RA Flashcards
What is rheumatoid arthritis (RA)?
A systemic disease characterized by bilateral inflammatory arthritis that usually affects the small joints of the hands, wrists, and feet
RA has a prevalence estimated at 1%–2%, predominantly affecting women until age 60.
At what age does the prevalence of RA equalize between genders?
After age 60
What type of disease is rheumatoid arthritis?
Autoimmune disease with a strong genetic predisposition
What are common symptoms of RA?
- Joint pain and stiffness
- Fatigue
- Warmth, redness, and swelling of the joints
- Symptoms usually have a symmetrical distribution
What laboratory tests are often positive in RA?
- Rheumatoid factor (RF)
- Elevated sedimentation rate
- C-reactive protein
- Anti–cyclic citrullinated peptide antibodies
- Normochromic normocytic anemia
What are some extra-articular manifestations of RA?
- Pulmonary fibrosis
- Vasculitis
- Dry eyes
What is the treatment goal for RA?
To control the inflammatory process leading to relief of pain, maintenance of function, and improved quality of life
What non-pharmacologic treatments are recommended for RA?
- Rest during exacerbation
- Occupational and physical therapy
- Maintenance of a normal weight
- Assistive devices if needed
- Surgery for tendons or joints
What is the preferred initial treatment for DMARD-naive patients with low disease activity?
Hydroxychloroquine
What is the first-line DMARD for patients with moderate to high disease activity?
Methotrexate
What should be monitored to measure treatment response in RA?
- Reduction in the number of affected joints
- Improvement in pain
- Decreased amount of morning stiffness
- Reduction in serologic markers such as RF
- Improvement in quality-of-life scales
True or False: NSAIDs affect disease progression in RA.
False
What is the risk associated with glucocorticosteroids in RA treatment?
Adverse effects such as osteoporosis, infection risk, and cardiovascular disease
What is the recommendation regarding the use of glucocorticosteroids in RA?
Short-term use (less than 3 months) is preferred to long-term use
Which biologic DMARDs are commonly used for severe RA?
- Etanercept
- Infliximab
- Adalimumab
- Certolizumab
- Golimumab
What is the recommended approach for patients with a history of tuberculosis or hepatitis B before starting biologic DMARDs?
Screening for tuberculosis and viral hepatitis is required
What dietary supplements are recommended for patients with RA to prevent osteoporosis?
- Calcium
- Vitamin D
- Bisphosphonates if prednisone 5 mg or more daily is prescribed
What comorbid conditions are patients with RA at higher risk for?
- Cardiovascular disease
- Malignancy
- Osteoporosis
Fill in the blank: The initial goal of RA treatment is _______.
[low disease activity]
