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AAA-MEDICINE (GI) > ARTHRITIS & ARTHRITIDIS 1.2 > Flashcards

ARTHRITIS & ARTHRITIDIS 1.2 Flashcards

1
Q

What triggers the immune system in rheumatoid arthritis (RA)?

A

Microbial infection (such as EBV)

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2
Q

What receptors recognize microbial infection in RA?

A

Toll-like receptors (TLR)

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3
Q

What is the result of Toll-like receptor activation in RA?

A

Upregulation of proinflammatory cytokines leading to synovial lining inflammation

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4
Q

What characterizes the preclinical stage of RA?

A

Breakdown in self-tolerance leading to activation of autoantibodies

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5
Q

What environmental factors can trigger RA?

A

Smoking

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6
Q

Which autoantibodies can be present years before RA symptoms appear?

A

Rheumatoid factor (RF) and anti-CCP antibodies

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7
Q

What is the role of citrullination in RA?

A

Citrullination of cellular proteins induces self-reactivity leading to immune complex formation

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8
Q

What are the primary criteria for diagnosing RA?

A

Signs and symptoms of chronic inflammatory arthritis

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9
Q

What imaging modality is best for early detection of RA bone abnormalities?

A

MRI

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10
Q

What is the earliest radiographic sign of RA?

A

Periarticular osteopenia

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11
Q

What cell type predominates in the synovial fluid of RA patients?

A

Neutrophils

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12
Q

What is the pathognomonic lab test for RA?

A

Positive anti-CCP antibody

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13
Q

What inflammatory markers are elevated in RA?

A

ESR

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14
Q

What is the usual white blood cell (WBC) count in synovial fluid of RA patients?

A

5000 to 50 000 WBC/uL

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15
Q

Which imaging modality is most sensitive for detecting early bone erosion in RA?

A

MRI

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16
Q

What is the significance of power Doppler ultrasound in RA?

A

It detects synovitis and increased joint vascularity

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17
Q

What is the most common cause of death in RA patients?

A

Ischemic heart disease

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18
Q

What is the median reduction in life expectancy for men and women with RA?

A

7 years for men. 3 years for women

19
Q

What factor increases the risk of extra-articular manifestations in RA?

A

Early onset of RA (<25 years old)

20
Q

What percentage of RA patients experience spontaneous remission within 6 months?

21
Q

What treatment is considered the DMARD of choice for RA?

A

Methotrexate

22
Q

Why is folic acid given alongside methotrexate?

A

To counteract the hematologic side effects of methotrexate

23
Q

What is the primary function of nonsteroidal anti-inflammatory drugs (NSAIDs) in RA?

A

Symptom relief (analgesic and anti-inflammatory)

24
Q

What is the role of glucocorticoids in RA treatment?

A

Rapid disease control before DMARDs become effective

25
Q

What test should be performed before administering high-dose glucocorticoids?

A

Infectious Disease Clearance

26
Q

What is the most serious long-term complication of glucocorticoid use?

A

Osteoporosis

27
Q

What are examples of conventional DMARDs used in RA?

A

Hydroxychloroquine. sulfasalazine. methotrexate. leflunomide

28
Q

Which DMARD is contraindicated in reproductive-age females?

A

Methotrexate

29
Q

What class of drugs includes TNF inhibitors for RA?

A

Biologic DMARDs

30
Q

Why are biologic DMARDs contraindicated in active infections?

A

They suppress the immune system

31
Q

What condition contraindicates TNF inhibitors in RA?

A

Chronic hepatitis B infection or class III/IV congestive heart failure

32
Q

What is the mechanism of action of Anakinra in RA?

A

IL-1 receptor antagonist

33
Q

What does Abatacept target in RA?

A

CD28-CD80/86 interaction to inhibit T cell co-stimulation

34
Q

What is the target of Rituximab in RA?

A

CD20 on B lymphocytes

35
Q

What does Tocilizumab target in RA?

A

IL-6 receptor

36
Q

What drug class does Tofacitinib belong to?

A

Small molecule JAK inhibitor

37
Q

What is the main goal of modern RA treatment strategies?

A

Decrease disease activity and prevent joint damage

38
Q

Why is early diagnosis and aggressive therapy important in RA?

A

To prevent joint fusion and disability

39
Q

What is the significance of achieving clinical remission in RA?

A

It allows patients to regain joint function and return to normal activities

40
Q

What physical therapy is recommended to prevent fractures in RA?

A

Lower-extremity strengthening and dynamic strength training

41
Q

What assistive device is recommended for RA patients with foot deformities?

A

Foot orthotics

42
Q

When is surgery indicated in RA?

A

For infection. gangrene. osteoporosis or severe joint deformities

43
Q

What criteria are used to define remission in RA?

A

Tender joint count. swollen joint count. CRP and global assessment

44
Q

What is the target score for clinical remission in RA?

A

Less than 1 for tender/swollen joint count and less than 3.3 for global assessment

AAA-MEDICINE (GI) (5 decks)

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