Introduction to the Case

Question 1

what is rheumatoid arthritis

Answer 1

a long term autoimmune condition that causes pain, swelling and stiffness in the joints

Question 2

what are the intervention steps for rheumatoid arthritis

Answer 2

1. identification of possible RA and referral to GP
   - start therapy within 3 months
2. management of RA therapy to minimise disease flare ups
3. management of therapy complications

Question 3

what are the main factors to consider when diagnosing rheumatoid arthritis

Answer 3

• age
• gender
• current drug therapy
• side effects
• ESR and C reactive protein are common inflammatory markers

Question 4

what is the main adverse drug reaction that can occur with hydroxychloroquine therapy and how can this complication be managed

Answer 4

one main adverse drug reaction with hydroxychloroquine is ocular toxicity. This complication can be managed by getting regular eye tests and perhaps stopping the medication and changing it to a different one

Question 5

name a drug that is contraindicated in the treatment of gout and explain mechanistically why this is the case

Answer 5

one drug that is contraindicated in the treatment of gout are diuretics. They increase the reabsorption of urate in the kidney, so more urate is retained and the concentration of urate is increased