RA Flashcards
1
Q
ACR diagnosis
A
Based in having score >6
Score based on number of joints, RhF or ant-CCP present, CRP or esr raised and more than 6/52 duration
2
Q
extra articulations Complications
A
Feltys syndrome Pulmonary fibrosis (NSIP most common) Scleritis/episcleritis Pyoderma gangrenous Mononeuritis multiplex Peripheral neuropathy Compression neuropathies Heart valves abnormalities Accelerated atherosclerosis Pericardial effusion Pleural effusion Lung nodules Bronchiolitis obliterates Atlanta-axial subluxation causing cervical myelopathy
3
Q
Treatment
A
Conservative eg PT, OT.
NSAIDs
COX-2 inhibitors (eg celecoxib)
DMARDs eg methotrexate, sulphasalazine, luflonamide, hydroxychliroquine
If 2 DMARDs for at least 4-6 weeks each fail to control sx then to start biological therapy
TNF blockade eg
Infliximab
Etanercept
Also rituximab
Any infection on anti-TNF needs admission and IV abx. FBC often not affected
