OA + RA Flashcards

1
Q

what is autoimmunity

A

adaptive immune response against self tissues and cells

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2
Q

what is OA

A

articular fibrocartilage thinning/ loss from wear and tear

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3
Q

what is the pathogenesis of OA

A

decrease in ECM synthesis

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4
Q

what factors can influence OA development

A

ageing, obesity, occupation/ hobbies/ sports (weight loading), muscle weakness

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5
Q

what can cause secondary OA

A

gout, spondylopathies, Paget’s, AVN, metabolic and systemic disease

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6
Q

what joints are commonly affected

A

hands DIP, PIP, knee, hip, spine (cervical and lumbar)

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7
Q

what clinical features are there of OA

A

crepitus, osteophytes, effusion/ baker’s cyst (knee), osteophytes –> spinal stenosis (numb/ pain)

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8
Q

what is seen on X ray on an osteoarthritic joint

A

Loss of joint space, osteophytes, subchondral cyst (fluid herniating out), subchondral sclerosis

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9
Q

what symptoms of OA are there (stiffness and pain)

A

worse on exertion, relieved by rest, stiffness that lasts less than 30mins, pain in joint and loss of function

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10
Q

what are lifestyle managements of OA

A

physio, weight loss, exercise, walking aids

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11
Q

what drugs can be used in OA (mild –> severe)

A

analgesia (paracetamol/ topical), NSAIDs, pain modulators, intra-articular steroid injections, surgical joint replacement

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12
Q

what pain modulators can be used on OA

A

tricyclics eg amitriptyline, anticonvulsants eg gabapentin (nerve pain)

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13
Q

what nodes can be seen at DIP and PIP joints

A

Herberden’s and Bouchard’s

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14
Q

what is rheumatoid arthritis

A

an inflammatory, autoimmune, seropositive disease affecting joints and is also systemic

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15
Q

who is most likely to get RA

A

females 30-50 (pre menopause), smokers

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16
Q

what gene can be present in RA

17
Q

what can be seen in early stages of RA

A

pannus formation - inflamed synovium

18
Q

what can be seen in chronic fibrosis

A

fibrosis, bony erosions and osteophytes

19
Q

what are the joint symptoms present in RA

A

pain and stiffness lasting >30 mins, usually symmetrical relieved by exercise. swollen joints (sore when squeezed), general MSK pain

20
Q

what joints are commonly affected in RA

A

PIP, MCP, MTP (DIP spared)

21
Q

what systemic symptoms of RA can present

A

SUBCUT NODES, OSTEOPOROSIS, lungs (fibrosis, Plural effusions), uveitis + scleritis, alopecia, CVD, renal

22
Q

what is the DAS28 score

A

shows how severe disease is, 5.1+ = active disease

23
Q

what bloods and autoantibodies can be done for RA

A

CRP, ESR, low Hb
anti-CCP
(RF - not very specific)

24
Q

what imaging can be done for RA

A

USS can catch synovitis in early disease. MRI if severe

25
what drug therapy can be used for RA
DMARDs (methotrexate), NSAIDs, steroids, biologics (infliximab)
26
when would biologics be started in RA
tried 2 DMARDs and high DAS 28