Brainscape's Knowledge GenomeTM

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


See full index

NAPLEX 21 > Autoimmune Conditions: RA > Flashcards

Autoimmune Conditions: RA Flashcards

1
Q

What are the non-specific lab blood tests that can be useful in detecting inflammation?

A

ESR

CRP

FR

ANA

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

The use of strong immunosuppressants can increase the risk of certain conditions including:

A

re-activation of TB, hep B, hep C; testing needs to be done prior to start

viruses - live vaccines must be given before start

lymphomas and certain skin cancers

infections

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

This autoimmune disease is a chronic, progressive autoimmune disorder that primary affects the joints

A

rheumatoid arthritis

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

Articular symptoms of RA

A

joint swelling - bilateral

pain

stiffness

bone deformity

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

Is stiffness and pain worse or better after rest in RA?

A

worse!

“morning stiffness” common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are useful lab tests in diagnosing RA?

A

Anti-citrullinated peptide antibody (ACPA) and rheumatoid factor (RF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the non-drug treatment for RA?

A

rest

physical therapy

occupational therapy

exercise, diet, weight control

joint replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patients with symptomatic RA should be started on what, regardless of the severity of the disease?

A

disease-modifying anti rheumatic drug (DMARD)

they slow the disease process and prevent further joint damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the preferred initial therapy for most patients with RA?

A

methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

For patients with mod-high disease activity, despite methotrexate, a combination of what is recommended?

A

DMARDs

OR

TNF inhibitor biologic

OR

non-TNF biologic

(with or without MTX) +/- steroid

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

What should you never use in combination due to the risk of fatal infections?

A

two biologic DMARDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drug is commonly used in RA flares and should be used at the lowest dose & shortest duration

A

steroids (<10mg/day prednisone or equiv)

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

What is used to “bridge” DMARDs?

A

low dose steroids and in patients with DMARD failure

NSAIDs are a weaker option, but less toxic – higher doses needed

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

Brand: Trexall

A

generic: methotrexate

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

What drug?

dosed 7.5-20mg once weekly (PO, SC, IM)

NEVER dosed daily for RA – liver damage

BW: hepatotoxicity, myleosuppression, mucositis/somatitis, pregnancy

A

methotrexate

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

What are the SC auto-injectors of MTX?

A

Otrexup and Rasuvo

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

This drug works by irreversibly binding and inhibiting dihydrofolate reductase, inhibiting folate, thymidylate synthetase and purine

A

MTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What drug?

CBC, LFTs, chest x-ray, hepatitis B & C serologies

A

MTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MTX - what can be give to dec hematological, GI and hepatic side effects

A

folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List traditional (non-biologic) disease-modifying anti rheumatic drugs (DMARDs)

A

methotrexate

hydroxychloroquine

sulfasalazine

leflunomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Brand: Plaquenil

A

generic: hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What traditional DMARD has a warning for irreversible retinopathy?

A

hydoxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What traditional DMARD has a contraindication in patients with a sulfa or salicylate allergy?

A

sulfasalazine

24
Q

What traditional DMARD can cause skin/urine to turn yellow/orange?

A

sulfasalazine

25
Q

Brand: Arava

A

generic: leflunomide

26
Q

This traditional DMARD’s MOA inhibits pyrimidine sythnesis

A

leflunomide

27
Q

This traditional DMARD has a boxed warning for use in pregnancy (must wait two years after d/c) and hepatoxicity.

It also has an accelerated drug elimination option

A

leflunomide

28
Q

tofacitinib/Xeljanz

baricitnib/ Oluminant

upadacitinib/ Rinvoq

drug class?

A

Janus Kinase Inhibitors (JAK)

29
Q

Can you use JAK inhibitors and DMARDs together?

A

NO!

30
Q

This drug class has a boxed warning for serious infection (TB, OI); malignancy; thrombosis

A

JAK inhibitors

31
Q

Methotrexate should not be taken with ____, this combo can increase the risk of liver toxicity

A

alcohol

32
Q

Are needles included with the anti TNF biologics (TNF alpha inhibitors)?

A

yes!

each drug also has its own pregnancy registry

33
Q

Brand: Enbrel

A

generic: Etanercept

34
Q

Brand: Humira

A

generic: adalimumab

35
Q

Brand: Remicade

A

generic: infliximab

36
Q

Brand: Cimiza

A

Brand: certolizumab pegol

37
Q

Brand: Simponi

A

generic: golimumab

38
Q

This anti TNF biologic is dosed 50mg SC weekly

A

etanercept/ Enbrel

39
Q

This anti TNF biologic is dosed SC every OTHER week

A

Humira (40mg), Cimiza (200mg)

40
Q

This anti TNF biologic is dosed only with IV

A

Remicade

0,2,6,8 weeks; delayed hypersensitivity, 3-12 days after

NS ONLY

41
Q

This anti TNF is dosed SC monthly

A

Simponi

*requires a filter

42
Q

This drug class has a boxed warning for serious infection and malignancies.

Warnings for demyelinating disease, hep B reactivation, heart failure, hepatoxicity, lupus-like syndrome

A

anti TNF biologics

*do not shake, freeze – requires fridge!

43
Q

Can you use anti TNF biologics with biologic DMARDs or with live vaccines?

A

no!!!!

44
Q

anti TNF biologics monitoring

A

TB test, HBV, signs of infection

If TB test is positive, must treat prior to starting

45
Q

What is first line for RA? what’s add on therapy?

A

1st - methotrexate

add-on - anti TNF biologics

UNLESS presentation is severe

46
Q

Rituximab

Abatacept

Anakinra

drug class?

A

Biologic DMARDs – non-TNF inhibitors

single-dose profiled syringe

needles come w drug

preg registry

47
Q

This non-TNF inhibitor’s MOA is depletes CD20 B cells

A

rituximab

48
Q

This non-TNF inhibitor is premeditated with a steroid, Tylenol, and an anthistamine

A

rituximab

49
Q

This non-TNF inhibitor has boxed warnings for infusion-related reactions, HBV reactivation

A

rituximab

50
Q

This non-TNF inhibitor has warnings for malignancies, and serious infections

A

anakinra

51
Q

What DMARDs are given WITH methotrexate?

A

Remicade/ infliximab

Simponi/ golimumab

Rituxan/ rituximab

52
Q

Brand: Rituxan

A

generic: rituximab

53
Q

What drug?

dosed once weekly for RA and psoriasis. Can cause liver damage, infection, mouth sores, GI blood

Take folic acid to decrease side effects

A

MTX

54
Q

What two drugs are single-use auto-injectors (abdomen or upper thigh only)

A

Rasuvo (5 seconds)

Otrexup (3 seconds)

55
Q

These medications are administered subQ and can cause infection, liver damage, and heart failure.

the medication should be stored in the fridge with protection from light and sources of heat.

A

Adalimumab - room temp for 14 days ok

etanercept - room temp for 14 days ok

golimumab

56
Q

adalimumab, etanercept, or golimumab?

abdomen or thigh for SC injection

A

adalimumab

57
Q

adalimumab, etanercept, or golimumab?

abdomen, upper arm, or thigh for SC injection

A

etanercept & golimumab

NAPLEX 21 (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions