Massive resvision Flashcards
Poor prognostic indicators for RA
- young age at onset
- male
- HLA DR4 positive
- many active joints
- delayed referral
- high CRP/PV at outset
- RhF/CCP positive
- early radiological erosions
- poorer functional scores at outset
- adverse socioeconomic circumstances
- extraarticular features
Anti-CD20
Biologic agent –> B cell depletion
Rituximab
Disruption of T cell costimulation
Abatacept
IL-1 inhibitor
Anakira
IL-6 inhibitor
Tocilizumab
Genes in RA
HLA-DR4, HLA-DR1
Who is SLE more common in
Women, asian, afro-carribean, hispanic etc
Not african blacks
Hormonal factors influencing SLE
incidence increased in those with higher oestrogen exposure - early menarche, on oestrogen containing contraceptives and HRT
Environmental factors and SLE
Viruses eg Epstein-Barr Virus
UV light may stimulate skin cells to secrete cytokines stimulating B-cells
Silica dust (found in cleaning powders, cigarette smoke and cement) may increase risk of developing SLE
Anti-Blys
Belimumab
What do patients with SLE die from?
Infection important cause of death in the early / medium stage of disease
Cardiovascular disease the major the cause of death in the late stages
Complications of SLE in the first few years
Late onset of disease
Male SLE
Lower socioeconomic class
Anti-ENA in SLE and
Secondary sjogrens features
Congenital heart block
Definition of vasculitis?
Presence of leukocytes/immune complexes in the vessel wall with reactive damage to mural structures
How do you assess vasculitis?
BVAS (Birmingham vasculitis score)
Takayasu arteritis
Large vessel
