8.1 Immunosuppression

Question 1

what is RA?

Answer 1

autoimmune inflammatory change initially in synovium of joints then leading to dissolution of cartilage and bone

Question 2

2 blood test markers of RA

Answer 2

rheumatoid factor
anti-CCP antibodies

Question 3

what’s RA called in children <4

Answer 3

juvenile idiopathic arthritis

Question 4

what type of remission is aimed for in RA

Answer 4

drug assisted

Question 5

Calcineurin inhibitors have mutiple DDIs. via what substance?

Answer 5

cyp450

Question 6

name some cyp450 inducers

Answer 6

rifampicin
carbamezepine
phenytoin
omeprazole

Question 7

name some cyp450 inhibitors

Answer 7

ciprofloxacin
HIV antivirals

Question 8

drug effective for lupus remission

Answer 8

cyclophosphamide

Question 9

cyclophosphamide is toxic to bladder epithelium via a metabolite. which one? and result?

Answer 9

acrolein
haemorrhage cystitis, can bleed to death by passing urine

Question 10

treatment of haemorrhage cystitis via cyclophosphamide

Answer 10

aggressive hydration and/or mesa

Question 11

safer drug than cyclophosphamide for lupus nephritis

Answer 11

mycophenolate mofetil

Question 12

methotrexate mechanism of action

Answer 12

competitively reversibly inhibits dihydrofolate reductase

Question 13

methotrexate as an abortifacient

Answer 13

limits folate supply to fertilised ovum to prevent rupture of ectopic pregnancy

Question 14

why is sulfasalazine good in practice?

Answer 14

effective
very few DDIs
not carcinogenic
safe in pregnancy

Question 15

what should be screened for before anti TNF treatment?

Answer 15

latent TB