MSK

Question 1

risk factors of rheumatoid arthritis

Answer 1

females 30-50 y/o
family hx
genetic susceptibility
smoking

Question 2

difference in gender incidence of RA

Answer 2

females more likely premenopause

gender equal after menopause age

Question 3

what is the significance of seropositive RA

Answer 3

usually IgM rheumatoid factor

associated with worse prognosis and more widespread disease with damage

Question 4

pathophysiology of RA

Answer 4

inflammatory activation causing swelling and pain of tendons/synovial sheaths and joints

leads to pain, swelling, deformities and loss of function

Question 5

typical presentation of RA

Answer 5

insidious onset, symmetrical polyarticular

female 30-50 y/o

Question 6

symptoms and signs of RA

Answer 6

red hot swollen painful joints usually fingers/feet but also wrists, knees, shoulders, ankles

tiredness

pain and morning stiffness

limited joint movement

joint deformities

Question 7

what is seronegative RA

Answer 7

no IgM rheumatoid factor

usually assymetrical involvement, usually affects wrist more than fingers

less widespread and better prognosis

Question 8

non-articular complications of RA

Answer 8

scleritis and episcleritis
sjögrens syndrome
bursitis/nodules
neuropathy
cervical spine compression
anaemia

Question 9

what are rheumatoid nodules

Answer 9

nodules found on pressure poinds usually elbow, fingers, achilles tendon

Question 10

RA can present as carpal tunnel syndrome - T or F

Answer 10

T

Question 11

investigation of RA

Answer 11

bloods - ESR CRP, rheumatoid factor, FBC - anaemia

xray, joint aspirate, doppler ultrasound

Question 12

what kind of anaemia is common in RA

Answer 12

normocytic normochromic anaemia

Question 13

management of RA

Answer 13

MDT Approach

analgesic and NSAIDs for pain
DMARDs - methotrexate
biologics - TNF-alpha and il-1 blockers