RA

Question 1

Patho physiology of ra

5 points

Answer 1

Autoimmune synovitis leads to synovial membrane infiltrated by inflammatory cells

Synovial membrane proliferates forming pannus leading to joint space narrowing

Cells in pannus release enzymes which degrade cartliage and connective tissue

Erosion of joint margins

Joint capsule unstable soft tissue inflammation, joint deformity

Question 2

Areas affected of Ra

Answer 2

Hands wrists ankle knees

Question 3

Clinical features of Ra

7 points

Answer 3

Joint pain
Odema
Morning stiffness
Fatigue fever malaise 
Foot deformity
Changed BMx leading to high pressure areas 
Rom/gait issues !

Question 4

Name a critia for Ra

Answer 4

ACR criteria 
No of joints involved 
Duration of symptoms 6 weeks
Sereology rheum factor
Acute phase response ESR abnormal

Question 5

Extra articular manifestations of RA

8

Answer 5

Constitinal (fever fatigue)
Cutaneous (nodules)
Cardiovascular (pericarditis)
Neurological (poly neuropathy)
Ocular (sjogrens)
Depression
Disability
Cancer

Question 6

Aims of management for RA

4

Answer 6

Relieve pain
Prevent progression
Increase function
Increase QoL

Question 7

Non pharm Tx of RA

6

Answer 7

Assess disease progress
Evaluate health
BMX foot ankle
Skin nail condition 
Footwear
Ulceration 

Surgery

Question 8

Pharm Tx of RA
Dmarmds 2
Nasaids
Gluco

Example, why

Answer 8

DMARDs: methotrexate prevent progression of disease
Cyclosporine

NSAIDs: ibuprofen for analgesia effect

Glucocorticoid: predinsolone for acute flair ups

Question 9

Aietology of RA

5 points

Answer 9

Risk factors:
Genetics
Smoking
Age 55
Diet (polyunsaturates, red meat alchol)
Immune system disorder