CCs - in brief

Question 1

How does rheumatoid arthritis present?

Answer 1

Symmetrical swollen, painful, stiff small joints of hands and feet
Worse in the morning
Later: ulnar deviation, subluxation of wrist and fingers
Swan neck deformities of fingers

Question 2

What are the extra-articular manifestations of rheumatoid arthritis?

Answer 2

Nodules on elbows, lungs, lymphadenopathy
Pleural disease, interstitial fibrosis
IHD, pericarditis, pericardial effusion
Episcleritis

Question 3

What do you expect to find when investigating rheumatoid arthritis?

Answer 3

Positive rheumatoid factor (>14 IU/ml)
Positive anti-CCP
High acute phase reactants (ESR, CRP)

Question 4

What are the risk factors for osteoporosis?

Answer 4

Age-related
Female gender
Parental history
>4 units alcohol daily
RA
BMI <19
Prolonged immobility
Steroid use
Early menopause

Question 5

What are the effects of osteoporosis?

Answer 5

Reduced bone mass
Crush fractures of vertebrae (trabecular bone affected)
Long bone fractures (cortical bone affected) eg hip fractures

Question 6

How do you manage osteoporosis?

Answer 6

Quit smoking and reduce alcohol
Weight-bearing exercise
Calcium / vit D rich diet
Bisphosphonates (alendrotnic acid) is used as management and prevention