
Infections (artrocentese em monoartrite com AR controlada)
Hematological abnormalities
Splenomegaly (Sind. Felty)
Renal disease
Gastrointestinal manifestations
27
Q

Eye complications in Established rheumatoid arthritis?

A
  • Episcleritis
  • Dry eyes
  • Escleromalacia
  • Ocular perforation
  • Iritis
28
Q

Vasculitis in Established rheumatoid arthritis?

A
  • Uncommon (1%), related to disease severity and activity
  • Necrotising vasculitis
  • Cutaneous ulceration
  • Peripheral neuropathy
29
Q

Pulmonary disease in Established rheumatoid arthritis?

A
  • Pleuritis
  • Intersticial pneumonitis
  • Intersticial fibrosis
  • Bronchiectasis
30
Q

Rare Pulmonary disease in Established rheumatoid arthritis?

A
  • Nodular lung disease

* Caplan Syndrome (macronodular AR + silicosis)

31
Q

Cardiac and cardiovascular disease in Established rheumatoid arthritis?

A

Arteriosclerosis

Pericarditis

32
Q

Mortality in Rheumatoid arthritis? Causes?

A

In severe forms, reduction of 5 years in life expectancy
Causes:
• Cardiovascular
• Infectious

33
Q

Therapeutic targets in Rheumatoid arthritis?

A 
Suppress inflammation
Protect against joint destruction
Preserve function
Prevent comorbidities (cardiovascular and others)
Improving the quality of life
34
Q

Disease assessment in Rheumatoid arthritis?

A

• Tight control: every 3 months
• Global disease activity assessment by the patient on VAS
• Number of tender joints (pressure)
• Number of swollen joints (pressure)
Stanford Health Assessment Questionnaire (HAQ)

35
Q

Remission criteria in Rheumatoid arthritis?

A

Tender joint count < 1
Swollen joint count < 1
Patient global assessment < 1
PCR < 1 mg/dl

36
Q

Symptomatic treatment in Rheumatoid arthritis?

A 
Rest
Analgesics
NSAIDs
CCTs
• Severe disease; NSAIDs contraindicated
• Average dose: prednisolone 7,5 mg/day
• EV methylprednisolone (500 mg to 1g/day, 3 consecutive days → flares)
37
Q

Indications of glucocorticoids in early arthritis and established rheumatoid arthritis?

A
  • Intra-articular in mono or oligo-articular flares
  • In established rheumatoid arthritis for symptomatic control
  • In a polyarticular flare for symptomatic control
38
Q

Fármacos modificadores da doença reumática (imunosupressores)?

A

Justification
• Effective control of clinical and biological signs of disease
• Prevent /retard radiological progression
• Induce remission
Time of prescription
• The earliest possible: after diagnosis
Duration prescription
• Long as it remains effective and well-tolerated

39
Q

DMARDs com Potencial prognóstico benigno ou dúvidas diagnósticas? E com prognóstico sério ou indeterminado? Ausência de resposta?

A

Hidroxicloroquina.
Metotrexato e Leflunamida.
Anti-TNF e Combination therapy.

40
Q

Conclusion remarks on Rheumatoid arthritis?

A

Disabling condition:
• High morbidity
• Disability
Decrease in life expectancy in five years, compared to the general population
Window of opportunity
• Need for early diagnosis
• Need to establish early the patient outcomes
• Early institution of the most appropriate therapy
Need for tight control

Reumatologia (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions